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Open Access Expert Review Issue
Neurological regulation of tumors: An interdisciplinary frontier from circuit mechanisms to targeted intervention
Journal of Army Medical University 2026, 48(6): 663-669
Published: 30 March 2026
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Traditional oncology research has long focused on genetic, immunological, and vascular mechanisms. In recent years, with the deepening interdisciplinary convergence, “cancer neuroscience” has rapidly emerged as a cutting-edge field for deciphering the mechanisms of tumor initiation and progression. In this article, we systematically review the research trajectory of neural-tumor interactions: from the early observations of neural infiltration within tumors to recent breakthroughs revealing that the nervous system actively regulates tumor processes through multiple mechanisms. In intracranial tumors, glioma cells can form functional synapses with neurons, "hijacking" neural signals such as glutamate to drive their own proliferation. In peripheral solid tumors, specific brain circuits (e. g., the amygdala-sympathetic nerve pathway) can remotely regulate the progression of cancers such as breast cancer; meanwhile, sympathetic, parasympathetic, and sensory nerves directly act on tumor cells or reshape the immune microenvironment through releasing neurotransmitters and neuropeptides, such as norepinephrine, acetylcholine, and calcitonin gene-related peptide (CGRP), thereby influencing tumor evolution. These findings collectively constitute a "neuro-immune-tumor" regulatory axis, providing a novel perspective for understanding tumor biology. Building upon our group's previous work, we propose that the nervous system represents an indispensable and active component of the tumor microenvironment, extensively participating in tumor initiation, progression, metastasis, and immune regulation through multi-level mechanisms involving electrical signals, chemical neurotransmitters, and neural circuits. Targeting neural-tumor interactions (e. g., using β-blockers or modulating specific neural circuits) has already demonstrated significant translational potential for synergizing with existing therapies. Through integrating key advances in this field, we systematically elaborate the translational pathway from basic discoveries to clinical exploration, analyze current technical and clinical challenges, and prospect a forward-looking perspective on interdisciplinary collaboration and precision intervention, thereby, providing theoretical reference and framework for deepening the understanding of systemic tumor regulation and developing novel neuro-targeted therapeutic strategies.

Open Access Clinical Medicine Issue
A novel estrogen receptor expression stratification (low/moderate/high) based on Chinese population provides more accurate prognosis prediction for HR+/HER2- early breast cancer patients
Journal of Army Medical University 2025, 47(22): 2792-2804
Published: 30 November 2025
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Objective

To stratify the estrogen receptor (ER) positive while human epidermal growth factor receptor 2 (HER2) negative breast cancer patients by the expression level of ER, providing new evidence for prognostic prediction and guiding precision endocrine therapy (ET) for those with different ER expression levels.

Methods

A retrospective cohort study was conducted on 1962 ER-positive/HER2-negative breast cancer patients treated in our department from January 1, 2013 to December 31, 2018. X-tile was used to calculate the optimal cutoff point of ER expression level, and then based on the results, they were divided into low (1%~10%), moderate (11%~30%), and high expression (31%~100%) groups. After propensity score matching (PSM) was performed to balance baseline characteristics, their prognostic outcomes were compared and the responses to ET were analyzed in the groups. Cox proportional risk regression model was applied to analyze the prognostic factors, and subgroup analysis was further performed.

Results

After PAM, 129 (11.5%) were assigned into a low ER expression group, 151 (13.5%) and 840 (75%) into moderate and high ER expression groups, respectively. Statistical differences were observed in disease-free survival (DFS) and overall survival (OS) among the 3 groups (P=8e-6, P=8e-14). In the low ER expression group, the patients treated with selective estrogen receptor modulators (SERMs) showed no significant differences in DFS and OS than those treated with aromatase inhibitors (AIs) (P>0.05). However, the patients from the moderate and high ER expression groups demonstrated significantly better DFS when treated with AI than with SERM (P=0.02, P=0.03). Multivariate analysis showed that compared with the moderate ER expression group, the high ER expression group exhibited significantly lower risk of disease recurrence/metastasis (HR=0.62, 95%CI: 0.43~0.88, P=0.009) and risk of death (HR=0.49, 95%CI: 0.26~0.93, P=0.03). Subgroup analysis revealed that when compared with the high ER expression group, the moderate ER expression group exhibited notably worse DFS in the following subgroups: oral SERM, non-breast-conserving surgery, lymph node metastasis, TNM stage Ⅱ, and chemotherapy, and shorter OS in the subgroups of oral SERM, non-breast-conserving surgery, lymph node metastasis, TNM stage Ⅱ subgroup, and chemotherapy.

Conclusion

Taking ER expression of 11%~30% as an independent stratification criterion can guide more accurate prognostic assessment and more rational ET selection in ER-positive/HER2-negative breast cancer patients.

Open Access Review Article Issue
Landscape of metabolic alterations and treatment strategies in breast cancer
Genes & Diseases 2025, 12(5): 101521
Published: 08 January 2025
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Breast cancer, the most prevalent cancer in women, poses a significant threat to their health. One of the prominent characteristics of malignant transformation in breast cancer cells is metabolic reprogramming, which encompasses glucose, lipid, and amino acid metabolism. Notably, breast cancer cells exhibit augmented energy metabolism and heightened glycolysis. In addition, there is an escalated demand for glutamine, which is met through intrinsic synthesis, uptake from extracellular sources via membrane transport proteins, or up-regulation of key metabolic enzymes in the glutamine metabolism pathway. Lipids not only serve as an energy source for tumor cells but also function as signaling molecules for intercellular communication. Extensive research in recent years has focused on unraveling the intricate mechanisms underlying metabolic reprogramming. Consequently, genes implicated in these processes have emerged as clinical therapeutic targets for cancer treatment. This review provides a comprehensive summary of the common metabolic alterations observed in cancer cells, discusses the factors and regulatory mechanisms influencing these changes, and explores potential therapeutic targets and strategies within the realm of cancer metabolism.

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