Malignant tumors, as a major public health issue facing the world, have extremely complex pathogenesis. Molecular biology features represented by acidic microenvironment and lipid metabolism disorders are closely related to tumor invasion and metastasis. Traditional Chinese medicine(TCM) holds that the diseases caused by phlegm toxicity are characterized by heaviness, turbidity, stickiness, and difficulty in resolving. Modern pharmacological research has confirmed that as a TCM for resolving phlegm and detoxifying to treat phlegm toxicity, it can not only exert anti-cancer effects by directly inhibiting tumor cell proliferation but also reshape the steady-state regulatory network of the tumor microenvironment, including downregulating the microenvironment of lactate accumulation mediated by hypoxia-inducible factor 1α(HIF-1α) and regulating fatty acid synthase(FASN)-related lipid metabolism reprogramming processes, thereby antagonizing tumor invasion and metastasis. The innovative TCM theory of cancer toxicity pathogenesis proposed by our team suggests that the pathogenic characteristics of phlegm toxicity are homologous to the pathological accumulation of abnormal metabolites in the tumor microenvironment. This study systematically reviews the relevant literature on the treatment of tumors with TCM for resolving phlegm and detoxifying, deeply analyzes the theoretical basis of TCM, summarizes the clinical experience of famous TCM practitioners, and explores the clinical efficacy of TCM for resolving phlegm and detoxifying against tumors. At the same time, this study objectively summarizes its active ingredients and anti-tumor mechanisms, so as to provide reference for the prevention and treatment of malignant tumors with TCM.

Lung cancer remains a life-threatening malignancy with complex pathogenesis. This paper provides a systematic review of autophagy and ferroptosis-related signaling pathways, key regulatory factors, and their associated mechanisms, including the nuclear receptor coactivator 4 (NCOA4)-mediated ferritin autophagy-ferroptosis axis, mitochondrial autophagy, lipid droplet autophagy, circadian autophagy, chaperone-mediated autophagy, etc.. The review elucidates the roles of the tumor microenvironment and non-coding RNAs in autophagy-ferroptosis processes in lung cancer. Furthermore, it explores the potential of modern drugs and active components from traditional Chinese medicine to improve lung cancer outcomes by targeting autophagy and ferroptosis, proposing that targeting their interactive pathways could offer novel therapeutic strategies for lung cancer.
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Objectives: Cases from our hospital and a systematic review were performed in this paper to get a better understanding on the diagnosis and therapies for primary pulmonary NUT carcinoma (PPNC) patients. Methods: The clinical features, pathological diagnosis, treatment and outcomes of PPNC patients from 2020-2025, including four cases from the First Affiliated Hospital of Soochow University, were collected delicately. The Kaplan-Meier method and Cox proportional hazard regression model were used to calculate cumulative survival and prognostic factors. Results: The male-to-female ratio of PPNC was 18∶15, the left to right ratio was 14∶19, the median age was 36 years old and the median tumor diameter was 6.1 cm. Most patients were already at an advanced stage with the clinical features-cough (16/33) and chest or back pain (13/33) when they first came to the hospital. The tumor cells were arranged in nest pattern with small-medium size, round to oval shape, and nuclei were deeply stained. The high positive staining of NUT (32/32) and CK-pan (16/19) was observed, NUTM1 gene translocation in 24 cases was detected by fluorescence in situ hybridization (FISH), and different gene rearrangements were located by NGS-NUTM1-BRD4 (8/12), NUTM1-BRD3 (2/12), NUTM1-BRD2 (1/12) and NUTM1-ZNF532 (1/12). Most patients accepted different chemotherapy regimens (25/29), including paclitaxel albumin and platinum (13/25), etoposide and platinum (8/25). Meanwhile, 12 cases were treated with PD-1/PD-L1 antibody during the therapy. The median follow-up time was 7 months in 28 cases tracked from 2-90 months. Univariate Cox regression analysis showed that metastasis of this disease affected patient prognosis (HR=2.55, 95% CI: 0.974-6.677, P=0.057) and the cumulative survival rate was lower in the older ones. Conclusions: PPNC, more often found in middle-aged patients, no difference in sex, can be diagnosed by pathmorphology and immunophenotype, while NUTM1 molecular test is highly suggested for the accurate therapy. Metastasis can be recognized as the prognostic risk factor. Early detection of the cancer improves the chances of successful treatment, especially in patients with older age.

Non-small cell lung cancer (NSCLC), as the predominant histological subtype of lung cancer, accounts for approximately 85% of all lung cancer cases. In recent years, immune checkpoint inhibitors (ICIs), represented by programmed death 1/programmed death ligand 1 (PD-1/PD-L1) inhibitors, have achieved breakthrough advancements in patients with driver gene-negative NSCLC. They have been established as a key component of first-line treatment regimens and have significantly improved clinical outcomes. However, limited clinical evidence has emerged showing the phenomenon of histological transformation from NSCLC to small cell lung cancer (SCLC) in patients experiencing disease progression after ICIs monotherapy or combination therapy. Systematic research data on the clinical characteristics, molecular biological basis, and subsequent treatment strategies for such transformation events are currently lacking. This article reports a case of SCLC transformation occurring in a patient with KRAS-mutated lung adenocarcinoma after 16 months of ICIs combination therapy and provides a systematic review of 22 similar published cases. The study demonstrates that small cell transformation is a critical mechanism of immunotherapy resistance, and transformed patients exhibit poor prognosis. The research emphasizes the importance of dynamic monitoring of neuron-specific enolase (NSE) and standardized repeat biopsies during treatment, providing a basis for clinical practice. This aids in enhancing the recognition and management capabilities for this rare histological transformation, ultimately improving patient outcomes.

Objective: The incidence of early-onset colorectal cancer (EOCRC) is increasing globally; however, the molecular characteristics and prognosis of sporadic EOCRC are unclear. In this systematic review and meta-analysis, we aimed to investigate the incidence of gene mutations and their association with cancer survival in sporadic EOCRC, focusing on six common gene mutations (TP53, BRAF, KRAS, NRAS, PTEN, and APC). Methods: Ovid Embase and Ovid Medline electronic databases were searched for studies involving patients with sporadic EOCRC (i.e., diagnosed with colorectal cancer before the age of 50 years and with no evidence of hereditary syndromes predisposing to colorectal cancer). The included articles were evaluated using quality assessment tools. Meta-analysis was performed using random-effects and fixed-effects models. Cochran's Q statistic and the I2 index were used to assess heterogeneity. The incidence of the six common gene mutations listed above in sporadic EOCRC and their association with cancer survival were evaluated. Results: (1) Incidence of specific gene mutations in sporadic EOCRC. A total of 34 articles were included in this meta-analysis. The incidence of APC gene mutation was 36% (from 13 articles, 95%CI: 19%-55%, P=0.043); of KRAS gene mutation 30% (from 26 articles, 95%CI: 24%-35%, P=0.190); of BRAF gene mutation 7% (from 18 articles, 95%CI: 5%-11%, P=0.422); of NRAS gene mutation 4% (from five articles, 95%CI: 3%-5%, P=0.586); of PTEN gene mutation 6% (from six articles, 95%CI: 4%-10%, P=0.968); and of TP53 gene mutation 59% (from 13 articles, 95%CI: 49%-68%, P=0.164). (2) Association between gene mutations and survival in sporadic EOCRC. A total of six articles were included in this meta-analysis. Compared with wild-type BRAF, mutant BRAF was significantly associated with increased overall mortality risk in patients with EOCRC (pooled HR=2.85, 95%CI: 1.45-5.60, P=0.002). Subgroup analysis showed that the incidence of BRAF gene mutation was higher in Eastern than in Western countries, whereas the incidence of TP53, KRAS, NRAS, and APC gene mutations was lower. There was no significant difference in the incidence of PTEN gene mutation between different regions. Conclusion: Compared with colorectal cancer occurring in the general population, the incidence of APC and KRAS mutations is lower in EOCRC, whereas the incidence of TP53 mutation remains consistent. BRAF mutation is associated with increased overall mortality risk in patients with EOCRC.

To explore the strategy of pregnancy-preserving and maternal- fetal management in patients with primary gynecologic neuroendocrine tumors (gNETs) during pregnancy.

To evaluate the effects of DNMT3A gene mutation on prognosis of patients with acute myeloid leukemia (AML) by a meta-analysis.

To analyze and explore the association between the 1607(1G/2G) single nucleotide polymorphism (SNP) in promoter of matrix metalloproteinase-1 (MMP-1) gene and susceptibility of head and neck cancer (HNC) by Meta-analysis.

To explore the association of the androgenic receptor (AR) CAG repeats with the risks of benign prostatic hyperplasia (BPH) and prostate cancer (PCa).

To explore the association between polymorphisms in the DNA repair gene, xeroderma pigmentosum group D (XPD), and development of hepatocellular carcinoma (HCC) in the Chinese population by performing a systematic review of the previously published clinical data.

Epidermal growth factor receptor (EGFR) and KRAS status were particularly critical for the choice of first-line targeted therapy of non-small cell lung cancer (NSCLC), while the primary tumor and metastases might be different in the EGFR and KRAS gene status. The aim of this pooled analysis is to compare EGFR and KRAS status in matching primary NSCLC and metastases and further to guide clinical practice.

Fourty years ago, Tokuhata and Lilienfeld provided the first epidemiologic evidence of familial aggregation of lung cancer. Familial aggregation and increased familial risk for lung cancer have been reported in several studies, subsequently. But the results are not consistent with each other. The aim of this study is to further explore the relationship between family history of lung cancer and lung cancer risk.

To investigate the clinicopathologic characteristics of familiar gastric cancer (FGC) in Chinese.