Clinical Medicine Insights-Oncology临床医学洞察：肿瘤学
Clinical Medicine Insights-Oncology(英文缩写 CLIN MED INSIGHTS-ON),ISSN 1179-5549,eISSN 1179-5549,中文译名:临床医学洞察：肿瘤学 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
Clinical Medicine Insights-Oncology 最新收录文献
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1. Efficacy and Safety Ranking of HER2-Targeted TKIs in Advanced Breast Cancer: A Bayesian Network Meta-Analysis.
1. HER2靶向TKIs在晚期乳腺癌中的疗效和安全性排名：一项贝叶斯网络荟萃分析PMID:日期:2026-09-15To compare the efficacy and safety of HER2-targeted tyrosine kinase inhibitors (TKIs) in patients with HER2-positive advanced or locally advanced breast cancer using a Bayesian network meta-analysis and to provide comparative evidence for individualized treatment decisions. PubMed, Embase, Web of Science, and the Cochrane Library were systematically searched for randomized controlled trials evaluating HER2-targeted TKIs in patients with HER2-positive advanced or locally advanced breast cancer. Progression-free survival (PFS), overall survival (OS), objective response rate (ORR), and disease control rate (DCR) were assessed as efficacy outcomes, while treatment-related adverse events were evaluated as safety outcomes. A Bayesian network meta-analysis was performed using R (version 4.2.2) and Stata (version 16.0). Treatments were ranked according to the surface under the cumulative ranking curve (SUCRA). The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD420250650274). Fourteen randomized controlled trials involving 5,289 patients were included. According to SUCRA rankings, pyrotinib plus capecitabine (Pyrotinib_C) showed the highest probability of favorable ranking PFS, ORR, and DCR. Tucatinib combined with trastuzumab and capecitabine (Tucatinib_T_C) demonstrated the highest probability of favorable OS ranking. Regarding safety, pyrotinib combined with trastuzumab and capecitabine (Pyrotinib_T_C) was associated with the highest incidence of serious adverse events, diarrhea, and hand-foot syndrome, whereas Pyrotinib_C showed the highest incidence of anemia and lapatinib plus capecitabine (Lapatinib_C) demonstrated the highest incidence of rash. Among currently available HER2-targeted TKIs, Pyrotinib_C showed the highest probability of favorable ranking for PFS and tumor response outcomes, whereas Tucatinib_T_C showed the highest probability of favorable OS ranking. However, pyrotinib-containing regimens were associated with a higher risk of treatment-related toxicities. These findings highlight the importance of balancing efficacy and safety when selecting HER2-targeted TKI therapies and support individualized treatment strategies for patients with HER2-positive advanced breast cancer.
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2. Immune Checkpoint Inhibitor-Associated Hemophagocytic Lymphohistiocytosis: A Systematic Review.
PMID:日期:2026-09-11Hemophagocytic lymphohistiocytosis (HLH) is a rare, life-threatening hyperinflammatory toxicity increasingly reported with immune checkpoint inhibitors (ICIs). We systematically reviewed published cases of ICI-associated HLH to characterize presentation, diagnostic patterns, treatment, outcomes, and rechallenge experience. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception to 10 March 2026 according to a prior protocol. English-language case reports and case series reporting ICI-associated HLH or macrophage activation syndrome with extractable patient-level data were included. Data were synthesized descriptively. The review was retrospectively registered with the Open Science Framework (OSF; DOI: 10.17605/OSF.IO/6ARJC). Ninety-six patients from 78 reports were included: 65 case reports and 13 case series. Median age was 60.0 years (IQR, 42.5-72.0; range, 2-86), and 53 patients (55.2%) were male. The most common malignancies were melanoma (27.1%), lung cancer (24.0%), breast cancer (9.4%), and kidney cancer (8.3%). Among reported cases, PD-1 blockade was the most common ICI exposure (60/96, 62.5%), followed by mixed-class regimens (20/96, 20.8%). HLH occurred after a median of 2 ICI cycles and 30 days from ICI initiation.Diagnostic ascertainment was heterogeneous: combined criteria were used in 31/96 patients (32.3%), HLH-2004 criteria in 27/96 (28.1%), HScore in 23/96 (24.0%), and clinician diagnosis in 15/96 (15.6%). Fever occurred in 94/96 patients (97.9%), cytopenias in 91/93 (97.8%), and ferritin was markedly elevated where reported, with a median of 10,450 ng/mL. Corticosteroids were administered in 96/96 patients (100%), whereas etoposide was used in 19/96 (19.8%), IL-6 blockade in 21/96 (21.9%), and IL-1 blockade in 10/96 (10.4%). Clinical improvement or resolution occurred in 78/94 patients (83.0%). Death occurred in 24/95 patients (25.3%). ICI rechallenge was reported in 7 patients, with recurrent HLH in 3. ICI-associated HLH should be considered early in ICI-treated patients presenting with fever, cytopenias, and marked hyperferritinemia. Published cases show heterogeneous diagnostic ascertainment, variable treatment escalation beyond corticosteroids, and substantial mortality, underscoring the need for standardized diagnostic workup, early multidisciplinary management, and cautious individualized decisions regarding ICI rechallenge.
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3. Prevalence of High-Risk Human Papillomavirus Infection and Associated Risk Factors Among Women Attending the Gynecology Unit in Bahir Dar, Northwest Ethiopia.
PMID:日期:2026-08-24Persistent infection with high-risk human papillomavirus (HR-HPV), particularly types 16 and 18, is the primary cause of cervical cancer The objective of this study was to determine the prevalence of HPV types 16 and 18 and identify associated risk factors among women attending the gynecology unit in Bahir Dar, northwest Ethiopia. An institution-based cross-sectional study was conducted among women attending the gynecology unit in Bahir Dar, northwest Ethiopia. A total of 344 women were selected and screened for HPV DNA. Data were collected between January and December 2025, analyzed using SPSS version 26. Cervical samples were collected and tested for HPV genotypes using the Abbott RealTime PCR System. Bivariable and multivariable logistic regression analyses were performed. Adjusted odds ratios with 95% confidence intervals were used to determine the strength of association, and a p-value <0.05 was considered statistically significant. The prevalence of HPV infection was 38.4% (132/344). The prevalence of HPV-16 and HPV-18 was 18.3% and 6.7%, respectively, with a combined prevalence of 25.0%. Women aged 40-50 years (AOR ≈ 3.8) and >50 years (AOR ≈ 4.9) had higher odds of HPV infection compared with those aged 30-40 years. Divorced or widowed women were more likely to be infected than married women. Having two or more sexual partners, long-term use of hormonal contraceptives (>5 years), a history of sexually transmitted infections, and HIV-positive status (AOR = 2.37; 95% CI: 1.13-4.96) were significantly associated with HPV infection. The prevalence of HPV infection among women was high, with a significant portion attributed to HPV types 16 and 18. Significant predictors included older age, marital status, multiple sexual partners, long-term use of hormonal contraceptives, and HIV infection. Strengthening HPV vaccination, improving cervical cancer screening programs, and integrating HPV prevention with HIV and STI services are crucial to reducing the burden of cervical cancer in Ethiopia.
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4. Impact of Preoperative Anemia on Short-Term Outcomes After Colorectal Cancer Surgery: How the Choice of Diagnostic Criteria Leads to Conflicting Findings.
PMID:日期:2026-08-21Whether preoperative anemia is independently associated with short-term postoperative outcomes in colorectal cancer (CRC) remains controversial. This study investigated the association between preoperative anemia and 30-day postoperative complications (PO30C) and evaluated how different anemia diagnostic criteria influence this association. In this retrospective cohort study, patients who underwent radical CRC surgery from January 2018 to January 2021 were consecutively enrolled. Firth's regression was used for univariate and multivariable analysis to evaluate the impact of preoperative anemia on short-term outcomes after CRC surgery. Dose-response analysis assessed the relationship between anemia severity and PO30C. Sensitivity analysis compared the association under WHO and China's anemia criteria, and misclassification analysis characterized criteria-related differences. Population-based examination of the misclassification mechanism was performed using China Health and Retirement Longitudinal Study (CHARLS) data. Internal validation used 10-fold cross-validation and bootstrap resampling. Among 231 patients, 108 (46.8%) had preoperative anemia and 29 (12.6%) developed PO30C. Multivariable analysis showed that preoperative anemia (OR = 2.39, 95% CI: 1.04-5.81, P = 0.039) and male sex (OR = 3.11, 95% CI: 1.23-9.24, P = 0.015) were independently associated with PO30C. A significant dose-response relationship was observed across anemia severity groups (P-trend = 0.005), with moderate-to-severe anemia independently associated with PO30C (OR = 2.88, 95% CI: 1.04-8.03, P = 0.042). The association was significant under China criteria (P = 0.039) but not under WHO criteria (P = 0.075). Misclassification analysis revealed that WHO criteria reclassified 33 borderline patients as anemic, whose PO30C rate (9.1%) resembled the normal group (6.7%) rather than the anemia group (18.5%), thereby attenuating the association. CHARLS data corroborated this misclassification mechanism. The model showed moderate discrimination (optimism-corrected C-index = 0.704). Preoperative anemia was independently associated with PO30C under the China criteria, whereas WHO criteria attenuated this association through misclassification of low-risk borderline patients. Population-appropriate diagnostic criteria are important for perioperative risk estimation and may explain conflicting findings in the existing literature.
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5. Treatment Patterns and Survival Outcomes of Oral Cavity Squamous Cell Carcinoma in Ethiopia: A Retrospective Study From Tikur Anbessa Specialized Hospital.
PMID:日期:2026-08-20Oral cavity squamous cell carcinoma (OSCC) remains an important cause of morbidity and mortality worldwide, with a disproportionately high burden and late presentation in low- and middle-income countries. However, published data on the treatment patterns and survival outcomes in Ethiopia are limited. The aim of this study was to describe the treatment patterns and survival outcomes of patients with oral cavity squamous cell carcinoma diagnosed at Tikur Anbessa Specialized Hospital (TASH). We conducted a retrospective study on all adult patients diagnosed with primary OSCC between January 1, 2022, and December 31, 2024, at Tikur Anbessa Specialized Hospital. Data were extracted, and descriptive statistics followed by Kaplan-Meier survival analysis were used to evaluate survival outcomes. A total of 91 patients were included in the study, with a late presentation rate of 86.1% (clinical stage III and IV). The study population had a median age of 50 years (IQR: 42-58). Although 86.8% were initially planned for curative-intent treatment, only 52.7% ultimately received curative therapy, while 34.1% received palliative care and 13.3% received no treatment. Of the 48 patients who received curative-intent treatment, 64.6% underwent multimodality therapy, while 35.4% received single-modality therapy. Treatment patterns differed across clinical T stages. Most patients with T4b (80.0%) and T4a (63.9%) disease received non-curative treatment, whereas most patients with T3 (72.0%) and early-stage (T1-T2) disease received curative-intent therapy. The median overall survival was 15.5 months, with 1-year and 3-year overall survival rates of 57.8% and 32.4%, respectively. Advanced stage and lack of curative treatment were associated with poorer survival. Most patients present with advanced-stage disease. Survival was poor, and univariable analyses showed that advanced stage and lack of curative treatment were associated with worse overall survival. These findings highlight the need for earlier diagnosis and improved access to curative treatment.
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6. Clinical Utility of Circulating Tumor DNA Analysis in Pancreatic Ductal Adenocarcinoma.
PMID:日期:2026-08-20Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with poor prognosis and limited early detection strategies. Circulating tumor DNA (ctDNA) offers a noninvasive method for tumor monitoring and prognostic prediction. We aimed to evaluate the clinical utility of ctDNA in PDAC, focusing on stage-dependent variations in ctDNA detection rate and its association with survival. The study included 35 patients with PDAC. Plasma and tissue samples were evaluated with next-generation sequencing to detect ctDNA and assess the concordance of mutations detected in ctDNA with those detected in tissue samples. The rates of ctDNA positivity and partial concordance were evaluated across disease stages. Demographics, clinicopathologic characteristics including neoadjuvant chemotherapy, and surgical outcomes were also evaluated. Among the study population, 91.4% received neoadjuvant chemotherapy, and ctDNA was detected in 57.1% of the patients. KRAS mutations in ctDNA were identified in 11.4% of the patients, ranging from 0.0% in stage I PDAC to 28.6% in stage IV PDAC. The partial concordance rate between ctDNA and tumor tissue mutations increased from 0.0% in stage I to 66.7% in stage IV. Although the difference was not statistically significant, the two-year survival tended to be worse in patients with detectable ctDNA than in those without ctDNA (44.0% vs. 86.2%, p = 0.071). Our analysis demonstrates the potential clinical relevance of ctDNA analysis in patients with PDAC, especially those with advanced disease. However, its limited sensitivity in the detection of early-stage PDAC highlights the need for methodologic improvements. Our findings support the potential integration of ctDNA analysis into clinical workflows as a biomarker for disease monitoring and prognosis.
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7. The Impact of Chronic Kidney Disease on Postoperative Outcomes in Patients With Bladder Cancer: A Meta-Analysis.
PMID:日期:2026-08-19Bladder cancer (BC) is a common malignancy, and chronic kidney disease (CKD) is an increasingly prevalent comorbidity that may adversely affect oncological outcomes. However, the prognostic impact of CKD in patients with BC remains unclear. We investigated the association between CKD and postoperative outcomes in patients with BC. This study was registered in PROSPERO (CRD420261417895). A systematic search of PubMed, Web of Science, Embase, and Cochrane Library was conducted from database inception up to June 8, 2026. The investigation concentrated on two primary keywords: BC and CKD. Stata SE 18 and R 4.5 were used for data analysis. Seven studies involving 2756 patients were included in this meta-analysis. CKD was significantly associated with increased risks of progression (OR = 2.23, 95% CI: 1.34-3.73, P < 0.05), recurrence (OR = 1.82, 95% CI: 1.53-2.18, P < 0.05), and poorer cancer-specific survival (CSS) (OR = 3.39, 95% CI: 1.45-7.94, P < 0.05). Conversely, no significant association was observed between CKD and overall survival (OR = 1.32, 95% CI: 0.65-2.69, P = 0.45). CKD correlated with unfavorable postoperative outcomes in patients with BC, particularly progression, recurrence, and CSS. These findings suggest that CKD may represent a clinically relevant prognostic factor that could aid risk stratification and postoperative surveillance. Further prospective studies are warranted to validate these findings.
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8. Molecular Mechanisms and Biomarkers Driving the Transition From Chronic Atrophic Gastritis to Gastric Cancer.
8. 驱动慢性萎缩性胃炎向癌症转变的分子机制和生物标志物PMID:日期:2026-08-11Gastric cancer continues to be a major contributor to global cancer morbidity and mortality. Although the is widely used as a model for gastric carcinogenesis, the molecular mechanisms driving the transition from chronic atrophic gastritis to invasive cancer have not been comprehensively integrated into a unified molecular framework. This review aims to synthesize current knowledge of the molecular events associated with each stage of the and to evaluate the clinical relevance of established and emerging biomarkers for risk stratification, early diagnosis, and personalized surveillance. This review summarizes the principal molecular mechanisms involved in the progression from chronic gastritis through chronic atrophic gastritis, intestinal metaplasia, dysplasia, and ultimately gastric cancer. These mechanisms include inflammatory cytokine networks, epigenetic modifications, genomic instability, disruption of signaling pathways, clonal evolution, and remodeling of the tumor microenvironment. Particular emphasis is placed on contemporary tissue and circulating biomarkers, their diagnostic and prognostic significance, and the application of advanced technologies including multi-omics analysis, spatial transcriptomics, single-cell sequencing, and liquid biopsy. The available evidence supports a conceptual model of gastric carcinogenesis as a continuous molecular evolutionary process in which chronic inflammation initiates progressive epigenetic and genetic alterations that promote clonal selection and malignant transformation. Integrating molecular biomarkers with conventional morphological assessment may improve risk stratification, facilitate earlier detection of disease progression, and support the implementation of personalized strategies for gastric cancer prevention, surveillance, and treatment.
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9. {"_":" Expression and Clinicopathological Features at the Invasive Front of Pancreatic Cancer.","i":["CXCL12"]}
9. CXCL12在癌症侵袭前沿的表达及临床病理特征PMID:日期:2026-08-11The clinical significance of CXC ligand 12 (CXCL12) expression at the invasive front of pancreatic ductal adenocarcinoma (PDAC) remains unclear. This study examined the expression of stromal using RNAscope for direct visualization of RNA localization and compared expression profiles with clinicopathological findings. This retrospective investigation analyzed expression in 66 PDAC tissue samples, specifically where the cancer had infiltrated the peripancreatic fatty tissue, using RNAscope. RNA expression was quantified and categorized into high and low groups for evaluating associations with clinicopathological data. Single-cell RNA sequencing (scRNA-seq) was employed to elucidate cellular expression patterns of and its receptor, . CXCL12-positive staining was found in 88% of samples, with expression predominantly in the stroma rather than in tumor cells. Venous invasion was significantly less in the high expression group (P = 0.019). We observed no significant difference in overall survival between the high and low expression groups (P = 0.233), although relapse-free survival showed a trend toward being longer in the high expression group (P = 0.0673). scRNA-seq revealed that was predominantly produced by fibroblasts and endothelial cells, while its receptor was expressed mainly on T cells, B cells, and myeloid cells. RNAscope findings revealed that stromal expression was associated with reduced PDAC progression and may represent a marker of favorable prognosis. Further studies are needed to confirm its role and prognostic value.
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10. {"_":"F-FDG PET/CT Metabolic Characteristics of Nasopharyngeal Carcinoma Across AJCC/UICC TNM-8 and TNM-9 Staging Systems: A Retrospective Cross-Sectional Study.","sup":["18"]}
PMID:日期:2026-08-08The 9th edition of the AJCC/UICC TNM staging system (TNM-9) has introduced key updates for nasopharyngeal carcinoma (NPC) compared with TNM-8. However, there is limited data on the metabolic basis and performance of TNM-9 evaluated using F-FDG PET/CT. We aimed to investigate the association between PET/CT metabolic parameters and TNM-8 and TNM-9 staging systems, and evaluate the metabolic homogeneity across TNM-9 substages. This single-center, retrospective cross-sectional study enrolled 822 NPC patients who underwent pre-treatment F-FDG PET/CT. Uptake, volumetric, glucose-normalized, and body composition-normalized metabolic parameters of the primary tumor (T) and the most metabolically active lymph node (LN) were compared across the TNM-8 and TNM-9 staging systems, and comparisons were also performed between the substages in the TNM-9 system. Multicollinearity diagnosis using the Variance Inflation Factor (VIF) and ordinal logistic regression were performed to identify independent stage-related parameters. Baseline age, fasting blood glucose and F-FDG dose were comparable across stages (all P>0.05), while weight differed significantly in both staging systems (both P<0.001). All metabolic parameters differed significantly among stages in both systems (all P<0.001). TNM-9 showed more coherent metabolic distributions compared with TNM-8, whereas TNM-8 exhibited distinct metabolic overlap between certain stages. Metabolic homogeneity was observed in volumetric parameters between TNM-9 stage Ia and Ib, and in all parameters between stage IVa and IVb. T/LN metabolic tumor volume (TMTV/LNMTV) and T/LN lean body mass-normalized maximum standardized uptake value (TSULmax/LNSULmax) were independent predictors in both systems, with a slightly higher McFadden R for TNM-9 (0.16 vs. 0.13). PET/CT metabolic parameters provide supportive evidence for the biological basis and clinical utility of TNM-9 in NPC. TNM-9 demonstrated superior metabolic homogeneity and slightly better model fit compared with TNM-8. TMTV, TSULmax, LNMTV, and LNSULmax can serve as promising complementary biomarkers for NPC staging.