Oncology Letters最新文献

{"title":"Multidetector computed tomography detection of perineural infiltration around the superior mesenteric artery in intrahepatic cholangiocarcinoma: A case report.","authors":"Myeong Hun Oh, Byeong Gwan Noh, Hyung Il Seo, Young Mok Park, Suk Kim, Nam Kyung Lee, Seung Baek Hong","doi":"10.3892/ol.2026.15658","DOIUrl":"10.3892/ol.2026.15658","url":null,"abstract":"<p><p>Intrahepatic cholangiocarcinoma (IHCC) is the second most common primary liver malignancy after hepatocellular carcinoma and is associated with a poor prognosis. Although surgical resection remains the only potentially curative treatment, the 5-year survival rate is <30%. Among various prognostic factors, perineural invasion (PNI) is considered noteworthy. Multidetector computed tomography (MDCT) plays a critical role in the diagnosis and staging of IHCC and may aid in the detection of PNI. The current study presents the clinical course and radiological findings of an 82-year-old woman with IHCC who showed PNI around the superior mesenteric artery, highlighting the importance of preoperative MDCT evaluation.</p>","PeriodicalId":19503,"journal":{"name":"Oncology Letters","volume":"32 1","pages":"303"},"PeriodicalIF":2.1,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic schwannoma misdiagnosed as colorectal cancer metastasis and the corresponding diagnostic lessons: A report of two cases.","authors":"Shilong Wang, Kaixiang Zhang, Xiangwu Lin, Feilai Xie, Jian Yang, Jie Li","doi":"10.3892/ol.2026.15659","DOIUrl":"10.3892/ol.2026.15659","url":null,"abstract":"<p><p>Schwannomas are neurogenic tumours originating from Schwann cells, and the vast majority of the tumours are benign lesions. Schwannomas are most commonly found in the head, neck and extremities; however, those occurring in the pelvis are rare. Due to the lack of specific clinical manifestations and radiographic features, pelvic schwannomas are difficult to detect and differentiate at an early stage. Cases of pelvic schwannomas coexisting with colorectal cancer have rarely been reported in both domestic and international literature. The current study presents two cases of pelvic schwannomas that were misdiagnosed as colorectal cancer metastases. Both lesions were initially identified as metastatic colorectal cancer during preoperative evaluation and were subsequently confirmed as schwannomas by postoperative pathological examination. This report analyses the causes of misdiagnosis, summarises the key distinguishing features between pelvic schwannomas and colorectal cancer metastases, and proposes a diagnostic algorithm for patients with colorectal cancer and pelvic masses of uncertain origin, with the aim of providing practical guidance for clinical practice.</p>","PeriodicalId":19503,"journal":{"name":"Oncology Letters","volume":"32 1","pages":"304"},"PeriodicalIF":2.1,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare <i>BRCA1</i> c.3418_3419insTGACTACT:p.S1140Mfs*18 germline mutation in a family with breast and ovarian cancer.","authors":"Chao Zhai, Long Jia, Chaoyang Wang, Liang Chen, Tuo Han, Dong Xiao","doi":"10.3892/ol.2026.15656","DOIUrl":"10.3892/ol.2026.15656","url":null,"abstract":"<p><p><i>BRCA1</i> is among one of the most frequently mutated tumor suppressor genes in breast and ovarian cancer. In the present retrospective study, a novel heterozygous germline mutation, <i>BRCA1</i> c.3418_3419insTGACTACT:p. S1140Mfs*18 (C>CAGTAGTCA), was identified in a family with breast and ovarian cancer via next-generation and Sanger sequencing analysis and the health status of 18 individuals (three with breast cancer, one with ovarian cancer, one with gastric cancer, one with lung cancer, one with colorectal cancer, three with non-cancer disease and eight healthy individuals) recruited from the 3201 Hospital of Xi'an Jiaotong University (Hanzhong, China) between September 2023 and January 2025 was examined. The aforementioned mutation occurred in four female patients with breast and ovarian and one healthy individual between September 2023 and January 2025, accounting for 27.78% (5/18) of the enrolled family members and 57.14% (4/7) of the patients with cancer. As of March 2025, the treatment of these patients with <i>BRCA1</i> c.3418_3419insTGACTACT mutations have demonstrated notable therapeutic effects. In particular, in two patients who underwent neoadjuvant chemotherapy, surgical resection and targeted therapy, no recurrence or metastasis as of March 2025. Age risk was analyzed in the present cohort; the area under the curve was 0.9107 and the P-value was 0.0078 between patients with cancer and healthy individuals. Age may also be a key factor that affects tumorigenesis in breast and ovarian cancer. In conclusion, <i>BRCA1</i> c.3418_3419insTGACTACT:p.S1140Mfs*18 (C>CAGTAGTCA) heterozygous germline mutation may affect the occurrence and development of cancer.</p>","PeriodicalId":19503,"journal":{"name":"Oncology Letters","volume":"32 1","pages":"301"},"PeriodicalIF":2.1,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical implications of lactylation modification in digestive system tumors (Review).","authors":"Lin Pan, Fengye Liu, Wenjing Yu","doi":"10.3892/ol.2026.15657","DOIUrl":"10.3892/ol.2026.15657","url":null,"abstract":"<p><p>Lactylation, a novel post-translational modification, has emerged as a critical mechanistic link between metabolic reprogramming and epigenetic regulation in cancer. The present review aimed to synthesize emerging evidence on the role of lysine lactylation in the pathogenesis and progression of major digestive system malignancies, including esophageal, gastric, colorectal, hepatocellular and pancreatic cancer. The molecular mechanisms through which lactate-derived lactylation modifies histone and non-histone proteins are described, which thereby regulate key oncogenic processes such as metabolic adaptation, cancer stemness maintenance, epithelial-mesenchymal transition, immunosuppressive tumor microenvironment remodeling, angiogenesis, perineural invasion and therapeutic resistance. The translational potential of targeting the lactylation axis by inhibiting lactate production, blocking lactate transport or directly modulating lactylation-related enzymes are explored, and the development of lactylation-based prognostic models and their implications for innovative combination strategies to overcome treatment resistance are also highlighted. The present review highlights lactylation as a pivotal regulator in digestive oncology and a promising target for novel diagnostic and therapeutic strategies.</p>","PeriodicalId":19503,"journal":{"name":"Oncology Letters","volume":"32 1","pages":"302"},"PeriodicalIF":2.1,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jaceosidin inhibits cell viability and induces apoptosis in non-small cell lung cancer by inhibiting the Ras/Raf/MEK/ERK and Akt pathways.","authors":"Xiaodie Cao, Chong Ma, Xin Wang, Cui Wang, Lanlin Shen, Jingru Wei, Rongmin Yang, Yan Li, Xu He, Li Chen","doi":"10.3892/ol.2026.15653","DOIUrl":"10.3892/ol.2026.15653","url":null,"abstract":"<p><p>Non-small cell lung cancer (NSCLC) remains a major health challenge due to its poor prognosis and low 5-year survival rate; therefore, the development of efficient and less toxic anti-NSCLC therapies is of great importance. The present study aimed to investigate the anti-survival and pro-apoptotic effects of Jaceosidin, a flavonoid, on human NSCLC cells and to uncover its underlying mechanism. Cell viability, cell cycle progression and apoptosis were assess using the MTS assay and flow cytometry, and protein expression was analyzed by western blot analysis. The results showed that Jaceosidin significantly reduced A549 cell viability in a dose-dependent manner, whereas it exhibited significantly lower cytotoxicity against 293T cells. In addition, cell cycle distribution analysis demonstrated that A549 cell treatment with Jaceosidin induced S-phase cell cycle arrest, which was accompanied by p21 upregulation. Jaceosidin also enhanced cell apoptosis, and upregulated cleaved-poly-ADP ribose polymerase and cleaved-caspase-3 expression in a dose-dependent manner. Furthermore, Jaceosidin promoted the release of cytochrome <i>c</i> (cyto-c) from mitochondria into the cytoplasm, as detected by digitonin-based fractionation and western blotting, thus resulting in increased cytosolic cyto-c levels. Finally, Jaceosidin significantly reduced the expression of Ras and Raf, and the downstream signaling molecules ERK1/2 and Akt, which may suppress A549 cell viability and enhance apoptosis. Overall, the current study suggested that Jaceosidin exerts potential anti-NSCLC activity with tumor-selective cytotoxicity through inhibiting the Ras/Raf/MEK/ERK and Akt pathways, and activating both intrinsic mitochondrial and extrinsic apoptotic pathways, thus representing a promising natural product candidate for future NSCLC therapy.</p>","PeriodicalId":19503,"journal":{"name":"Oncology Letters","volume":"32 1","pages":"298"},"PeriodicalIF":2.1,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ubiquitination and N⁶-methyladenosine in cancer: Convergent regulation of oncogenic signaling pathways (Review).","authors":"Hailong Li, Xuelin Lu","doi":"10.3892/ol.2026.15652","DOIUrl":"10.3892/ol.2026.15652","url":null,"abstract":"<p><p>Ubiquitination and N⁶-methyladenosine (m⁶A) RNA methylation constitute two fundamental layers of post-translational and post-transcriptional regulation that coordinately govern gene expression in cancer. These regulatory systems exhibit intricate crosstalk, revealing that they frequently converge on shared oncogenic signaling pathways to fine-tune malignant cell behaviors. Cooperative regulation by ubiquitination and m⁶A is involved in modulating core cancer-driving circuits, including the PI3K-AKT and NF-κB pathways, thereby taking part in tumor cell proliferation, metastatic dissemination, immune evasion, metabolic adaptation and resistance to targeted therapies and chemotherapy. The interaction between them forms intricate feedback loops and exhibits context specificity, with the same regulatory axis capable of promoting or restraining tumorigenesis depending on cell types, mutation background and microenvironmental cues. Elucidating the molecular mechanisms underlying ubiquitin-m⁶A crosstalk is thus key for developing next-generation precision oncology strategies. Notably, components of these pathways such as ubiquitin ligases, deubiquitinases and m⁶A writers, erasers and readers, have been regarded as potential diagnostic biomarkers and therapeutic targets. Future advances relying on integrative multi-omics profiling, sophisticated functional models and rigorous <i>in vivo</i> validation are essential to unravel the complexity of these multi-layered regulatory networks. Such insights may ultimately enable the rational design of therapies that exploit ubiquitin-m⁶A crosstalk to more effectively suppress cancer progression.</p>","PeriodicalId":19503,"journal":{"name":"Oncology Letters","volume":"32 1","pages":"297"},"PeriodicalIF":2.1,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13204317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of squamous differentiation in pT2N0 urothelial bladder cancer.","authors":"Alper Coskun, Ahmet Bilgehan Sahin, Selva Kabul, Mehmet Emin Dagtekin, Seda Sali, Buket Erkan Ozmarasali, Adem Deligonul, Erdem Cubukcu, Meral Kurt, Gursel Savci, Turkkan Evrensel, Ismet Yavascaoglu","doi":"10.3892/ol.2026.15654","DOIUrl":"10.3892/ol.2026.15654","url":null,"abstract":"<p><p>Bladder cancer is the ninth most common malignancy worldwide, with urothelial carcinoma (UC) representing the predominant histopathological subtype. UC may present as pure urothelial carcinoma (PUC), or alongside other variant histologies (VHs), with squamous differentiation in UC (SD) being the most frequently observed variant. The present study provides a population-based insight into the survival outcomes of patients with SD compared with PUC in early-stage disease. The present retrospective, observational study analyzed pathology reports from all cystectomies (n=632) performed at Uludag University Faculty of Medicine (Bursa, Turkey) between December 2010 and December 2023. A total of 23 patients with SD and 45 patients with PUC were evaluated; all of the patients had pathological stage T2N0 (pT2N0). The median follow-up period was 5.27 years (range, 0.23-16.60). Kaplan-Meier survival analysis demonstrated no statistically significant difference in disease-free survival (DFS) or overall survival (OS) between the SD and PUC groups. Univariate Cox regression analysis identified that age at diagnosis was a potential prognostic factor of both DFS and OS. The findings suggest that SD does not significantly affect DFS or OS in patients with pT2N0 UC. However, further prospective, multicenter, large-scale studies are warranted to validate and expand upon these findings.</p>","PeriodicalId":19503,"journal":{"name":"Oncology Letters","volume":"32 1","pages":"299"},"PeriodicalIF":2.1,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13202194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary endometrioid adenocarcinoma of the vagina after total hysterectomy for adenomyosis: A case report.","authors":"Tingting Wang, Xin Li, Liping Chen, Jing Zhang, Lina Peng, Haitao Yang","doi":"10.3892/ol.2026.15650","DOIUrl":"10.3892/ol.2026.15650","url":null,"abstract":"<p><p>Primary vaginal cancer is a rare malignant tumor; its pathogenesis remains unclear and only a limited number of cases have been documented in the literature. The present report outlines a rare case of primary vaginal endometrioid adenocarcinoma that occurred in a patient 3 years after a total hysterectomy for uterine adenomyosis. Pathogenesis, clinical features, diagnosis, treatment and prognosis are discussed to improve clinical recognition and management of this rare condition. A 49-year-old female patient who had undergone a total hysterectomy for uterine adenomyosis 3 years earlier presented with postcoital vaginal bleeding. Gynecological examination identified a mass in the vaginal stump. A biopsy revealed low-grade vaginal adenocarcinoma. The patient underwent an extensive laparoscopic parametric resection, partial upper vaginectomy, pelvic lymph node dissection and bilateral oophorectomy. The postoperative pathology determined a diagnosis of primary vaginal endometrioid adenocarcinoma. Concurrent chemoradiotherapy was initiated 6 weeks after surgery. At the last follow-up (15 months postoperatively), the patient was in good general condition with no evidence of recurrence. The present case indicates that long-term surveillance of the vaginal stump is valuable for patients who have undergone total hysterectomy for benign uterine diseases, as it allows early detection of vaginal stump lesions. In particular, for patients with a history of other malignant tumors, specific attention should be paid to the genetic susceptibility of the underlying tumor.</p>","PeriodicalId":19503,"journal":{"name":"Oncology Letters","volume":"32 1","pages":"295"},"PeriodicalIF":2.1,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13201983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weekly cisplatin and nab-paclitaxel neoadjuvant chemoradiotherapy increases pathological complete response in locally advanced esophageal squamous cell carcinoma: A real-world study.","authors":"Li Li, Xuquan Jing, Jiling Niu, Yan Yi, Yujie Wang, Ke Zhao, Jingyu Luo, Jinming Yu, Hui Zhu","doi":"10.3892/ol.2026.15648","DOIUrl":"10.3892/ol.2026.15648","url":null,"abstract":"<p><p>Although neoadjuvant chemoradiotherapy (nCRT) is the standard treatment regimen for patients with locally advanced esophageal squamous cell carcinoma (LA-ESCC), no consensus exists regarding the optimal chemotherapy regimen. The present study aimed to compare the safety/efficacy of weekly (QW) vs. triweekly (Q3W) cisplatin/nab-paclitaxel nCRT in LA-ESCC. This retrospective study analyzed 136 patients with LA-ESCC who underwent esophagectomy after nCRT (QW, n=32; Q3W, n=104). The data included pathological complete response (pCR), major pathological response (MPR), toxicity, survival and postoperative outcomes. The results demonstrated that QW exhibited significantly higher pCR (56.25 vs. 33.65%; P=0.022) and MPR (81.25 vs. 61.54%; P=0.039) rates than Q3W. Hematological toxicity rates were lower for QW, including neutropenia of all grades (46.88% vs. 70.81%, P=0.0001) and thrombocytopenia of all grades (18.75% vs. 31.73%, P=0.033). Grade ≥3 leukopenia (18.75 vs. 51.92%; P=0.001) and grade ≥3 neutropenia (15.62 vs. 38.46%; P=0.016) were less frequent in QW. In addition, the incidence of acute pneumonia of all grades was also lower (0% vs. 16.35%, P>0.05). However, survival outcomes were comparable between the groups, including 1-year overall survival (QW vs. Q3W, 96.6 vs. 100.0%) and progression-free survival (86.5 vs. 85.6%) rates (P>0.05). In conclusion, QW cisplatin/nab-paclitaxel nCRT achieved superior pCR rates and reduced hematological toxicity compared with Q3W dosing in LA-ESCC, thus suggesting its potential use as a safer and more effective neoadjuvant regimen. The survival benefit remains to be validated with an extended follow-up.</p>","PeriodicalId":19503,"journal":{"name":"Oncology Letters","volume":"32 1","pages":"293"},"PeriodicalIF":2.1,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal cancer with indeterminate ¹⁸F-FDG PET/CT findings: Diagnostic efficacy analysis of ⁶⁸Ga-FAPI-04 PET/MRI.","authors":"Jingxuan Miao, Yifei Xu, Feng Qiao, Ni Chen, Muhammad Imran Khan, Ye Zhao, Hui Wang","doi":"10.3892/ol.2026.15647","DOIUrl":"10.3892/ol.2026.15647","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The present prospective study aimed to investigate whether gallium-68-labeled fibroblast activation protein inhibitor-04 (&lt;sup&gt;68&lt;/sup&gt;Ga-FAPI-04) positron emission tomography (PET)/magnetic resonance imaging (MRI) could provide notably increased diagnostic accuracy, semi-quantitative parameters, staging capability, diagnostic guidance value and improved clinical benefits compared with fluorine-18-labeled fluorodeoxyglucose (&lt;sup&gt;18&lt;/sup&gt;F-FDG) PET/computed tomography (CT) in gastrointestinal (GI) cancer with atypical metabolic activity (uncertain &lt;sup&gt;18&lt;/sup&gt;F-FDG imaging results). In total, 22 patients with histopathologically confirmed GI cancer, clinically suspected of recurrence or metastasis, but with atypical/inconclusive &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT results, were analyzed. The present study planned to perform &lt;sup&gt;68&lt;/sup&gt;Ga-FAPI-04 PET/MRI within 1-4 days. The diagnostic performance of both tracers was evaluated. Tumor-to-background ratio was used to quantify the radiotracer uptake. The present study employed Fisher's exact test to statistically analyze the association between pathological subtypes and changes in tumor staging, as well as treatment decisions indicated by &lt;sup&gt;68&lt;/sup&gt;Ga-FAPI-04 PET. The results demonstrated that &lt;sup&gt;68&lt;/sup&gt;Ga-FAPI-04 had significantly higher sensitivity compared with &lt;sup&gt;18&lt;/sup&gt;F-FDG in detecting lymph node involvement (100 vs. 89.01%; P=0.001) and distant organ metastases (92.31 vs. 61.54%; P=0.008). Me &lt;sup&gt;68&lt;/sup&gt;Ga-FAPI-04 uptake was significantly higher in primary tumors [median, 6.13 (range, 5.71-7.57) vs. 2.62 (1.82-3.03); P=0.004], lymph nodes (9.07±2.93 vs. 3.96±1.73; P&lt;0.001) and various metastatic sites (3.31±2.19 vs. 6.87±4.16; P&lt;0.001). The findings indicated that &lt;sup&gt;68&lt;/sup&gt;Ga-FAPI-04 has potential advantages in diagnostic efficiency and visual evaluation. Furthermore, &lt;sup&gt;68&lt;/sup&gt;Ga-FAPI-04 altered staging in 36.4% (8/22) of patients and refined the treatment strategies for 27.3% (6/22), particularly those with poorly differentiated adenocarcinoma or mucinous carcinoma. For the 22 patients in the present study, the hospital cost for &lt;sup&gt;68&lt;/sup&gt;Ga-FAPI-04 PET/MRI was higher compared with that for &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/CT. However, it generated overall benefits that essentially offset the additional costs. By enabling the timely detection of anastomotic recurrence, lymph node metastasis and distant metastasis for prompt intervention, it saved time, reduced the risk of further disease progression, and also minimized some unnecessary medical procedures caused by false-positive &lt;sup&gt;18&lt;/sup&gt;F-FDG results. These findings suggested that &lt;sup&gt;68&lt;/sup&gt;Ga-FAPI-04 PET/MRI is key to enhancing the diagnostic performance for &lt;sup&gt;18&lt;/sup&gt;F-FDG metabolically atypical GI tumors, refining clinical decision-making and providing economic benefits. This clinical trial was registered at Clinicaltrials.gov with ID NCT06270394 (date of registration, February 20th, 2024; retrospectively registered)","PeriodicalId":19503,"journal":{"name":"Oncology Letters","volume":"32 1","pages":"292"},"PeriodicalIF":2.1,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}