The receptor tyrosine kinase encoded by the MET gene plays an important role in various cellular processes such as growth,survival,migration and angiogenesis,and its abnormal activation is closely related to the occur...The receptor tyrosine kinase encoded by the MET gene plays an important role in various cellular processes such as growth,survival,migration and angiogenesis,and its abnormal activation is closely related to the occurrence and development of various tumors.This article reviews the recent advances in diagnosis and treatment of MET-variant digestive tract tumors.In terms of diagnosis,the application of next-generation sequencing technology and liquid biopsy technology makes the detection of MET variants more accurate and efficient,providing a reliable basis for individualized treatment.In terms of treatment,MET inhibitors such as crizotinib and cabotinib have shown good efficacy in clinical trials.In addition,the combination of immunotherapy and MET inhibitors also demonstrated potential synergies,further improving the therapeutic effect.However,the complexity and heterogeneity of drug resistance mechanisms are still one of the difficulties in current research.In the future,it is necessary to further deepen the understanding of the mechanism of MET variation and explore new combination treatment strategies to improve the overall survival rate and quality of life of patients.The diagnosis and treatment of MET-variant digestive tract tumors are moving towards precision and individualization,and have broad application prospects.展开更多
BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical res...BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical resection of CRC is the main way of achieving an early cure.AIM To investigate the logistic regression analysis of bone metastasis after CRC surgery and related influencing factors.METHODS We selected 100 patients who underwent surgery for CRC and were admitted from February 2018 to February 2024,collected the general data of bone metastasis,and collected the pathological characteristics of patients with bone metastasis.Next,we divided them into groups with and without bone metastasis(Bone metastases group,n=44;no bone metastases group,n=56),compared the clinical data of the two groups,and analyzed the risk factors of bone metastasis using logistic regression analysis.RESULTS Among the 100 patients,the mean age was 54.33±8.45 years,and most were male(54.55%).The proportion of patients with lytic bone changes was 43.18%.The most common location of combined bone metastasis was the pelvis,whereas only 5 patients had limb transfer.There was a higher incidence of lung than of pancreatic or liver metastases.Regression analysis showed that the primary location of the cancer was rectal cancer.Lymph node involvement,lung metastasis,and no postoperative chemotherapy were the risk factors for postoperative bone metastasis in patients who underwent surgery for CRC(P<0.05).CONCLUSION Rectal cancer,lymph node involvement,complicated pulmonary metastasis,and no postoperative chemotherapy treatment can help predict high risk of bone metastasis in CRC.展开更多
Effective communication and collaboration among healthcare professionals are crucial for delivering high-quality patient care.Interdepartmental miscommunication poses a significant challenge to healthcare systems,pote...Effective communication and collaboration among healthcare professionals are crucial for delivering high-quality patient care.Interdepartmental miscommunication poses a significant challenge to healthcare systems,potentially undermining the quality of healthcare services provided.In the same manner,communication barriers between referring physicians and radiologists can specifically affect radiology services and patient outcomes.This article attempts to put the spotlight on the ever-present chronic challenges of this issue and prompt readers to recognize the relevant potential pitfalls in their daily clinical practice.Practical solutions are explored and proposed,which should be tailored to the specific needs and issues that each individual institution may face.展开更多
BACKGROUND The Borrmann classification system is used to describe the macroscopic appearance of advanced gastric cancer,and Borrmann typeⅣdisease is independently associated with a poor prognosis.AIM To evaluate the ...BACKGROUND The Borrmann classification system is used to describe the macroscopic appearance of advanced gastric cancer,and Borrmann typeⅣdisease is independently associated with a poor prognosis.AIM To evaluate the prognostic significance of lymphatic and/or blood vessel invasion(LBVI)combined with the Borrmann type in advanced proximal gastric cancer(APGC).METHODS The clinicopathological and survival data of 440 patients with APGC who underwent curative surgery between 2005 and 2012 were retrospectively analyzed.RESULTS In these 440 patients,LBVI+status was associated with Borrmann typeⅣ,low histological grade,large tumor size,and advanced pT and pN status.The 5-year survival rate of LBVI+patients was significantly lower than that of LBVI– patients,although LBVI was not an independent prognostic factor in the multivariate analysis.No significant difference in the prognosis of patients with Borrmann typeⅢ/LBVI+disease and patients with Borrmann typeⅣdisease was observed.Therefore,we proposed a revised Borrmann typeⅣ(r-BorⅣ)as Borrmann typeⅢplus LBVI+,and found that r-BorⅣwas associated with poor prognosis in patients with APGC,which outweighed the prognostic significance of pT status.CONCLUSION LBVI is related to the prognosis of APGC,but is not an independent prognostic factor.LBVI status can be used to differentiate Borrmann typesⅢandⅣ,and the same approach can be used to treat r-BorⅣand Borrmann typeⅣ.展开更多
Anaplastic lymphoma kinase(ALK)rearrangements are present in about 5–6%of non-small cell lung cancer(NSCLC)cases and associated with increased risks of central nervous system(CNS)involvement.Envonalkib,a novel ALK in...Anaplastic lymphoma kinase(ALK)rearrangements are present in about 5–6%of non-small cell lung cancer(NSCLC)cases and associated with increased risks of central nervous system(CNS)involvement.Envonalkib,a novel ALK inhibitor,demonstrated promising anti-tumor activity and safety in advanced ALK-positive NSCLC in the first-in-human phase I study.This phase III trial(ClinicalTrials.gov NCT04009317)investigated the efficacy and safety of first-line envonalkib in advanced ALK-positive NSCLC cases.Totally 264 participants were randomized 1:1 to receive envonalkib(n=131)or crizotinib(n=133).Median independent review committee(IRC)-assessed progression-free survival(PFS)times were 24.87(95%confidence interval[CI]:15.64–30.36)and 11.60(95%CI:8.28–13.73)months in the envonalkib and crizotinib groups,respectively(hazard ratio[HR]=0.47,95%CI:0.34–0.64,p<0.0001).IRC-assessed confirmed objective response rate(ORR)was higher(81.68%vs.70.68%,p=0.056)and duration of response was longer(median,25.79[95%CI,16.53–29.47]vs.11.14[95%CI,9.23–16.59]months,p=0.0003)in the envonalkib group compared with the crizotinib group.In participants with baseline brain target lesions,IRC-assessed CNS-ORR was improved with envonalkib compared with crizotinib(78.95%vs.23.81%).Overall survival(OS)data were immature,and median OS was not reached in either group(HR=0.84,95%CI:0.48–1.47,p=0.5741).The 12-month OS rates were 90.6%(95%CI,84.0%–94.5%)and 89.4%(95%CI,82.8%–93.6%)in the envonalkib and crizotinib groups,respectively.Grade≥3 treatment-related adverse events were observed in 55.73%and 42.86%of participants in the envonalkib and crizotinib groups,respectively.Envonalkib significantly improved PFS and delayed brain metastasis progression in advanced ALK-positive NSCLC.展开更多
基金2023 Anhui Province Clinical Medical Research Transformation Project,No.202304295107020016.
文摘The receptor tyrosine kinase encoded by the MET gene plays an important role in various cellular processes such as growth,survival,migration and angiogenesis,and its abnormal activation is closely related to the occurrence and development of various tumors.This article reviews the recent advances in diagnosis and treatment of MET-variant digestive tract tumors.In terms of diagnosis,the application of next-generation sequencing technology and liquid biopsy technology makes the detection of MET variants more accurate and efficient,providing a reliable basis for individualized treatment.In terms of treatment,MET inhibitors such as crizotinib and cabotinib have shown good efficacy in clinical trials.In addition,the combination of immunotherapy and MET inhibitors also demonstrated potential synergies,further improving the therapeutic effect.However,the complexity and heterogeneity of drug resistance mechanisms are still one of the difficulties in current research.In the future,it is necessary to further deepen the understanding of the mechanism of MET variation and explore new combination treatment strategies to improve the overall survival rate and quality of life of patients.The diagnosis and treatment of MET-variant digestive tract tumors are moving towards precision and individualization,and have broad application prospects.
文摘BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical resection of CRC is the main way of achieving an early cure.AIM To investigate the logistic regression analysis of bone metastasis after CRC surgery and related influencing factors.METHODS We selected 100 patients who underwent surgery for CRC and were admitted from February 2018 to February 2024,collected the general data of bone metastasis,and collected the pathological characteristics of patients with bone metastasis.Next,we divided them into groups with and without bone metastasis(Bone metastases group,n=44;no bone metastases group,n=56),compared the clinical data of the two groups,and analyzed the risk factors of bone metastasis using logistic regression analysis.RESULTS Among the 100 patients,the mean age was 54.33±8.45 years,and most were male(54.55%).The proportion of patients with lytic bone changes was 43.18%.The most common location of combined bone metastasis was the pelvis,whereas only 5 patients had limb transfer.There was a higher incidence of lung than of pancreatic or liver metastases.Regression analysis showed that the primary location of the cancer was rectal cancer.Lymph node involvement,lung metastasis,and no postoperative chemotherapy were the risk factors for postoperative bone metastasis in patients who underwent surgery for CRC(P<0.05).CONCLUSION Rectal cancer,lymph node involvement,complicated pulmonary metastasis,and no postoperative chemotherapy treatment can help predict high risk of bone metastasis in CRC.
文摘Effective communication and collaboration among healthcare professionals are crucial for delivering high-quality patient care.Interdepartmental miscommunication poses a significant challenge to healthcare systems,potentially undermining the quality of healthcare services provided.In the same manner,communication barriers between referring physicians and radiologists can specifically affect radiology services and patient outcomes.This article attempts to put the spotlight on the ever-present chronic challenges of this issue and prompt readers to recognize the relevant potential pitfalls in their daily clinical practice.Practical solutions are explored and proposed,which should be tailored to the specific needs and issues that each individual institution may face.
基金Supported by the Foundation of Innovative Talents in Higher Education of Liaoning Province,No.LR2016043
文摘BACKGROUND The Borrmann classification system is used to describe the macroscopic appearance of advanced gastric cancer,and Borrmann typeⅣdisease is independently associated with a poor prognosis.AIM To evaluate the prognostic significance of lymphatic and/or blood vessel invasion(LBVI)combined with the Borrmann type in advanced proximal gastric cancer(APGC).METHODS The clinicopathological and survival data of 440 patients with APGC who underwent curative surgery between 2005 and 2012 were retrospectively analyzed.RESULTS In these 440 patients,LBVI+status was associated with Borrmann typeⅣ,low histological grade,large tumor size,and advanced pT and pN status.The 5-year survival rate of LBVI+patients was significantly lower than that of LBVI– patients,although LBVI was not an independent prognostic factor in the multivariate analysis.No significant difference in the prognosis of patients with Borrmann typeⅢ/LBVI+disease and patients with Borrmann typeⅣdisease was observed.Therefore,we proposed a revised Borrmann typeⅣ(r-BorⅣ)as Borrmann typeⅢplus LBVI+,and found that r-BorⅣwas associated with poor prognosis in patients with APGC,which outweighed the prognostic significance of pT status.CONCLUSION LBVI is related to the prognosis of APGC,but is not an independent prognostic factor.LBVI status can be used to differentiate Borrmann typesⅢandⅣ,and the same approach can be used to treat r-BorⅣand Borrmann typeⅣ.
基金This study was funded by the National Natural Science Foundation Project of China(Grant No.82072558).
文摘Anaplastic lymphoma kinase(ALK)rearrangements are present in about 5–6%of non-small cell lung cancer(NSCLC)cases and associated with increased risks of central nervous system(CNS)involvement.Envonalkib,a novel ALK inhibitor,demonstrated promising anti-tumor activity and safety in advanced ALK-positive NSCLC in the first-in-human phase I study.This phase III trial(ClinicalTrials.gov NCT04009317)investigated the efficacy and safety of first-line envonalkib in advanced ALK-positive NSCLC cases.Totally 264 participants were randomized 1:1 to receive envonalkib(n=131)or crizotinib(n=133).Median independent review committee(IRC)-assessed progression-free survival(PFS)times were 24.87(95%confidence interval[CI]:15.64–30.36)and 11.60(95%CI:8.28–13.73)months in the envonalkib and crizotinib groups,respectively(hazard ratio[HR]=0.47,95%CI:0.34–0.64,p<0.0001).IRC-assessed confirmed objective response rate(ORR)was higher(81.68%vs.70.68%,p=0.056)and duration of response was longer(median,25.79[95%CI,16.53–29.47]vs.11.14[95%CI,9.23–16.59]months,p=0.0003)in the envonalkib group compared with the crizotinib group.In participants with baseline brain target lesions,IRC-assessed CNS-ORR was improved with envonalkib compared with crizotinib(78.95%vs.23.81%).Overall survival(OS)data were immature,and median OS was not reached in either group(HR=0.84,95%CI:0.48–1.47,p=0.5741).The 12-month OS rates were 90.6%(95%CI,84.0%–94.5%)and 89.4%(95%CI,82.8%–93.6%)in the envonalkib and crizotinib groups,respectively.Grade≥3 treatment-related adverse events were observed in 55.73%and 42.86%of participants in the envonalkib and crizotinib groups,respectively.Envonalkib significantly improved PFS and delayed brain metastasis progression in advanced ALK-positive NSCLC.
