Malignant tumors seriously affect people's survival and prognosis. Exosomes, as vesicle structures widely existing in human tissues and body fluids, are involved in cell-to-cell transmission. Tumor-derived exosomes were secreted from tumors and involved in the development of carcinogenesis. Circular RNA (circRNA), a novel member of endogenous noncoding RNAs, is widespread in human and play a vital role in many physiological or pathological processes. Tumor-driven exosomal circRNAs are often involved in tumorigenesis and development including the proliferation, invasion, migration and chemo-or-radiotherapy sensitivity of tumor cell by multiple regulatory mechanisms. In this review, we will elaborate the roles and functions of tumor-driven exosomal circRNAs in cancers which may be used as potential cancer biomarkers and novel therapeutic targets.

Introduction The Pfannenstiel incision is often used in gynecological Cesarean section; however, there is limited research on the use of the Pfannenstiel incision for specimen extraction in laparoscopic surgery for the treatment of colorectal cancer. Aim To evaluate the safety of using the...

Background: Locally advanced gastric/gastroesophageal junction (G/GEJ) adenocarcinoma faces high recurrence risks despite radical surgery. Perioperative chemotherapy (e.g., FLOT regimen) improves survival but has limited pathological complete response (pCR) rates and significant toxicity. Immunotherapy and anti-angiogenic agents show promise in advanced G/GEJ cancer. This trial evaluates fruquintinib (a VEGFR-1/2/3 inhibitor), sintilimab (PD-1 inhibitor), and SOX (oxaliplatin+S-1) as perioperative therapy for resectable locally advanced G/GEJ adenocarcinoma.Methods: This prospective, single-arm, phase II trial (N = 25) enrolls treatment-naïve adults (18–75 years) with histologically confirmed, resectable cT3-4aN+M0 G/GEJ adenocarcinoma (AJCC 8th edition). Patients receive 3 cycles of neoadjuvant therapy:Fruquintinib:4 mg orally, days 1–14 (21-day cycle). S-1: 80–120 mg orally twice daily (based on BSA), days 1–14. Oxaliplatin: 130 mg/m² IV, day 1. Sintilimab: 200 mg IV, day 1.Radical gastrectomy with D2 lymphadenectomy follows 4–6 weeks post-neoadjuvant therapy. Adjuvant therapy (3 cycles of sintilimab for pCR patients; 3 cycles of preoperative regimen for non-pCR) starts 4–6 weeks post-surgery. Endpoints: Primary: pCR rate (ypT0/Tis ypN0 per CAP criteria). Secondary: R0 resection rate, major pathological response (MPR, ≤10% residual tumor), 2-year event-free survival (EFS), 2-year overall survival (OS), safety (NCI CTCAE v5.0). Exploratory: Biomarker analysis of tumor microenvironment. Statistical Analysis: Sample size (25 patients) was calculated using Fisher’s exact test (one-sided α = 0.05, power = 80%), assuming pCR improvement from 5% (historical control) to 20%. Efficacy analyses use intention-to-treat (ITT) population; safety analyses include patients receiving ≥1 neoadjuvant dose.Discussion: This is the first trial combining fruquintinib, sintilimab, and SOX in perioperative G/GEJ cancer. If successful, it may expand treatment options for locally advanced disease. Limitations include single-arm design and small sample size.Trial Registration: Chinese Clinical Trial Registry (ChiCTR2400084194)

Low temperature plasma (LTP), as an emerging cancer treatment technology, has shown significant therapeutic potential due to its unique physical and chemical properties and biological effects. This article reviews the basic characteristics of LTP and its multiple mechanisms of application in tumor treatment. LTP can induce various cell death modes, including apoptosis, pyroptosis, and autophagy, through its unique chemical and physical properties. Additionally, studies have demonstrated that the combination of LTP with traditional chemotherapy drugs (such as cisplatin and paclitaxel) can enhance the anti-tumor efficacy of the drugs while reducing drug resistance. The combined application of LTP and nanomaterials also shows promising prospects. However, LTP still faces some challenges and limitations in medical applications. Future research needs to further explore the specific applications of LTP in different tumor types, optimize treatment plans, and develop more portable and efficient LTP devices to promote its application in clinical treatment.

Background: Recent years have witnessed a proliferation of studies aimed at developing clinical models capable of predicting lymph node metastasis (LNM) in early gastric cancer (EGC), yet tools for prediction grounded in the Lauren classification remain scarce. Methods: Data of 6468 patients diagnosed with EGC from fifteen Chinese high-volume cancer centers between January 2005 and December 2015 were retrospectively analyzed. Utilizing multivariate logistic regression analysis and the multilayer perceptron (MLP) prediction algorithm, a nomogram and an artificial neural network (ANN) model were developed and validated, respectively, for predicting the likelihood of LNM in non-intestinal EGC cases. The models’ performances were evaluated and a comparative analysis of their parameters was undertaken. Subsequently, in-depth risk stratification analyses were performed around the two models. Results: Non-intestinal type EGC demonstrated an elevated LNM rate and inferior prognosis compared to the intestinal type. Both nomogram and ANN model were developed and performed well in discrimination, calibration and clinical utility. Notably, the ANN model surpassed the nomogram in specificity (95.8% vs. 71.3%, P < 0.001), positive predictive value (PPV) (62.0% vs. 36.2%, P < 0.001) and overall accuracy (82.7% vs. 70.5%, P < 0.001). Patients with different risk strata derived from the nomogram, ANN model, and their combined application exhibited significantly different outcomes. The extent of lymph node dissection significantly influenced prognoses in high-risk patients identified by the combined model, whereas the anatomical location of metastatic lymph nodes did not. Conclusion: The ANN model established in this study can screen the patients at high risk of LNM in non-intestinal type EGC more accurately. Considering the high extragastric LNM rate observed in the high-risk stratum, radical gastrectomy combined with D2 lymph node dissection is strongly recommended.

Introduction Natural orifice specimen extraction (NOSE) laparoscopic surgery is emerging as a new and promising technique, especially in gastric cancer (GC). Aim To analyze the difference between transvaginal and transumbilical specimen extraction following totally laparoscopic gastrectomy...