Table of Content

20 April 2026, Volume 26 Issue 02

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Original Articles and Clinical Research

COL7A1 promotes the development of biliary tract cancer by activating the PI3k/AKT pathway

LIU Ye, LIANG Jiao, YU Hao, ZHOU Zhiheng, XU Junyao

2026, 26(02):  75-83.  DOI: 10.3969/j.issn.1009-976X.2026.02.001

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Objective To investigate the expression characteristics, prognostic value, biological functions, and regulatory mechanism of COL7A1 on the PI3K/AKT signaling pathway in biliary tract cancer. Methods Using TCGA cholangiocarcinoma transcriptome data, differential expression analysis, Cox regression, and LASSO regression were performed to screen key prognostic genes. A COL7A1 stable knockdown model was established in HCCC-9810 cells. Cell proliferation, invasion, and migration were assessed by CCK-8, Transwell, and wound healing assays. A subcutaneous xenograft tumor model in nude mice was established to evaluate the effect of COL7A1 knockdown on tumor growth. Immunohistochemistry was used to detect CD8⁺ T cell infiltration. Western blotting was performed to detect the expression levels of AKT and p-AKT in cells to verify the regulatory effect of COL7A1 on the PI3K/AKT pathway. Results COL7A1 expression was significantly upregulated in cholangiocarcinoma tissues, and high expression was associated with poor patient prognosis. Knockdown of COL7A1 significantly inhibited the proliferation, invasion, and migration of HCCC-9810 cells, as well as the growth of subcutaneous xenograft tumors in nude mice. Following COL7A1 knockdown, CD8⁺ T cell infiltration in xenograft tissues was increased. At the cellular level, p-AKT phosphorylation levels were reduced after COL7A1 knockdown, while total AKT expression remained unchanged. Conclusion COL7A1 is highly expressed in biliary tract cancer and promotes tumor cell proliferation, invasion, migration, and in vivo tumorigenesis by positively regulating the phosphorylation of the PI3K/AKT pathway. Its expression level is negatively correlated with CD8⁺T cell infiltration, suggesting that COL7A1 may serve as a prognostic biomarker and therapeutic target for biliary tract cancer.

M2 macrophage-derived SIGLEC11 enhances stemness and promotes metastasis in esophageal squamous cell carcinoma

WEI Xue, SUN Xiao, LI Lei

2026, 26(02):  84-95.  DOI: 10.3969/j.issn.1009-976X.2026.02.002

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Objective This study investigates the expression profile of sialic acid-binding immunoglobulin-like lectin 11 （SIGLEC11） in esophageal squamous cell carcinoma （ESCC） and elucidates its role in maintaining tumor stemness and promoting invasion and metastasis. We further evaluated whether SIGLEC11 acts as a key pro-tumorigenic molecule mediated by M2 macrophages, thereby providing theoretical support for understanding the regulatory mechanisms of the ESCC immune microenvironment and identifying potential therapeutic targets. Methods Proteomic analysis was performed to compare the secretome profiles of M0, M1, and M2 macrophages differentiated from THP-1 monocytes. The expression levels of SIGLEC11 in different macrophage subtypes were validated using qPCR, western blotting, and multiplex immunofluorescence, and its association with immune-cell infiltration was assessed via the TIMER2 database. Sphere formation assays and Transwell migration/invasion assays were conducted to evaluate the effects of exogenous recombinant SIGLEC11 protein on the stemness maintenance and motility of ESCC cell lines KYSE30, KYSE180, and KYSE510. Kaplan-Meier survival analysis and clinicopathological correlation analyses were performed based on publicly available datasets to determine the association between SIGLEC11 expression and patient prognosis. Results Proteomic screening and subsequent validation at both the protein and transcript levels demonstrated that SIGLEC11 was specifically and highly expressed in M2 macrophages and could be released via a secretory pathway. TIMER2 analysis indicated a positive correlation between SIGLEC11 expression and macrophage infiltration. Functional in vitro assays showed that exogenous SIGLEC11 significantly enhanced the self-renewal, migration, and invasion capacities of ESCC cells, suggesting its promotive effect on tumor stemness. Analysis of the TCGA database demonstrated that SIGLEC11 expression was closely associated with tumor aggressiveness, and survival analysis further indicated that high SIGLEC11 expression correlated with poor patient prognosis. Conclusion SIGLEC11 is specifically upregulated in M2-polarized macrophages, where it functions to enhance tumor stemness and to promote the migration and invasion of ESCC cells. Its expression is closely associated with tumor malignancy and with unfavorable clinical outcomes. These findings suggest that SIGLEC11 serves as a pivotal molecular hub linking the tumor immune microenvironment to the malignant phenotype of ESCC, highlighting its potential as a novel therapeutic target for diagnosis, prognostic assessment, and immunotherapy in ESCC.

A prognostic risk score for breast cancer based on cancer stem cell-related immune genes

ZHU Xiaoxuan, LIU Jieqiong

2026, 26(02):  96-103.  DOI: 10.3969/j.issn.1009-976X.2026.02.003

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Objective Based on TCGA-BRCA data, we integrated cancer stem cell （CSC） related genes with immune-related gene information to construct and evaluate a prognostic risk model for breast cancer patients. Methods Gene expression profiles and clinical data from 1,073 breast cancer patients in The Cancer Genome Atlas （TCGA-BRCA） were collected. Weighted gene co-expression network analysis （WGCNA） was applied to detect co-expression modules of immune-related genes. CSC-associated genes were retrieved from the BCSCdb database and intersected with immune-related genes and differentially expressed genes （DEGs） to obtain 70 candidate genes. Least absolute shrinkage and selection operator （LASSO） Cox regression followed by multivariable Cox regression were used to further select key genes and build a 12-gene prognostic risk model. Model performance was assessed by Kaplan-Meier survival analysis, time-dependent receiver operating characteristic （ROC） curves, and nomogram analysis. Gene set enrichment analysis （GSEA） and immune infiltration analyses were performed to explore underlying biological mechanisms. Results The CSC-related immune prognostic model stratified patients into high- and low-risk groups with significantly different overall survival. Time-dependent ROC analysis indicated good predictive ability for 1-, 3-, and 5-year survival （area under the curve [AUC] = 0.81, 0.77, and 0.75, respectively）. The nomogram demonstrated favorable discriminative performance with a C-index ranging from 0.78 to 0.81. GSEA and immune infiltration analyses provided further insight into pathways and immune features associated with risk stratification. Conclusion We developed a prognostic risk model that integrates CSC-related immune gene expression information in breast cancer. The model effectively discriminated between high- and low-risk patients and shows promising prognostic value.

Correlation between the anatomical morphology of the proximal tibiofibular joint and the development of knee osteoarthritis

JIANG Chenghao, SHAO Bin, WANG Dawei, XING Jianqiang, LI Peng, DOU Yongfeng

2026, 26(02):  104-108.  DOI: 10.3969/j.issn.1009-976X.2026.02.004

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Objective To propose a new method for measuring the anatomical parameters of the proximal tibiofibular joint （PTFJ） and to evaluate the correlation between PTFJ anatomical parameters and the occurrence of knee osteoarthritis （OA）. Methods Magnetic resonance imaging data from 81 adults were collected and divided into an OA group （40 cases） and a healthy group （41 cases）. By comparing the inclination angle, declination angle, and contact area （including PTFJ contact area S, lateral stress-bearing area Sφ, weight-bearing area Sτ, and posterior stress-bearing area Sν） of the PTFJ between the two groups, the correlation between PTFJ anatomical parameters and the occurrence of knee osteoarthritis was analyzed. Results The inclination angle, declination angle, and contact areas （S, Sτ, Sν） of the PTFJ in the OA group were significantly greater than those in the healthy group （P<0.05）. There was no statistically significant difference between the two groups in the lateral stress-bearing area （Sφ）, age, or BMI （P>0.05）. Conclusion The anatomical parameters of the proximal tibiofibular joint have a significant impact on the occurrence of knee osteoarthritis; the method of measuring PTFJ anatomical parameters using magnetic resonance imaging demonstrates high accuracy.

The evolution of self-efficacy in patients with nonspecific chronic low back pain： a qualitative study

ZHOU Jinlang, LIANG Anjing, QIU Xuemei, WANG Yucui, HUANG Zhiling, HE Xiang, CHEN Guilian

2026, 26(02):  109-113.  DOI: 10.3969/j.issn.1009-976X.2026.02.005

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Objective To identify changes, barriers, and facilitators of self-efficacy in patients with nonspecific chronic low back pain. Methods A purposive sampling method was employed to select patients with nonspecific chronic low back pain who visited the outpatient clinic from August to November 2025 for semi-structured interview. The Colaizzi thematic analysis method was used to analyze, summarize, and extract themes from the data. Results A total of 11 patients with non-specific chronic low back pain were enrolled, including 5 males and 6 females, with disease duration ranging from 6 months to over 20 years. The evolution of their self-efficacy can be summarized into four themes, including the decline in physical and psychosocial function, the dilemma of diverse attempts with uncertain efficacy, the establishment of patient-physician collaboration and support systems, and the solidification and evolution of self-management behaviors, along with 16 sub-themes. Conclusion Management of nonspecific chronic low back pain should extend beyond mere symptom relief and pay adequate attention to changes in patients' self-efficacy, implement a patient-centered, empowerment-oriented holistic support model.

Quantitative dynamic contrast-enhanced MRI and PI-RADS score in differentiating prostate cancer from benign prostatic hyperplasia

JIANG Linling, SI Ge

2026, 26(02):  114-118.  DOI: 10.3969/j.issn.1009-976X.2026.02.006

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Objective The surgical approaches for prostate cancer （PCa） and benign prostatic hyperplasia （BPH） differ. PCa typically requires radical prostatectomy, while BPH is often managed with partial resection to alleviate symptoms. This study aimed to utilize quantitative dynamic contrast-enhanced magnetic resonance imaging （qDCE-MRI） to differentiate between PCa and BPH, thereby guiding the selection of surgical strategy. Methods Fifty-four patients with prostate nodules underwent conventional MRI and qDCE-MRI. The qDCE-MRI data were analyzed using the extended Tofts model to calculate quantitative and semi-quantitative parameters. The Mann-Whitney U test was employed to compare the differences in qDCE-MRI parameters between PCa and BPH groups. The predictive efficacy of each parameter was evaluated using receiver operating characteristic （ROC） curve analysis. The Spearman rank correlation test was used to analyze the linear correlation between quantitative parameters and PCa ISUP grade groups. Results Among the 54 patients, there were 31 cases of PCa and 23 cases of BPH. The PSA, Ktrans, Kep, Cmax, and Slopemax values were significantly higher in the PCa group than in the BPH group, while TTP was lower in the PCa group （P<0.05）. The areas under the ROC curve for differentiating PCa from BPH ranged from 0.710 to 0.971. The sensitivity, specificity, and accuracy of PI-RADS score in discriminating PCa from BPH were 0.784, 0.882 and 0.815, respectively. Slopemax showed a positive correlation with the PCa ISUP grade group （r=0.451, P=0.011）, whereas other parameters did not exhibit significant correlations （P>0.05）. Conclusion Both semi-quantitative and quantitative parameters derived from qDCE-MRI can effectively distinguish PCa from BPH, providing valuable guidance for selecting the appropriate surgical approach for prostate diseases.

Case Report

A rare case report and literature review of advanced thyroid carcinoma with tracheal invasion and intravascular tumor thrombus

VONG Houin, WANG Jing, WANG Tiantian, YU Xing

2026, 26(02):  119-124.  DOI: 10.3969/j.issn.1009-976X.2026.02.007

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Objective To investigate the surgical treatment and postoperative quality of life in locally advanced thyroid carcinoma with tracheal invasion and intravascular tumor thrombus. Methods The clinical presentation, auxiliary examinations, diagnosis and treatment process, and prognosis of one case of locally advanced thyroid carcinoma were retrospectively analyzed, along with a review of relevant literature. Results An elderly female patient diagnosed with thyroid carcinoma complicated by tracheal invasion and intravascular tumor thrombus underwent surgical treatment directly following a multidisciplinary discussion. The tumor and surrounding invaded areas were completely resected through a collaborative effort involving departments of thyroid surgery, otolaryngology, vascular surgery, and anesthesiology. At 16 months of postoperative follow-up, the patient has a favorable prognosis, remains in disease-free survival status, and shows no evidence of local recurrence or distant metastasis. Conclusion Surgical treatment is one of the effective methods for managing locally advanced thyroid carcinoma. Preoperative risk stratification assessment and multidisciplinary discussions are beneficial for formulating appropriate treatment plans. Multi-department collaboration can enhance surgical outcomes and improve the patient′s postoperative quality of life.

Early enteral nutrition intolerance and intestinal ischemic necrosis in brain-dead patients： a case report of 3 cases and literature review

HAO Mingze, WANG Ning, QIU Xiaohong, HAO Peng, HE Qing

2026, 26(02):  125-130.  DOI: 10.3969/j.issn.1009-976X.2026.02.008

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Brain-dead patients are a significant source for organ transplantation, but complications such as intestinal ischemia and necrosis often affect organ quality. This study retrospectively analyzed the clinical data of three patients who became brain-dead following brain injuries due to different etiologies. All three patients rapidly developed severe enteral nutrition intolerance after early initiation of enteral nutrition, and subsequent organ procurement surgeries confirmed varying degrees of intestinal ischemic necrosis. The occurrence of severe intolerance following early enteral nutrition in brain-dead patients may signal the presence of intestinal ischemia and necrosis. Clinicians should be vigilant regarding such signs, promptly assess intestinal perfusion and structural damage, and further research is needed in the future to optimize nutritional support strategies for brain-dead patients and improve the quality of organs obtained.

Review

“Intelligent” treatment for thyroid cancer： application and prospect of artificial intelligence in thyroid cancer diagnosis and treatment

NUERBANNU Tabusibieke, SHAO Guoan

2026, 26(02):  131-139.  DOI: 10.3969/j.issn.1009-976X.2026.02.009

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Thyroid cancer （TC） is the most common malignant tumor of the endocrine system, with its incidence continuously rising worldwide. Although most patients have a favorable prognosis, challenges remain, including insufficient accuracy in early diagnosis, inaccurate assessment of lymph node metastasis, difficulties in effectively implementing individualized treatment, and low follow-up efficiency. In recent years, the rapid development of artificial intelligence （AI） technology has brought transformative changes to the precise diagnosis and treatment of TC. This review primarily focuses on the application of AI in TC diagnosis, outlining the evolution of AI technologies and comparing the efficacy of different methods in distinguishing benign from malignant lesions, predicting lymph node metastasis, and molecular subtyping. Simultaneously, it explores the potential of AI in treatment decision-making, prognosis assessment, and follow-up management, analyzes current challenges, and aims to promote the translation of AI technology into clinical practice.