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Review Article Open Access
Yiwei Chen, Dayi Pan, Neil Roberts, Bomeng Du, Mingzhu Zheng, Zhilin Qian, Shangwen Jin, Jixia Wei, Fang Wan, Bensheng Qiu, Yaying Li
Published online December 30, 2025
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Future Integrative Medicine. doi:10.14218/FIM.2025.00025
Abstract
Ovarian cancer (OC) is a major global health problem. The main treatments are surgery and chemoradiotherapy. A drawback of the latter is that repeated treatments are likely to lead [...] Read more.

Ovarian cancer (OC) is a major global health problem. The main treatments are surgery and chemoradiotherapy. A drawback of the latter is that repeated treatments are likely to lead to cancer cells developing resistance to the drug, resulting in recurrence, development of metastases, and poor prognosis for patients. Consequently, there is interest in combining chemoradiotherapy with treatment using active components extracted from natural products. One such component is resveratrol (RVT), which is a natural anti-tumor ingredient extracted from plants. Although there are many reviews on the biological activity of RVT, only a few studies have been performed to investigate the diversity of protein binding of RVT with OC and the application of various novel drug formulations containing RVT to treat OC. The review presented here may provide some ideas for the prevention and treatment of OC.

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Original Article Open Access
Zachary Coty-Fattal, David Escobar, Juehua Gao, Jessica Nguyen, Jennifer Ju, Lawrence Jennings, Guang-Yu Yang
Published online December 30, 2025
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Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2025.00035
Abstract
DNA polymerase epsilon catalytic subunit A (POLE) gene plays a crucial role in DNA repair and chromosomal replication. Mutations in the POLE gene have been linked to cancer, particularly [...] Read more.

DNA polymerase epsilon catalytic subunit A (POLE) gene plays a crucial role in DNA repair and chromosomal replication. Mutations in the POLE gene have been linked to cancer, particularly colorectal carcinoma (CRC). However, the genomic landscape and pathological significance of POLE mutant CRC remain underreported. This study aimed to characterize the clinicopathologic features and genomic landscape of CRC harboring POLE mutations and to investigate the implications of co-occurring genetic alterations.

We identified thirty-four CRC cases with POLE mutations from our institution’s database using the next-generation sequencing gene panels including 161-gene panel for the cases of 2016–2021 and the 505-gene panel for the case of 2022–2023. We collected clinicopathologic data (age, sex, tumor site, and grading) and conducted comprehensive next-generation sequencing. Survival outcomes were assessed by reviewing patients’ medical records at the time of data collection, with survival status determined based on the most recent clinical follow-up available with overall survival as the primary endpoint and a median follow-up time of 20.5 months. Statistical analyses, including chi-squared testing and CoMutation plotting, were performed using Python.

The enrolled 34 patients had a median age of 60.5 years (range: 37–84); tumors were in the colon (26 cases, 77%) and rectum (8 cases, 23%), with a mismatch repair deficiency rate of 29%. Next-generation sequencing analysis of a 505-gene panel revealed that POLE mutations were predominantly missense (89%). The mutations were distributed across various domains: 11.4% in the exonuclease domain, 25.7% in the catalytic domain, 20% in an unknown functional domain, and 42.9% in a nonfunctional domain. The average number of genomic mutations per case was 12.1 ± 12.3. CoMutation analysis identified two subsets: genomic mutation high (>5 mutations, range 6–60 mutations, n = 22) and mutation low (. Notably, TP53 mutations occurred in 55% of cases, and defects in double-stranded DNA repair proteins occurred in 47% of cases. POLE mutant CRC with co-occurring DNA repair mutations exhibited a significantly higher total number of genomic mutations (19.9 ± 14.4, range 7–60 mutations; chi-squared = 5.1, p-value = 0.02). Although a survival comparison between TP53 wild-type and TP53 mutant subgroups of POLE-mutant CRC is not statistical significant (p = 0.37), it showed a trend toward better survival in the TP53 wild-type group.

Our findings reveal unique genomic landscapes in POLE mutant CRC, particularly with co-occurring TP53 or double-stranded DNA repair mutations, which are critical in colorectal carcinogenesis. These tumors demonstrate increased genetic instability, highlighting potential for immunotherapy.

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Consensus Open Access
Pancreatic Disease Collaborative Group, Chinese Society of Digestive Endoscopy
Published online May 27, 2026
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Cancer Screening and Prevention. doi:10.14218/CSP.2026.00004
Abstract
Pancreatic cancer remains a highly lethal malignancy owing to the difficulty of early detection. In 2021, the Chinese Consensus on Early Screening and Surveillance for Pancreatic [...] Read more.

Pancreatic cancer remains a highly lethal malignancy owing to the difficulty of early detection. In 2021, the Chinese Consensus on Early Screening and Surveillance for Pancreatic Cancer in High-risk Individuals was first established. However, the evidence landscape has evolved rapidly, necessitating an updated, evidence-based framework tailored to the Chinese healthcare context. This revised consensus aims to standardize the early screening and surveillance process for high-risk populations in China. A multidisciplinary expert panel comprising 53 specialists from 17 provincial-level regions systematically reviewed the literature using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. A modified Delphi process was employed, with consensus predefined as ≥75% agreement. The panel formulated 26 evidence-based recommendations covering screening objectives, the definition of high-risk populations (hereditary susceptibility, new-onset diabetes, chronic pancreatitis, and pancreatic cystic neoplasms), age at screening initiation, surveillance intervals, imaging modalities (magnetic resonance imaging/magnetic resonance cholangiopancreatography, endoscopic ultrasound, computed tomography), surgical indications, and lifestyle modifications. Of these recommendations, 14 are strong and 12 are weak, supported by evidence levels ranging from A to D. Implementation of this consensus in clinical practice will help improve the early diagnosis of stage I pancreatic cancer and high-grade precursor lesions, thereby advancing standardized multidisciplinary care and ultimately improving patient outcomes in China.

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Review Article Open Access
Yan Hu, Alan Zhu, Robert Wesolowski, Maryam Tahir, Gary Tozbikian, Anil V. Parwani, Ziyu Su, Khalid Niazi, Zaibo Li
Published online May 20, 2026
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Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2026.00007
Abstract
Artificial intelligence (AI) is increasingly reshaping diagnostic pathology, with breast pathology representing one of the most advanced and clinically impactful areas of adoption. [...] Read more.

Artificial intelligence (AI) is increasingly reshaping diagnostic pathology, with breast pathology representing one of the most advanced and clinically impactful areas of adoption. Despite rapid progress, many practicing pathologists remain unfamiliar with core AI concepts and their practical implications. This review provides a concise and accessible overview of AI in breast pathology, focusing on foundational principles, current clinical applications, and future directions.

Pertinent literature was reviewed. Personal experiences were also summarized and incorporated.

Key AI concepts, including algorithms, models, architectures, machine learning, deep learning, neural networks, and multimodal and foundational models, are introduced to establish a common framework. Important distinctions among generative, black-box, and explainable AI are highlighted, emphasizing the need for transparency and interpretability in clinical settings. The evolution of AI in breast pathology is reviewed, from early rule-based computer-assisted diagnostic systems to modern deep learning approaches leveraging large-scale whole-slide imaging datasets. Current applications span multiple domains, including detection of lymph node metastases, Nottingham grading, classification of benign and malignant lesions, and automated quantification of critical biomarkers. AI-based approaches to prognosis, risk stratification, prediction of treatment response, and analysis of the tumor microenvironment are also discussed. Finally, the review addresses challenges associated with real-world implementation, including data quality, bias, regulatory considerations, cost, infrastructure, and workflow integration.

As AI continues to evolve toward large-scale, multimodal, and explainable models, it is expected to function as an augmentative tool rather than a replacement for pathologists, supporting diagnostic accuracy, standardization, and personalized management in breast cancer care.

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Original Article Open Access
Renaud Nonmarmbaye, Alcherif Hamid Mahamat, Sidiki Neteydji, Fadoul Mahamat Fadoul, Touo’yem Nkemmo Willy Stéphane, Elisabeth Ngo Bum
Published online September 1, 2025
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Journal of Exploratory Research in Pharmacology. doi:10.14218/JERP.2024.00039
Abstract
Sclerocarya birrea (A. Rich) Hochst (Anacardiaceae) is a plant widely used by traditional healers in several African countries to treat numerous illnesses such as Alzheimer’s disease, [...] Read more.

Sclerocarya birrea (A. Rich) Hochst (Anacardiaceae) is a plant widely used by traditional healers in several African countries to treat numerous illnesses such as Alzheimer’s disease, schizophrenia, inflammation, infections, arterial hypertension, headaches, and others. This study aimed to determine the therapeutic efficacy of Sclerocarya birrea (S. birrea) against glutamate-induced neurotoxicity.

Thirty naïve white mice (Mus musculus Swiss, Muridae), of both genders and weighing between 18 and 25 g, were used in the experiments. Different doses (102.5, 205, and 410 mg/kg) of the extract and vitamin C (100 mg/kg) were administered to the animals one hour before administration of monosodium glutamate (4 mg/kg) for 15 consecutive days. T-maze and Y-maze tests were conducted over three days to assess the animals’ behavioral performance. After behavioral testing, the animals were sacrificed and their brains removed for analysis of oxidative stress parameters.

S. birrea extract reversed glutamate-induced behavioral alterations by significantly (P < 0.001) reducing the latency to reach the platform in the T-maze and significantly increasing the percentage of spontaneous alternation in the Y-maze. The extract also significantly counteracted (P < 0.001) glutamate-induced oxidative stress parameters. The 102.5 and 205 mg/kg doses of the extract significantly (P < 0.001) reduced catalase and reduced glutathione levels, as well as the increase in malondialdehyde levels induced by glutamate.

S. birrea root bark extract exhibits neuroprotective properties that facilitate memory and ameliorate glutamate-induced cognitive deficits in white mice. The results provide partial justification for the traditional medicinal use of S. birrea extract.

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Case Report Open Access
Lan Zheng, Shimin Hu, Bogdan Czerniak, Charles C. Guo
Published online March 20, 2026
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Journal of Clinical and Translational Pathology. doi:10.14218/JCTP.2025.00053
Abstract
Mediastinal germ cell tumors (GCTs) are rare malignant neoplasms that occasionally develop somatic-type malignancies (SMs), such as sarcomas, carcinomas, and hematologic malignancies. We [...] Read more.

Mediastinal germ cell tumors (GCTs) are rare malignant neoplasms that occasionally develop somatic-type malignancies (SMs), such as sarcomas, carcinomas, and hematologic malignancies.

We report a unique case of a 16-year-old male patient with a mediastinal GCT that simultaneously developed two different SMs: well-differentiated angiosarcoma and acute megakaryoblastic leukemia (AML). The patient initially presented with left shoulder pain and intermittent shortness of breath. The imaging study demonstrated a 12.5 × 9.0 × 8.5 cm heterogeneous mass in the left anterior mediastinum. The mediastinal mass was resected and showed a cystic mature teratoma with somatic transformation into well-differentiated angiosarcoma and AML. A subsequent bone marrow biopsy confirmed the diagnosis of AML, and next-generation sequencing demonstrated the presence of PTEN and TP53 gene mutations in the AML. Despite aggressive chemotherapy and allogeneic stem cell transplantation, the patient died 10 months after diagnosis.

Our report demonstrates the unique capability of mediastinal GCTs to simultaneously develop two different SMs. The presence of two different SMs in mediastinal GCTs is associated with extremely aggressive behavior and a poor prognosis.

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Review Article Open Access
Yuan Gao, Yunyi Gao, Dong Ji, Zhongjie Hu
Published online January 22, 2026
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2025.00465
Abstract
Cirrhotic ascites develops when portal hypertension and arterial under-filling chronically activate neuro-hormonal pathways that drive renal sodium-water retention. Augmented proximal [...] Read more.

Cirrhotic ascites develops when portal hypertension and arterial under-filling chronically activate neuro-hormonal pathways that drive renal sodium-water retention. Augmented proximal tubular sodium reabsorption, predominantly mediated by the apical sodium/hydrogen exchanger 3 (NHE3), plays a fundamental role in this process. Given the spatial coupling of NHE3 and the sodium-glucose cotransporter 2 (SGLT2), selective SGLT2 inhibition reduces NHE3 activity via functional suppression within the apical microdomain. The increased sodium chloride delivery to the macula densa augments tubuloglomerular feedback and modulates the renin–angiotensin–aldosterone system. Early clinical investigations, ranging from case reports and retrospective analyses to pilot randomized trials, indicated potential benefits in controlling ascites and reducing decompensation events. However, their limited sample size, heterogeneous endpoints, and predominantly observational design constrain the generalizability of the findings. This review concentrates on the molecular mechanisms and emerging clinical evidence supporting the therapeutic potential of SGLT2 inhibitors in the management of cirrhotic ascites.

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Original Article Open Access
Evgeniya Saidakova, Larisa Korolevskaya, Violetta Vlasova
Published online January 13, 2026
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Gene Expression. doi:10.14218/GE.2025.00065
Abstract
Human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfection leads to severe systemic inflammation, increasing non-AIDS morbidity and mortality risk. CD39 ectoenzyme on [...] Read more.

Human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfection leads to severe systemic inflammation, increasing non-AIDS morbidity and mortality risk. CD39 ectoenzyme on T-cells, which catalyzes the conversion of pro-inflammatory purines to immunosuppressive adenosine, plays an important role in inflammation control. The role of CD39+ T-cells in systemic inflammation during HIV/HCV coinfection under antiretroviral therapy (ART) remains unexplored. This study aimed to identify specific patterns of CD39 expression on T-cells in ART-treated HIV/HCV coinfected patients and assess their relationship with systemic inflammation.

We conducted a case-control study that enrolled 41 HIV/HCV coinfected patients on stable ART (cases) and 23 healthy controls. CD39 expression on blood CD4+ and CD8+ T-cells, including CD45RA+ and CD45RA– subsets, was quantified using flow cytometry. Cytokines were assessed using multiplex and enzyme-linked immunosorbent assays.

A significant proportion of CD4+ T-cells expressed CD39 in both groups (cases – 24.0%; controls – 16.1%). That was not true for CD8+ T-cells (cases – 3.2%; controls – 2.8%). CD39 expression was higher on CD45RA+ than CD45RA– CD4+ T-cells (cases – 39.4% vs. 19.0%; controls – 24.6% vs. 9.2%). HIV/HCV coinfected patients exhibited a significantly increased proportion of CD39+ CD4+ T-cells compared to uninfected controls (P < 0.01). A negative correlation was observed between the percentage of CD39+ CD4+ CD45RA– T-cells and levels of pro-inflammatory chemokines monocyte chemoattractant protein 1 (R = –0.392; P < 0.01) and eotaxin (R = –0.325; P < 0.05).

The data suggest a compensatory expansion of cells with regulatory properties that is ultimately insufficient to control systemic immune activation.

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Review Article Open Access
Swarup K. Chakrabarti, Dhrubajyoti Chattopadhyay
Published online January 28, 2026
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Exploratory Research and Hypothesis in Medicine. doi:10.14218/ERHM.2025.00042
Abstract
Gliomas remain a major challenge in brain cancer treatment. Although genetic mutations have been widely studied, recent research indicates that epigenetic changes, which alter gene [...] Read more.

Gliomas remain a major challenge in brain cancer treatment. Although genetic mutations have been widely studied, recent research indicates that epigenetic changes, which alter gene activity without changing the DNA sequence, also contribute significantly to tumor growth and treatment resistance. This review seeks to elucidate the principal drivers and modulators of brain tumor development, emphasizing the complex interaction between tumor metabolism and epigenetic regulation. It highlights how metabolic intermediates influence chromatin structure and transcriptional events driving glioma progression. Metabolic intermediates, such as acetyl-CoA and S-adenosylmethionine, serve as essential epigenetic cofactors, directly impacting chromatin structure and gene expression. Additionally, metabolic disorders like diabetes not only frequently coexist with gliomas but also exacerbate tumor progression through mechanisms such as inflammation, oxidative stress, and epigenetic reprogramming. Tumors located near brain regions controlling heart function may also increase the risk of sudden death, particularly in diabetic patients. The review proposes a comprehensive framework to understand glioma development by linking metabolism, epigenetics, and overall health. This integrated perspective leads to novel personalized treatment approaches, targeting both the tumor and the patient’s broader metabolic health, with the potential to improve survival rates and quality of life for glioma patients.

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Review Article Open Access
Moana Da Silva Santiago, George Y. Wu
Published online April 27, 2026
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Journal of Clinical and Translational Hepatology. doi:10.14218/JCTH.2026.00043
Abstract
Alpha-1 antitrypsin deficiency (AATD) is an autosomal codominant genetic disorder caused by mutations in the SERPINA1 gene. It results in reduced circulating levels of alpha-1 antitrypsin [...] Read more.

Alpha-1 antitrypsin deficiency (AATD) is an autosomal codominant genetic disorder caused by mutations in the SERPINA1 gene. It results in reduced circulating levels of alpha-1 antitrypsin (AAT), a serine proteinase inhibitor (PI) primarily produced by hepatocytes. The most common deficient alleles are PI*S and PI*Z, with PI*ZZ homozygotes having the most severe deficiency and highest risk for lung and liver disease. While AATD is well established as a cause of early-onset emphysema and liver cirrhosis, emerging evidence suggests a potential association with the formation of arterial aneurysms. The pathophysiological rationale for this association centers on protease-antiprotease imbalance and potential extracellular matrix degradation of elastin in arterial vessel walls. Several studies have reported increased frequencies of AATD alleles in patients with abdominal aortic aneurysms and intracranial aneurysms compared to the general population, with some demonstrating statistically significant associations. Additionally, patients with the PI*ZZ genotype have been shown to have larger aortic diameters, greater aortic stiffness, and reduced distensibility compared to controls. However, the evidence is inconsistent, as several large studies have failed to demonstrate significant associations between AATD and aneurysm formation. Overall, current evidence suggests an association of AATD with the development of arterial aneurysms. However, it is also clear that the presence of AATD alone is not sufficient to increase the risk of developing new-onset arterial aneurysms.

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