Driver-response relationships in a large shallow lake since the Anthropocene: Short-term abrupt perturbations versus long-term sustainable.

Lakes, as integral social-ecological systems, are hotspots for exploring climatic and anthropogenic impacts, with crucial pathways revealed by continuous sediment records. However, the response of multi-proxies in large shallow lakes to typical abrupt events and sustained drivers since the Anthropocene remains unclear. Here, we explored the driver-identification relationships between multi-proxy peaks and natural and anthropogenic events as well as the attribution of short-term perturbations and long-term pressures. To this end, sediment core records, socio-ecological data, and documented events from official records were integrated into a large shallow lake (Dongting Lake, China). Significant causal cascades and path effects (goodness-of-fit: 0.488; total effect: -1.10; p < .001) were observed among catchment environmental proxies, lake biogenic proxies, and mixed-source proxies. The peak-event identification rate (PEIR) and event-peak driving rate were proposed, and values of 28.57%-46.43% and 50%-81.25% were obtained, respectively. The incomplete accuracy of depicting event perturbations using sediment proxies was caused by various information filters both inside and outside the lake. PEIRs for compound events were 1.41 (±0.72) and 1.09 (±0.46) times greater than those for anthropogenic-dominated and natural-dominated events, respectively. Furthermore, socio-economic activity, hydrologic dynamics, land-use changes, and agriculture exerted significant and persistent pressures, cumulatively contributing 55.3%-80.9% to alterations in sediment proxies. Relatively synergistic or antagonistic trends in temporal contributions of these forces were observed after 2000, which were primarily attributed to the "Grain for Green" project and the Three Gorges Dam. This study represents one of the few investigations to distinguish the driver-response relationship of multiple proxies in large shallow lakes under typical event perturbations and long-term sustained pressures since the Anthropocene. The findings will help policymakers and managers address ecological perturbations triggered by climate change and human activities over long-term periods.

Coupled effects of human activities and river-Lake interactions evolution alter sources and fate of sedimentary organic carbon in a typical river-Lake system.

Interconnected river-lake systems record sedimentary organic carbon (OCsed) dynamics and watershed environmental changes, providing valuable information for global carbon budgets and watershed management. However, owing to the evolving river-lake interactions under global change, monitoring OCsed is difficult, thereby impeding the understanding of OCsed transport and fate. This study provided new insights into the dynamical mechanisms of OCsed in a typical river-lake system consisting of Dongting Lake and its seven inlet/outlet rivers (the three inlets of the Yangtze River and four tributaries) over the last century using stable isotope tracing and quantified the influences of climate change and human activities on OCsed. Results indicated that exogenous OC dominated the OCsed in the lake (58.2 %-89.0 %) and was lower in the west than in the east due to the differences in the material inputs and depositional conditions within the lake. Temporally, the distribution patterns of OCsed sources mainly responded to human activities in the basin rather than to climate change. Before 2005, the Yangtze River contributed the most OCsed (53.5 %-74.6 %), attributed to the high-intensity land use changes (path coefficient (r∂): 0.48, p-value < 0.01) and agriculture-industry activities (r∂: 0.44, p-value < 0.001) in the Yangtze River basin that increased soil erosion. After 2005, a large amount of Yangtze River OC was intercepted by the Three Gorges Dam, altering the OC exchange in the river-lake system and shifting OCsed dominance to the four tributaries (52.2 %-63.8 %). These findings highlight the active response of OCsed to the river-lake interaction evolution and anthropogenic control, providing critical information for regulating watershed management behavior under global change.

Mechanisms of cadmium release from manganese-rich sediments driven by exogenous DOM and the role of microorganisms.

Dissolved organic matter (DOM) is a crucial component of natural sediments that alters Cd sequestration. Nevertheless, how different types of DOM fuel Cd mobilization in Mn-rich sediments has not been elucidated. In the present study, four typical DOM, fluvic acid (FA), bovine serum albumin (BSA), sodium alginate (SA), and sodium dodecyl benzene sulfonate (SDBS), were used to amend Cd-contaminated sediment to study their effects on Cd/Mn biotransformation and microbial community response. The results demonstrated that different DOM drive microbial community shifts and enhance microbially mediated Mn oxide (MnO) reduction and Cd release. The amendment of terrestrial- and anthropogenic-derived DOM (FA and SDBS) mainly contributed to enriching Mn-reducing bacteria phylum Proteobacteria, and its abundance increased by 38.16-74.47 % and 56.41-73.98 %, respectively. Meanwhile, microbial-derived DOM (BSA and SA) mainly stimulated the abundances of metal(loid)-resistant bacteria phylum Firmicutes. Accompanied by microbial community structure, diversity, and co-occurrence network shifts, the DOM concentration and oxidation-reduction potential changed, resulting in enhanced Cd mobilization. Importantly, FA stimulated Cd release most remarkably, probably because of the decreased cooperative interactions between bacterial populations, stronger reduction of MnOs, and higher aromaticity and hydrophobicity of the sediment DOM after amendment. This study linked DOM types to functional microbial communities, and explored the potential roles of different DOM types in Cd biotransformation in lake sediments.

Total Neoadjuvant Therapy With PD-1 Blockade for High-Risk Proficient Mismatch Repair Rectal Cancer.

Importance: Total neoadjuvant therapy (TNT) is the standard treatment for locally advanced rectal cancer, especially for patients with high-risk factors. However, the efficacy of TNT combined with immunotherapy for patients with proficient mismatch repair (pMMR) rectal cancer is unknown. Objectives: To evaluate the safety and efficacy of TNT with induction chemoimmunotherapy followed by long-course chemoradiation in patients with high-risk, pMMR rectal cancer and to identify potential molecular biomarkers associated with treatment efficacy. Design, Setting, and Participants: This cohort study was a single-arm phase 2 trial conducted at Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, from June 2020 to October 2021. Biopsies and plasma were collected before treatment for whole-exome sequencing and cell-free DNA sequencing, respectively. Data were analyzed from May 2022 to September 2022. Interventions: Participants received 3 cycles of induction oxaliplatin and capecitabine combined with camrelizumab and radiotherapy (50.6 Gy in 22 fractions) with concurrent capecitabine. Patients without disease progression received 2 cycles of consolidation oxaliplatin/capecitabine. Main Outcomes and Measures: The primary end point was pathologic complete response rate. Results: Of 25 patients enrolled (19 men [76%]; 6 women [24%]; median [IQR] age, 58 [48-64] years), 22 patients (88%) completed the TNT schedule. The pathologic complete response rate was 33.3% (7/21). Twelve patients (48%) achieved clinical complete response, and 4 patients (16%) chose to watch and wait. R0 resection was achieved in 21 of 21 patients, and the major pathologic response rate was 38.1% (8/21). The most common adverse event was nausea (80%, 20/25); grade 3 toxic effects occurred in 9 of 25 patients (36%). Patients with tumor shrinkage of 50% or greater after induction oxaliplatin/capecitabine and camrelizumab or clinical complete response had higher percentages of LRP1B mutation. Mutation of LRP1B was associated with high tumor mutation burden and tumor neoantigen burden. Patients with high tumor mutation burden all benefited from therapy. Conclusions and Relevance: This study found that TNT with induction chemoimmunotherapy followed by long-course chemoradiation was safe and effective for patients with high-risk rectal cancer with pMMR status. Longer follow-up and larger clinical studies are needed to validate this innovative regimen. There is also an urgent need to further validate the predictive value of LRP1B and discover other novel biomarkers with potential predictive value for rectal cancer.

Recent advances in the role of dissolved organic matter during antibiotics photodegradation in the aquatic environment.

The presence of residual antibiotics in the environment is a prominent issue. Photodegradation behavior is an important way of antibiotics reduction, which is closely related to dissolved organic matter (DOM) in water. The review provides an overview of the latest advancements in the field. Classification, characterization of DOM, and the dominant mechanisms for antibiotic photodegradation were discussed. Furthermore, it summarized and compared the effects of DOM on different antibiotics photodegradation. Moreover, the review comprehensively considered the factors influencing the photodegradation of antibiotics in the aquatic environment, including the characteristics of light, temperature, dosage of DOM, concentration of antibiotics, solution pH, and the presence of coexisting ions. Finally, potential directions were proposed for the development of predictive models for the photodegradation of antibiotics. Based on the review of existing literature, this paper also considered several pathways for the future study of antibiotic photodegradation. This study allows for a better understanding of the DOM's environmental role and provides important new insights into the photochemical fate of antibiotics in the aquatic environment.

Immunohistochemical characteristics and potential therapeutic regimens of hepatoid adenocarcinoma of the stomach: a study of 139 cases.

Hepatoid adenocarcinoma of stomach (HAS) is a special subtype of gastric cancer with poor prognosis. Immunohistochemical analysis could provide important clues for the treatment of HAS. A total of 159 patients were diagnosed as HAS and 139 were enrolled in this study. Statistical differences were determined using relative test methods and survival analyses were performed by the Kaplan-Meier method to find survival differences. All tumors in this study were negative for Epstein-Barr virus-encoded small RNAs (EBERs) and almost all showed no loss of mismatch repair (MMR) proteins and were positive for alpha fetoprotein (AFP or spalt like transcription factor 4 (SALL4). About half of the tumors had a positive programmed death-ligand 1 combined positive score (CPS) and 17.3% were positive for human epidermal growth factor receptor 2 (HER2). In addition, there was a relatively high proportion of cmet expression. We also found that HAS patients with recurrent disease treated by emerging therapy had a better survival than those treated with traditional chemotherapy (p = 0.002, median recurrence-to-death survival: 23 months versus 6 months); HAS patients who received anti-HER2 therapy or harbored MMR deficiency had favorable prognosis. Overall, high proportions of MMR protein proficiency, positivity for AFP or SALL4, overexpression of HER2, CPS and cmet, as well as negative EBER findings, are distinctive characteristics of HAS patients. While negative EBER and MMR proficiency indicate molecular features of HAS, positivity for AFP or SALL4 could aid in the diagnosis of HAS. In addition, HAS patients could benefit from anti-HER2 therapy, immunotherapy, and anti-angiogenesis therapy.

Small arteriole sign: an imaging feature for staging T4a colon cancer.

OBJECTIVES: By analyzing the distribution of existing and newly proposed staging imaging features in pT1-3 and pT4a tumors, we searched for a salient feature and validated its diagnostic performance. METHODS: Preoperative multiphase contrast-enhanced CT images of the training cohort were retrospectively collected at three centers from January 2016 to December 2017. We used the chi-square test to analyze the distribution of several stage-related imaging features in pT1-3 and pT4a tumors, including small arteriole sign (SAS), outer edge of the intestine, tumor invasion range, and peritumoral adipose tissue. Preoperative multiphase contrast-enhanced CT images of the validation cohort were retrospectively collected at Beijing Cancer Hospital from January 2018 to December 2018. The diagnostic performance of the selected imaging feature, including accuracy, sensitivity, and specificity, was validated and compared with the conventional clinical tumor stage (cT) by the McNemar test. RESULTS: In the training cohort, a total of 268 patients were enrolled, and only SAS was significantly different between pT1-3 and pT4a tumors. The accuracy, sensitivity, and specificity of the SAS and conventional cT in differentiating T1-3 and T4a tumors were 94.4%, 81.6%, and 97.3% and 53.7%, 32.7%, and 58.4%, respectively (all p < 0.001). In the validation cohort, a total of 135 patients were collected. The accuracy, sensitivity, and specificity of the SAS and the conventional cT were 93.3%, 76.2%, and 96.5% and 62.2%, 38.1%, and 66.7%, respectively (p < 0.001, p = 0.021, p < 0.001). CONCLUSION: Small arteriole sign positivity, an indirect imaging feature of serosa invasion, may improve the accuracy of identifying T4a colon cancer. CLINICAL RELEVANCE STATEMENT: Small arteriole sign helps to distinguish T1-3 and T4a colon cancer and further improves the accuracy of preoperative CT staging of colon cancer. KEY POINTS: • The accuracy of preoperative CT staging of colon cancer is not ideal, especially for T4a tumors. • Small arteriole sign (SAS) is a newly defined imaging feature that shows the appearance of tumor-supplying arterioles at the site where they penetrate the intestine wall. • SAS is an indirect imaging marker of tumor invasion into the serosa with a great value in distinguishing between T1-3 and T4a colon cancer.

Combined role of ground cover management in altering orchard surface‒subsurface erosion and associated carbon-nitrogen-phosphorus loss.

The combined role of ground cover management in controlling soil erosion and nutrient loss from new orchards is still less understood. In this study, four ground cover management practices, orchard with grass cover (OG), orchard with interplant cover (OI), orchard with straw cover (OS), and orchard with bare ground (OB), were designed to identify their impacts on soil erosion and associated carbon-nitrogen-phosphorus loss in new orchards by rainfall simulation tests with rainfall intensities of 60, 90, and 120 mm h-1 and 90 min rainfall duration. The results showed that OS had the lowest surface flow coefficient (6.6%) and highest subsurface flow coefficient (32.5%). The highest soil loss rate occurred in the OB plot (65.4 g m-2 min-1), and the lowest soil loss rate occurred in the OS plot (0.5 g m-2 min-1). OS plot showed better effectiveness in improving soil erosion. However, the increased infiltration capacity was facilitated in terms of causing non-point source pollution. The C-N-P ratios of surface flow in different cover measures (OB, OI, OG, and OS) were 1.4:1.2:0.9:1, 1.8:1.7:1.2:1, and 2.3:1.9:1.2:1, respectively. The ratios of sediment in different cover measures were 7.3:9:2.3:1, 2:1.5:1.2:1, and 1.2:1:0.8:0.7, respectively. Cover management plots play an active role in reducing nutrient loss in surface flow and sediment, but the increased infiltration in covered management plots is associated with the risk of groundwater contamination in subsurface flow. The C-N-P ratios of subsurface flow in OB and covered managed plots (OI, OG, and OS) were 1:3.3:1.6:2.7, 1:1.5:2.2:2.4 and 1:1.2:1.5:1.3, respectively. Therefore, when managing the phenomenon of soil erosion through ground cover measures, attention should also be focused on the function of cover measures in regulating non-point source pollution underground, such as subsurface flow. This research recommends a combination of cover management measures to further mitigate erosion and the risk of groundwater contamination.

Preoperative assessment of retroperitoneal Liposarcoma using volume-based 18F-FDG PET/CT: implications for surgical strategy and prognosis.

PURPOSE: Retroperitoneal liposarcoma (RLPS) poses a challenging scenario for surgeons due to its unpredictable biological behavior. Surgery remains the primary curative option for RLPS; however, the need for additional information to guide surgical strategies persists. Volume-based 18F-FDG PET/CT may solve this issue. METHODS: We analyzed data from 89 RLPS patients, measuring metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) and explored their associations with clinical, prognostic, and pathological factors. RESULTS: MTV, TLG of multifocal and recurrent RLPS were significantly higher than unifocal and primary ones (P < 0.001, P < 0.001, P = 0.003 and P = 0.002, respectively). SUVmax correlated with FNCLCC histological grade, mitotic count and Ki-67 index (P for G1/G2 = 0.005, P for G2/G3 = 0.017, and P for G1/G3 = 0.001, P < 0.001 and P = 0.024, respectively). MTG, TLG and SUVmax of WDLPS were significantly lower than DDLPS and PLPS (P for MTV were 0.009 and 0.022, P for TLG were 0.028 and 0.048, and P for SUVmax were 0.027 and < 0.001, respectively). Multivariable Cox analysis showed that MTV > 457.65 (P = 0.025), pathological subtype (P = 0.049) and FNCLCC histological grade (P = 0.033) were related to overall survival (OS). CONCLUSIONS: Our findings indicate that MTV is an independent prognostic factor for RLPS, while MTV, TLG, and SUVmax can preoperatively predict multifocal lesions, histological grade, and pathological subtype. Volume-based 18F-FDG PET/CT offers valuable information to aid in the decision-making process for RLPS surgical strategies.

Analysis of enhanced CT imaging signs and clinicopathological prognostic factors in hepatoid adenocarcinoma of stomach patients with radical surgery: a retrospective study.

BACKGROUND: To investigate the association between CT signs and clinicopathological features and disease recurrence in patients with hepatoid adenocarcinoma of stomach (HAS). METHODS: Forty nine HAS patients undergoing radical surgery were retrospectively collected. Association between CT and clinicopathological features and disease recurrence was analyzed. Multivariate logistic model was constructed and evaluated for predicting recurrence by using receiver operating characteristic (ROC) curve. Survival curves between model-defined risk groups was compared using Kaplan-Meier method. RESULTS: 24(49.0%) patients developed disease recurrence. Multivariate logistic analysis results showed elevated serum CEA level, peritumoral fatty space invasion and positive pathological vascular tumor thrombus were independent factors for disease recurrence. Odds ratios were 10.87 (95%CI, 1.14-103.66), 6.83 (95%CI, 1.08-43.08) and 42.67 (95%CI, 3.66-496.85), respectively. The constructed model showed an area under ROC of 0.912 (95%CI,0.825-0.999). The model-defined high-risk group showed poorer overall survival and recurrence-free survival than the low-risk group (both P < 0.001). CONCLUSIONS: Preoperative CT appearance of peritumoral fatty space invasion, elevated serum CEA level, and pathological vascular tumor thrombus indicated poor prognosis of HAS patients.

Anti-PRL-3 Monoclonal Antibody inhibits the Growth and Metastasis of colorectal adenocarcinoma.

Background: Colon cancer is the one of leading causes of cancer-related death. Chemotherapy, radiotherapy and immunotherapy will be the mainstream in inoperable advanced cancer in clinics. Precision treatment is still lack in colon cancer. Materials and Methods: We developed a series of mAbs targeting PRL-3 through different types of immunogens. The binding domains of mAbs were identified through the ELISA and Western blotting experiments. The antitumor activity of mAbs was verified by cell proliferation, migration and invasion experiments. Xenograft subcutaneous and metastatic models and patient derived Xenograft (PDX) model were established. Results: mAb 12G12 targeting 77-120AA exhibited inhibition in migration and invasion experiments. 12G12 inhibited the migration of multiple types of cancer cells, including colon cancer, gastric cancer, esophagus cancer, liver cancer, lung cancer and pancreatic cancer cells. 12G12 decreased the tumor growth and metastasis in Xenograft subcutaneous and metastatic tumor model, respectively. The antitumor activity of mAb 12G12 was also confirmed in PDX model of gastric cancer. PRL-3 interacted with Golgi protein TMED10. Knockdown of TMED10 expression attenuated the cell migration triggered by purified GST-PRL-3 protein. Conclusion: Our results confirmed the antitumor activity of mAb 12G12 in colorectal adenocarcinoma and provided a new potential targeted therapy of colon cancer.

Usefulness of attenuation value on computed tomography plain scan for diagnosing enlarged mediastinal lymph nodes metastases.

Background: To evaluate the diagnostic value of computed tomography (CT) attenuation in mediastinal lymph node metastases of malignant tumors. Methods: A retrospective review was conducted of a Chinese institutional database of consecutive patients with a history of malignant tumors. Those who had enlarged, necrotic, or hypermetabolic lymph nodes detected in the mediastinum during routine CT examination or positron emission tomography (PET)/CT imaging from January 2019 to December 2021 were collected for investigation. All patients underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and were followed up for at least 6 months to diagnose lymph node metastases. One-to-one correlation was attempted between the CT images of the lymph nodes and EBUS-TBNA area of the same lymph node groups and similar size. Radiologists measured size, as well as plain CT and contrast-enhanced CT (CECT) attenuation values of mediastinal lymph nodes, and evaluated the effectiveness of these variables in diagnosing lymph node metastasis. Results: A total of 135 lymph nodes of 114 patients were included in the study. In the univariate analysis, the long-axis diameter, short-axis diameter, short-axis/long-axis ratio, and plain CT attenuation values of lymph nodes were found to be statistically significantly different between the metastatic and non-metastatic lymph nodes. The areas under receiver operator characteristic (ROC) curves (AUCs) of long-axis diameter, short-axis diameter, short-axis/long-axis ratio, and plain CT attenuation value for diagnosing metastases were 0.711, 0.788, 0.671, and 0.827, respectively. The best value of the AUC for diagnosing lymph node metastases was 0.827 [95% confidence interval (CI): 0.749-0.890] using plain CT attenuation value ≤45 Hounsfield units (HU). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 92.8%, 69.2%, 86.5%, and 81.8%, respectively. Similar results were obtained from the 68 cases of lung cancer. Plain CT attenuation values reached the best AUC (0.860) for diagnosing lymph node metastases. Conclusions: Plain CT attenuation of lymph nodes is an effective method for diagnosing enlarged mediastinal lymph nodes with a history of multiple malignancies or lung cancer. Plain CT could be used as an additional test where there is no PET/CT available in cases of diagnostic dilemma.

Deep learning-derived spatial organization features on histology images predicts prognosis in colorectal liver metastasis patients after hepatectomy.

Histopathological images of colorectal liver metastases (CRLM) contain rich morphometric information that may predict patients' outcomes. However, to our knowledge, no study has reported any practical deep learning framework based on the histology images of CRLM, and their direct association with prognosis remains largely unknown. In this study, we developed a deep learning-based framework for fully automated tissue classification and quantification of clinically relevant spatial organization features (SOFs) in H&E-stained images of CRLM. The SOFs based risk-scoring system demonstrated a strong and robust prognostic value that is independent of the current clinical risk score (CRS) system in independent clinical cohorts. Our framework enables fully automated tissue classification of H&E images of CRLM, which could significantly reduce assessment subjectivity and the workload of pathologists. The risk-scoring system provides a time- and cost-efficient tool to assist clinical decision-making for patients with CRLM, which could potentially be implemented in clinical practice.

Divergent control and variation in bacterial and fungal necromass carbon respond to the abandonment of rice terraces.

The abandonment of rice terraces in hilly agroecosystems in recent decades has caused substantial changes in microbial characteristics and their impact on microbial necromass carbon (MNC) and soil organic carbon (SOC). Nevertheless, the regulatory mechanisms and impact pathways of MNC remain unclear. Here, soil samples were collected from 0 to 120 cm soil profiles in rice terraces, dry land (DL), and forest land (FL) for analysis. After converting rice terraces to DL and FL, MNC decreased significantly by 31.12% and 38.33%, while SOC decreased significantly by 51.26% and 29.87% respectively. These reductions are due to the loss of terrace management practices and associated functions. There were no significant changes in bacterial necromass carbon (BNC), whereas fungal necromass carbon (FNC) experienced a significant decrease. As a result, the decline in SOC may be primarily attributed to the reduction in FNC. BNC and FNC were regulated by bacterial life history strategies and fungal biomass, respectively. However, bacterial copiotrophs experienced a significant reduction after rice terrace abandonment. The regulation of BNC may be influenced by other factors, potentially offsetting the negative impact of abandonment. Dissolved organic carbon and bulk density were the primary control factors for bacterial community composition and fungal biomass, respectively. Additionally, the impact of soil layers on the alterations in MNC and SOC was more significant compared to the abandonment of rice terraces. These findings indicate that short-term abandonment of rice terraces results in a decrease in SOC, potentially compromising the ecological service function of the hilly agroecosystems. In the face of rapid population growth and global warming, it is crucial to minimize terrace abandonment and enhance utilization rates. This approach will effectively support sustainable terrace management and ecological services.

ANO1-Mediated Inhibition of Cancer Ferroptosis Confers Immunotherapeutic Resistance through Recruiting Cancer-Associated Fibroblasts.

The application of immunotherapy in gastrointestinal (GI) cancers remains challenging because of the limited response rate and emerging therapeutic resistance. Combining clinical cohorts, multi-omics study, and functional/molecular experiments, it is found that ANO1 amplification or high-expression predicts poor outcomes and resistance to immunotherapy for GI cancer patients. Knocking-down or inhibiting ANO1 suppresses the growth/metastasis/invasion of multiple GI cancer cell lines, cell-derived xenograft, and patient-derived xenograft models. ANO1 contributes to an immune-suppressive tumor microenvironment and induces acquired resistance to anti-PD-1 immunotherapy, while ANO1 knockdown or inhibition enhances immunotherapeutic effectiveness and overcomes resistance to immunotherapy. Mechanistically, through inhibiting cancer ferroptosis in a PI3K-Akt signaling-dependent manner, ANO1 enhances tumor progression and facilitates cancer-associated fibroblast recruitment by promoting TGF-ß release, thus crippling CD8+ T cell-mediated anti-tumor immunity and generating resistance to immunotherapy. This work highlights ANO1's role in mediating tumor immune microenvironment remodeling and immunotherapeutic resistance, and introduces ANO1 as a promising target for GI cancers' precision treatment.

Liquid biopsy: circulating tumor DNA monitors neoadjuvant chemotherapy response and prognosis in stage II/III gastric cancer.

A good response to neoadjuvant chemotherapy (NACT) is strongly associated with a higher curative resection rate and favorable outcomes for patients with gastric cancer (GC). We examined the utility of serial circulating tumor DNA (ctDNA) testing for monitoring NACT response and prognosis in stage II-III GC. Seventy-nine patients were enrolled to receive two cycles of NACT following gastrectomy with D2-lymphadenectomy. Plasma at baseline, post-NACT, and after surgery, and tissue at pretreatment and surgery were collected. We used a 425-gene panel to detect genomic alterations (GAs). Results show that the mean cell-free DNA concentration of patients with clinical stage III was significantly higher than patients with stage II (15.43 ng·mL-1 vs 14.40 ng·mL-1 ). After receiving NACT and surgery, the overall detection rate of ctDNA gradually reduced (59.5%, 50.8%, and 47.4% for baseline, post-NACT, and postsurgery). The maximum variant allele frequency (max-VAF) and the number of GAs decreased from 0.50% to 0.08% and from 2.9 to 1.7 after NACT. For patients with a partial response after NACT, the max-VAF and the number of GAs declined significantly, but they increased for patients with progressive disease. Patients with detectable ctDNA at baseline, after NACT, or after surgery have a worse overall survival (OS) than patients with undetectable ctDNA. The estimated 3-year OS was 73% for the post-NACT ctDNA-negative patients and 34% for ctDNA-positive. Patients with perpetual negative ctDNA before and after NACT have the best prognosis. In conclusion, ctDNA was proposed as a potential biomarker to predict prognosis and monitor the NACT response for stage II-III GC patients.

Discrimination of Liver Metastases of Digestive System Neuroendocrine Tumors From Neuroendocrine Carcinoma by Computed Tomography-Based Radiomics Analysis.

OBJECTIVE: The aim of the study is to investigate the value of computed tomography (CT) radiomics features to discriminate the liver metastases (LMs) of digestive system neuroendocrine tumors (NETs) from neuroendocrine carcinoma (NECs). METHODS: Ninety-nine patients with LMs of digestive system neuroendocrine neoplasms from 2 institutions were included. Radiomics features were extracted from the portal venous phase CT images by the Pyradiomics and then selected by using the t test, Pearson correlation analysis, and least absolute shrinkage and selection operator method. The radiomics score (Rad score) for each patient was constructed by linear combination of the selected radiomics features. The radiological model was constructed by radiological features using the multivariable logistic regression. Then, the combined model was constructed by combining Rad score and the radiological model into logistic regression. The performance of all models was evaluated by the receiver operating characteristic curves with the area under curve (AUC). RESULTS: In the radiological model, only the enhancement degree (odds ratio, 8.299; 95% confidence interval, 2.070-32.703; P = 0.003) was an independent predictor for discriminating the LMs of digestive system NETs from those of NECs. The combined model constructed by the Rad score in combination with the enhancement degree showed good discrimination performance, with AUCs of 0.893, 0.841, and 0.740 in the training, testing, and external validation groups, respectively. In addition, it performed better than radiological model in the training and testing groups (AUC, 0.893 vs 0.726; AUC, 0.841 vs 0.621). CONCLUSIONS: The CT radiomics might be useful for discrimination LMs of digestive system NECs from NETs.

Binding of Cd(II) to birnessite and fulvic acid organo-mineral composites and controls on Cd(II) availability.

Manganese oxide minerals (MnOs) are major controls on cadmium (Cd) mobility and fate in the environment. However, MnOs are commonly coated with natural organic matter (OM), and the role of this coating in the retention and availability of harmful metals remains unclear. Herein, organo-mineral composites were synthesized using birnessite (BS) and fulvic acid (FA), during coprecipitation with BS and adsorption to preformed BS with two organic carbon (OC) loadings. The performance and underlying mechanism of Cd(II) adsorption by resulting BS-FA composites were explored. Consequently, FA interactions with BS at environmentally representative (5 wt% OC) increase Cd(II) adsorption capacity by 15.05-37.39% (qm = 156.5-186.9 mg g-1), attributing to the enhanced dispersion of BS particles by coexisting FA led to significant increases in specific surface area (219.1-254.8 m2 g-1). Nevertheless, Cd(II) adsorption was notably inhibited at a high OC level (15 wt%). This might have derived from the supplementation of FA decreased pore diffusion rate and generated Mn(II/III) competition for vacancy sites. The dominant Cd(II) adsorption mechanism was precipitation with minerals (Cd(OH)2), and complexation with Mn-O groups and acid oxygen-containing functional groups of FA. In organic ligand extractions, the exchange Cd content decreased by 5.63-7.93% with low OC coating (5 wt%), but increased to 33.13-38.97% at a high OC level (15 wt%). These findings help better understand the environmental behavior of Cd under the interactions of OM and Mn minerals, and provide a theoretical basis for organo-mineral composite remediation of Cd-contaminated water and soil.

Accurate and Rapid Detection of Peritoneal Metastasis from Gastric Cancer by AI-Assisted Stimulated Raman Molecular Cytology.

Peritoneal metastasis (PM) is the mostcommon form of distant metastasis and one of the leading causes of death in gastriccancer (GC). For locally advanced GC, clinical guidelines recommend peritoneal lavage cytology for intraoperative PM detection. Unfortunately, current peritoneal lavage cytology is limited by low sensitivity (<60%). Here the authors established the stimulated Raman molecular cytology (SRMC), a chemical microscopy-based intelligent cytology. The authors firstly imaged 53 951 exfoliated cells in ascites obtained from 80 GC patients (27 PM positive, 53 PM negative). Then, the authors revealed 12 single cell features of morphology and composition that are significantly different between PM positive and negative specimens, including cellular area, lipid protein ratio, etc. Importantly, the authors developed a single cell phenotyping algorithm to further transform the above raw features to feature matrix. Such matrix is crucial to identify the significant marker cell cluster, the divergence of which is finally used to differentiate the PM positive and negative. Compared with histopathology, the gold standard of PM detection, their SRMC method could reach 81.5% sensitivity, 84.9% specificity, and the AUC of 0.85, within 20 minutes for each patient. Together, their SRMC method shows great potential for accurate and rapid detection of PM from GC.

Total neoadjuvant treatment for MRI-stratified high-risk rectal cancer: a single-center, single-arm, prospective Phase II trial (PKUCH-R02).

Background: Induction chemotherapy combined with neoadjuvant chemoradiotherapy has been recommended for patients with high-risk, locally advanced rectal cancer. However, the benefit of more intensive total neoadjuvant treatment (TNT) is unknown. This study aimed to assess the safety and efficacy of induction chemotherapy combined with chemoradiotherapy and consolidation chemotherapy for magnetic resonance imaging-stratified high-risk rectal cancer. Methods: This was a single-center, single-arm, prospective Phase II trial in Peking University Cancer Hospital (Beijing, China). Patients received three cycles of induction oxaliplatin and capecitabine (CapeOX) followed by chemoradiotherapy and two cycles of consolidation CapeOX. The primary end point was adverse event rate and the second primary end points were 3-year disease-free survival rate, completion of TNT, and pathological downstaging rate. Results: Between August 2017 and August 2018, 68 rectal cancer patients with at least one high risk factor (cT3c/3d/T4a/T4b, cN2, mesorectal fascia involvement, or extramural venous invasion involvement) were enrolled. The overall compliance of receiving the entire treatment was 88.2% (60/68). All 68 patients received induction chemotherapy, 65 received chemoradiotherapy, and 61 received consolidation chemotherapy. The Grade 3-4 adverse event rate was 30.8% (21/68). Nine patients achieved clinical complete response and then watch and wait. Five patients (7.4%) developed distant metastasis during TNT and received palliative chemotherapy. Fifty patients underwent surgical resection. The complete response rate was 27.9%. After a median follow-up of 49.2 months, the overall 3-year disease-free survival rate was 69.7%. Conclusions: For patients with high-risk rectal cancer, this TNT regimen can achieve favorable survival and complete response rates but with high toxicity. However, it is necessary to pay attention to the possibility of distant metastasis during the long treatment period.