Chinese Journal of Cancer Research最新文献

{"title":"AI agents in cancer imaging: Concepts, advances, and clinical perspectives.","authors":"Ruiying Yao","doi":"10.21147/j.issn.1000-9604.2026.04.05","DOIUrl":"10.21147/j.issn.1000-9604.2026.04.05","url":null,"abstract":"<p><p>Medical imaging serves as a critical source of evidence for cancer diagnosis, treatment, and follow-up. However, most existing medical imaging artificial intelligence (AI) systems still operate on predefined tasks and inputs, limiting their ability to address the evolving needs of clinical practice and research. AI agents use foundation models as central engines for reasoning and orchestration. They organize analytical processes according to task objectives, invoke external tools and data resources, and adapt subsequent actions based on intermediate results. They may therefore facilitate a shift in cancer imaging AI from isolated model applications toward continuous workflow support. This review outlines the fundamental principles, system components, and evaluation approaches for AI agents from a cancer imaging perspective and summarizes representative advances in image interpretation, clinical decision support, and research workflows. Current evidence suggests that agents can connect previously fragmented imaging, clinical, and knowledge resources, thereby potentially improving the continuity and traceability of complex tasks. Nevertheless, clinical evidence for AI agents remains limited, as most studies have been conducted in controlled settings and have yet to demonstrate consistent value in real-world clinical workflows. Clinical translation is further constrained by the computational demands and potential error propagation inherent in multistep execution, as well as by the dependence of agent performance on specific tools, data environments, and workflow configurations. Future research should move beyond task-level performance toward system-level validation, with particular emphasis on whether agents can reliably organize information, interpret findings, and collaborate effectively with clinicians. Such evidence will be essential to clarify their practical role in cancer imaging care and research.</p>","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":"38 4","pages":"431-443"},"PeriodicalIF":6.7,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric cancer in the Era of neural regulation.","authors":"Jingwu Yue, Shi Jiao, Zhaocai Zhou","doi":"10.21147/j.issn.1000-9604.2026.04.03","DOIUrl":"10.21147/j.issn.1000-9604.2026.04.03","url":null,"abstract":"<p><p>Neural regulation of gastric cancer (GC) has conventionally been parsed into isolated axes-vagal, sympathetic, or sensory. This compartmentalized view is increasingly untenable. The stomach is embedded in a multilayered neural architecture in which tumor-infiltrating nerves, the enteric nervous system (ENS), and long-range brain-gut pathways operate at distinct yet interconnected spatial scales. These layers do not simply deliver unidirectional \"nerve-to-tumor\" commands; they dynamically shape epithelial behavior, stromal and immune states, organ physiology, and ultimately treatment responses. Here we propose a three-level framework for neural regulation in GC: local neural remodeling within tumors, the ENS as an intrinsic organ-level network, and central control through brain-gut axes. Within this framework, we emphasize that the same neural pathway can exert opposing effects depending on disease stage, anatomical compartment, neuronal subtype, and the prevailing microenvironmental and systemic context. Critically, neural regulation must be understood as a bidirectional, multi-modal dialogue: nerves modulate every cellular compartment of the tumor microenvironment (TME), while TME components (e.g. cancer cells, immune infiltrates, vascular endothelium, and fibroblasts) reciprocally remodel neural architecture and function. This dialogue is further conditioned by macroenvironmental factors (psychosocial stress, dietary metabolism, and gut microbiota) and local physicochemical cues (mechanical forces, epigenetic states, metabolites, secreted protein signals, and even cell-surface RNAs). Unraveling this complexity will require not only classical neural tracing but also a new generation of technologies-tissue-specific secretomes, <i>in vivo</i> cell-cell interaction labeling, and cell-surface nucleic-acid sequencing at single-cell resolution.</p>","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":"38 4","pages":"406-410"},"PeriodicalIF":6.7,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13551096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial transcriptome revealed associated biomarkers for endocrine therapy response in HR-positive/HER2-negative early breast cancer.","authors":"Yujing Tan, Jiani Wang, Zhe Chen, Shengbo Lin, Cheng Zeng, Lin Zhu, Yufei Wang, Haili Qian, Binghe Xu, Ying Fan, Fei Ma","doi":"10.21147/j.issn.1000-9604.2026.03.15","DOIUrl":"10.21147/j.issn.1000-9604.2026.03.15","url":null,"abstract":"<p><strong>Objective: </strong>Endocrine resistance occurs in nearly all patients with hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) early breast cancer (EBC), which can develop local and distant recurrence. The situation highlights the need to explore biomarkers for the efficacy of endocrine therapy (ET).</p><p><strong>Methods: </strong>We performed digital spatial profiling on postoperative tumor samples from 20 HR+/HER2- EBC patients receiving adjuvant tamoxifen therapy, based on a designated panel comprising 235 ET-related genes. Paired patients were stratified into resistant and sensitive groups based on ET response. A total of 111 regions in three tissue compartments defined by morphology markers [tumor (PANCK+), leucocytes (CD45+), and nonimmune stroma (CD45-/PANCK-)] were investigated for immune and transcriptomic biomarkers.</p><p><strong>Results: </strong>A total of 27, 13, and 5 differentially expressed genes (DEGs) were identified in PANCK+, CD45+, and CD45-/PANCK- regions. In the PANCK+ regions, mRNA expression of fourteen DEGs was significantly associated with disease-free survival (DFS), among which seven DEGs were further selected to construct a model for DFS. In the model, patients with low-risk scores had a median DFS of 55.77 months, significantly longer than 21.67 months among those with high-risk scores [P=2.1e-4, hazard ratio (HR)=6.73, 95% confidence interval (95% CI) =2.20-20.60)]. The area under curve for 1-year, 3-year, and 5-year DFS was 0.98, 0.95, and 0.91, indicating its superior efficacy. ET-sensitive patients had significantly higher non-classical monocyte infiltration in the CD45+ regions (P=0.03), whereas ET-resistant patients had significantly higher plasma cell infiltration in the CD45-/PANCK- regions (P=0.01).</p><p><strong>Conclusions: </strong>Our study has first demonstrated the spatial transcriptomic landscapes of patients with different responses to ET, which may help stratify patients who are responsive to ET and motivate the exploration of the molecular mechanisms of endocrine resistance.</p>","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":"38 3","pages":"365-378"},"PeriodicalIF":6.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breakthroughs in malignancy therapy: New advances and emerging trends in renal cell carcinoma.","authors":"Xieqiao Yan, Xiaowen Wu, Xinan Sheng","doi":"10.21147/j.issn.1000-9604.2026.03.07","DOIUrl":"10.21147/j.issn.1000-9604.2026.03.07","url":null,"abstract":"","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":"38 3","pages":"307-310"},"PeriodicalIF":6.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preface to Special Issue: Breakthroughs in malignancy therapy: New advances and emerging trends.","authors":"Zengfu Zhang, Jinming Yu","doi":"10.21147/j.issn.1000-9604.2026.03.01","DOIUrl":"https://doi.org/10.21147/j.issn.1000-9604.2026.03.01","url":null,"abstract":"","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":"38 3","pages":"289-290"},"PeriodicalIF":6.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a neutrophil percentage to albumin ratio-based nomogram for predicting survival in patients with locally advanced gastric cancer.","authors":"Shunyu Deng, Maoxing Liu, Fei Tan, Jiadi Xing, Pin Gao, Kai Xu, Xiangqian Su","doi":"10.21147/j.issn.1000-9604.2026.03.16","DOIUrl":"10.21147/j.issn.1000-9604.2026.03.16","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to clarify the predictive value of the neutrophil percentage to albumin ratio (NPAR) for postoperative survival in patients with locally advanced gastric cancer (LAGC) and to develop a prognostic model on the basis of these findings.</p><p><strong>Methods: </strong>Patients with LAGC who underwent radical surgery at Peking University Cancer Hospital between June 2010 and January 2021 were retrospectively screened. Three analytical approaches, percentile classification, cutoff value analysis, and restricted cubic splines (RCS), were utilized to evaluate the association between the NPAR and 3-year disease-free survival (DFS) rates. Survival curves were generated using the Kaplan-Meier method. Univariate and multivariate Cox regression analyses were used to identify the risk factors for 3-year DFS. A novel prognostic nomogram was then constructed and validated using both internal validation (via a 7:3 random split) and temporal external validation (stratified by the surgery dates before and after December 2017).</p><p><strong>Results: </strong>A total of 348 patients were enrolled. All three analytical approaches consistently identified a high NPAR as a robust predictor of an unfavorable prognosis. Specifically, NPAR>1.70 (75th percentile) was associated with significantly lower DFS rates [hazard ratio (HR)=2.506; 95% confidence interval (95% CI): 1.964-3.198]. The optimal cutoff analysis confirmed that NPAR of 1.60 exhibited good discriminative ability (HR=3.639; 95% CI: 2.640-5.016), whereas the RCS analysis revealed a non-linear dose-response relationship between an elevated NPAR and low DFS rates. Multivariate Cox regression revealed the NPAR as an independent risk factor, along with pathological stage, differentiation type, and incomplete postoperative chemotherapy. The resulting prognostic nomogram demonstrated excellent and stable predictive performance across both internal and external temporal validation.</p><p><strong>Conclusions: </strong>The NPAR was strongly associated with 3-year DFS rates in LAGC patients. Nomogram based on the NPAR exhibits high predictive accuracy and represents a practical tool for assessing DFS in clinical practice.</p>","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":"38 3","pages":"379-392"},"PeriodicalIF":6.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-metabolism integrated therapy: A new paradigm for fertility-sparing treatment in endometrial cancer.","authors":"Tao Xing, Jianliu Wang","doi":"10.21147/j.issn.1000-9604.2026.03.06","DOIUrl":"10.21147/j.issn.1000-9604.2026.03.06","url":null,"abstract":"","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":"38 3","pages":"304-306"},"PeriodicalIF":6.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updates of CSCO guidelines for colorectal cancer version 2026.","authors":"Xian Zhong, Jinyi Chen, Yan Zhang, Hanguang Hu, Shanshan Weng, Suzhan Zhang, Ying Yuan","doi":"10.21147/j.issn.1000-9604.2026.03.10","DOIUrl":"10.21147/j.issn.1000-9604.2026.03.10","url":null,"abstract":"","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":"38 3","pages":"329-335"},"PeriodicalIF":6.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early prediction of synergistic cardiotoxicity induced by PD-1 inhibitors and doxorubicin using cardiac ¹⁸F-FDG PET/MRI.","authors":"Yuqi Cai, Tingting Yuan, Xiaoxia Xu, Yang Sun, Xuetao Chen, Maomao Wei, Yichen Wu, Hua Zhu, Zhi Yang, Xuejuan Wang","doi":"10.21147/j.issn.1000-9604.2026.03.14","DOIUrl":"10.21147/j.issn.1000-9604.2026.03.14","url":null,"abstract":"<p><strong>Objective: </strong>Early detection of synergistic cardiotoxicity induced by sequential anthracycline and programmed cell death protein 1 (PD-1) inhibitor therapy remains challenging because conventional assessments identify late-stage functional impairment. This study aimed to determine the sensitive imaging probe for early therapy-associated cardiotoxicity and validate findings using integrated positron emission tomography/magnetic resonance imaging (PET/MRI).</p><p><strong>Methods: </strong>Cardiotoxicity was assessed in mouse models treated with PD-1 inhibitor or sequential doxorubicin (DOX) and PD-1 inhibitor therapy. Serial biodistribution analyses of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG), ¹⁸F-fibroblast activation protein inhibitor (¹⁸F-FAPI), ^99mTc-methoxyisobutylisonitrile (^99mTc-MIBI), and ¹¹C-acetate were performed. Histopathological evaluation assessed inflammation, mitochondrial injury, and fibrosis. Findings were validated in a prospective lymphoma cohort receiving sequential anthracycline and PD-1 inhibitor therapy using integrated ¹⁸F-FDG PET/MRI. Myocardial maximum standardized uptake value (SUV_max), strain parameters, tissue mapping indices, and electrocardiographic (ECG) changes were analyzed.</p><p><strong>Results: </strong>Sequential DOX and PD-1 inhibitor therapy induced an early increase in myocardial ¹⁸F-FDG uptake in mice before preceding systolic dysfunction. Histopathological examination confirmed inflammatory cell infiltration and mitochondrial swelling without extracellular matrix remodeling. In contrast, uptake of ¹⁸F-FAPI, ^99mTc-MIBI, and ¹¹C-acetate remained unchanged. In patients with lymphoma, myocardial SUV_max was significantly higher in patients with ECG abnormalities [ECG(+)] than in those without ECG abnormalities [ECG(-)], whereas global longitudinal strain, global radial strain, and global circumferential strain were significantly reduced (all P<0.05). After the third PD-1 cycle, myocardial SUV_max remained elevated in ECG(+) patients, whereas strain parameters declined after 5-6 cycles, suggesting that metabolic alterations precede functional impairment. SUV_{max_heart} demonstrated the highest diagnostic accuracy for cardiotoxicity [cutoff=3.0; area under the curve (AUC)=0.873; sensitivity=93.3%; specificity=80.0%].</p><p><strong>Conclusions: </strong>Cardiac ¹⁸F-FDG PET/MRI enables early detection of synergistic cardiotoxicity induced by DOX and PD-1 inhibitors before structural or functional deterioration occurs. SUV_{max_heart} may serve as an imaging biomarker for risk stratification and timely cardioprotective intervention.</p>","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":"38 3","pages":"347-364"},"PeriodicalIF":6.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking false-negative rate of sentinel node navigation surgery after non-curative endoscopic submucosal dissection: Insights from SENORITA 2 trial.","authors":"Zimeng Wang, Zhi Zheng, Jie Yin, Guangyong Chen, Jun Zhang, Peng Li, Zhongtao Zhang, Shutian Zhang","doi":"10.21147/j.issn.1000-9604.2026.03.13","DOIUrl":"10.21147/j.issn.1000-9604.2026.03.13","url":null,"abstract":"","PeriodicalId":9882,"journal":{"name":"Chinese Journal of Cancer Research","volume":"38 3","pages":"343-346"},"PeriodicalIF":6.7,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}