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The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors

  • Zongyu Li , Li Yang , Yan Zhu , Shengli Ye , Xin Fang and Qiuping Xu EMAIL logo
Published/Copyright: August 4, 2025
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Open Medicine
From the journal Open Medicine Volume 20 Issue 1

Abstract

Aim

To discover the predictive indicators of the risk of interstitial lung disease (ILD) after treatment of malignant tumors from myositis-specific autoantibodies (MSA) and myositis-associated autoantibodies (MAA) and explore possible predictive value and significance.

Methods

A total of 73 patients hospitalized in the Shulan (Hangzhou) Hospital from January 2020 to March 2021 were screened retrospectively, they all completed the MSA and MAA, and the imaging was consistent with changes in ILD. We analyzed the characteristics of MSA and MAA in tumor patients and non-tumor patients, and the characteristics of MSA and MAA positive in patients with ILD after treatment.

Results

A total of 58 patients with ILD were diagnosed, 19 patients (32.76%) with malignant tumors, 16 patients with positive MSA or MAA (84.21%), of which 10 (50%) patients had anti-RO-52 antibodies. After treatment, 12 cases (46.15%) developed ILD and 10 cases (90.91%) had a positive spectrum of specific inflammatory diseases.

Conclusion

The MSA and MAA may have a predictive effect on people who are prone to ILD during the treatment of malignant tumors, and the anti-RO-52 antibody may be an important predictive antibody index.

Graphical abstract

Keywords: malignant tumors; anti-RO-52; interstitial lung disease; predictive

1 Introduction

Malignant tumors have now become one of the main public health problems that seriously threaten the health of the Chinese population. According to the latest statistics in 2015, deaths from malignant tumors accounted for 23.91% of all deaths among residents. The mortality rate is second only to heart disease. The current main treatments for tumors are chemotherapy, radiotherapy, targeted therapy, and immunotherapy. It should not be overlooked that during the treatment process with immunosuppressive agents, interstitial lung disease (ILD) has been confirmed as a rare but potentially serious event. Especially for drugs targeting the PD-1/PD-L1 axis, there are even some fatal pneumonia cases [1,2]. At the same time, the occurrence or acute progression of ILD has also been observed in other treatment options for tumors.

ILD is based on diffuse lung parenchyma, alveolar inflammation, and interstitial fibrosis, with active dyspnea as the clinical manifestation. There are many causes of ILD, and currently known causes include environmental factors, pulmonary toxicity drugs, occupational exposure, radiation therapy, and systemic diseases (such as connective tissue diseases, etc.) [3,4]. With the continuous development of cancer treatment methods, tumor-related ILD has gradually become a clinical focus, especially the ILD induced during the treatment of cancer patients. There is an urgent need to further explore its pathogenesis and predictive biomarkers.

In clinical practice, serum myositis-specific autoantibodies (MSA) and myositis-associated autoantibodies (MAA) are widely recognized and used. Each antibody is associated with different clinical phenotypes and outcomes [5–8]. Especially in inflammatory diseases such as myositis, the clinical significance of MSA and MAA has been extensively studied. MSA and MAA are closely related to the immune profile of myositis and provide important clues for the diagnosis, prognosis, and treatment of the disease. In adolescent myositis patients with ILD, those who were positive for anti-Ro-52 antibodies typically experienced a chronic and persistent course, with fewer instances of a single episode. These patients had a longer treatment duration and were more prone to relapse [9]. Additionally, a study evaluating patients with anti-MDA5 antibody-positive, non-myopathic dermatomyositis complicated by pulmonary interstitial disease found that anti-RO-52 antibodies were significantly associated with rapidly progressive ILD and the development of skin ulcers. It was suggested that these patients may have a poor response to conventional immunosuppressive treatment, leading to increased mortality [10]. However, there is no clear report regarding the use of these specific antibody profiles to predict the occurrence of ILD in cancer patients, particularly acute ILD after cancer treatment. To explore the potential role of MSA and MAA in tumor-related ILD, we retrospectively collected data from all patients who underwent MSA or MAA testing (16 items) at the Department of Respiratory and Critical Care Medicine of Shulan (Hangzhou) Hospital between January 1, 2020 and March 1, 2021, and conducted a retrospective analysis. By observing the relationship between MSA or MAA and the occurrence of ILD in cancer patients, particularly the association with ILD after cancer treatment, this study aimed to reveal the clinical value of MSA and MAA as potential biomarkers and further explore their role in reducing the occurrence of ILD in cancer patients.

2 Materials and methods

2.1 Study design and participants

We conducted a retrospective analysis of all patient records from the Department of Respiratory and Critical Care Medicine of Shulan (Hangzhou) Hospital between January 1, 2020 and March 1, 2021. The inclusion criteria were as follows: (1) imaging findings consistent with ILD changes, including grid shadow, honeycomb sign, ground glass shadow with traction bronchiectasis, peripheral or bronchial consolidation ground glass shadow, distribution around lobules, central lobular nodules with unclear borders, and subpleural line shadows; (2) completion of comprehensive MSA and MAA testing (referred to as the myositis panel), including anti-JO-1 antibodies, anti-PL-7 antibodies, anti-PL-12 antibodies, anti-EJ antibodies, anti-OJ antibodies, anti-SRPα antibodies, anti-HMGCR antibodies, anti-cN-1A antibodies, anti-Mi-2 antibodies, anti-Mi-2α antibodies, anti-Mi-2β antibodies, anti-NXP-2 antibodies, anti-SAE antibodies, anti-TIF1-Y antibodies, anti-MDA5 antibodies, anti-Ku antibodies, anti-PM-Scl100 antibodies, anti-PM-Scl75 antibodies, anti-Ro-52 antibodies, and anti-U1-nRNP antibodies; and (3) patients aged over 18 years. The exclusion criteria were (1) patients with lung involvement due to drug or environmental exposure history, (2) pregnant or breastfeeding women, and (3) patients lacking relevant clinical data. A total of 773 patients were included in the final analysis.

2.2 Diagnostic criteria

Once all selected patients had changes in ILD found on chest imaging, based on the patient’s medical history, physical examination, laboratory tests, and high-resolution CT (HRCT) scans, the patients were divided into ILD and non-ILD. Then, based on imaging, ILD patients were divided into two categories: usual interstitial pneumonia (UIP) and non-UIP. All patient data and imaging were reviewed by clinical experts and imaging experts with experience in ILD in our hospital. Idiopathic interstitial pneumonia (IIP) diagnostic criteria referred to the classification opinions and diagnostic criteria of IIPs published by the American Thoracic Society and European Respiratory Society in 2013 [11].

2.3 Data collection

Data from all patients were collected through the hospital’s electronic medical record system, covering the period from January 1, 2020 to March 1, 2021. We collected basic information, including gender, age, history, time of onset (from the onset of symptoms to diagnosis), tumor type, and imaging typing; 22 items of autoantibodies, anti-myeloperoxidase antibodies (MPO), antiproteinase 3 antibody (PR3), anti-streptolysin O (ASO), anti-cyclic citrullinated peptide antibody (CCP), C-reactive protein (CRP), rheumatoid factor (RF), sialic sugar chain antigen KL-6 detection (KL-6), erythrocyte sedimentation rate (ESR), myositis spectrum, and other serologic tests; as well as imaging assessments, including chest X-ray, CT, and HRCT.

The rheumatic and autoimmune diseases addressed in this study include: dermatomyositis, characterized by skin damage and muscle weakness, with classification criteria based on recent research [12]; rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease primarily affecting the joints and may also involve other organs, and relevant classification criteria for RA can be found in pertinent reports [13]; systemic sclerosis is defined by fibrosis of the skin and internal organs, with clearly established diagnostic criteria [14]; Sjögren’s syndrome primarily manifests as dry eyes and dry mouth, potentially accompanied by other systemic symptoms, with classification standards derived from the latest reports [15].

2.4 Detection method of idiopathic inflammatory myopathy spectrum antibody

Serum from all patients was sent to the Hangzhou European Union Medical Laboratory for testing, using the anti-myositis antibody profile 4 IgG detection kit (EUROLine western blot assay) and EUROBlotMaster II fully automatic immunoblotting and interpretation system for testing. Operation steps: After centrifugation, 15 μL of the test serum was diluted and mixed with 1.5 mL of sample buffer. The test strip, with the numbered side facing up, was placed into the incubation trough. Each trough was filled with 1.5 mL of sample buffer and incubated for 5 minutes. The buffer was then removed, and the diluted serum samples were added to the troughs and incubated on a shaker for 30 minutes. Next, 1.5 mL of wash buffer was used to wash the strips three times, each for 5 minutes. Then, 1.5 mL of alkaline phosphatase-labeled anti-human IgG was added and incubated on a shaker for 30 minutes, followed by another round of washing using wash buffer. Subsequently, 1.5 mL of substrate solution was added to each trough for color development for 10 minutes. The strips were then rinsed three times with distilled water, each for 1 minute. Finally, the test strips were placed on the interpretation template and allowed to air dry. The results were evaluated using EUROLineScan software.

2.5 Statistical methods

SPSS 26.0 software was used for statistical analysis. Normally distributed continuous data were expressed as mean ± standard deviation, and a t-test was used for comparison between groups. Non-normally distributed continuous data were expressed as median (range), and the Mann–Whitney U-test was used for comparison between groups. Categorical data are expressed as n (%), with group comparisons made using the Chi-square test.

  1. Ethics approval: This study is approved by the Ethics Committee of Shulan (Hangzhou) Hospital (Reference Number: KY2023051).

3 Results

3.1 General conditions of all selected patients

We analyzed 73 patients, including 35 males (47.95%) and 38 females (52.05%). Among them, 58 patients were diagnosed with ILD.

3.2 Analysis of the general conditions of patients diagnosed with ILD

Among the 58 patients diagnosed with ILD, 19 were identified as malignant tumor cases (32.76%) and 39 were classified as non-tumor cases (67.24%). The cohort consisted of 31 male patients and 27 female patients. Imaging examinations revealed 28 cases (48.28%) of non-UIP and 30 cases (51.72%) of UIP. There was no statistically significant difference in the mean age and gender of the patients in both groups (Table 1). However, the prevalence of rheumatic immune diseases was significantly higher in non-tumor patients (P < 0.05), specifically including dermatomyositis (five cases), RA (two cases), scleroderma (one case), and Sjögren’s syndrome (one case). The tumor group had significantly higher levels of CRP compared to the non-tumor group (57.4 vs 17.6, P < 0.05).

Table 1

Baseline characteristics of the two groups of patients

Index characteristics of ILD Tumor patients (N = 19) Non-tumor patients (N = 39) P
Basic situation
Age 63.05 (34–88) 68.15 (48–92) 0.129
Gender, male (n, %) 12 (63.2) 19 (48.7) 0.309
Past history
Rheumatic immune disease (n, %) 0 (0) 9 (23.1) 0.023
Structural lung disease (n, %) 1 (5.3) 3 (7.7) 0.737
Diabetes (n, %) 5 (26.3) 8 (20.5) 0.662
Laboratory diagnosis
KL-6 1125.2 (361–3309) 1290.8 (232–4732) 0.535
ESR 52.7 (8–104) 41.3 (7–121) 0.211
CRP 57.4 (2.2–182.8) 17.6 (0.5–99.8) 0.001
MPO 6.7 (0.1–64.2) 17.2 (0.1–201.8) 0.403
PR3 20.2 (0.5–185.7) 10.2 (0.1–92.9) 0.379
CCP 4.4 (0.5–52.4) 8.2 (0.5–250) 0.717
ASO 48.8 (4.7–130.2) 40.5 (6.2–121) 0.437
RF 21 (3.2–76.8) 18.4 (2.7–194.9) 0.771
22 autoantibodies
Antinuclear antibody (n, %) 6/18 (33.3) 31/37 (83.8) 0.0001
Antineutrophil perinucleus antibody (n, %) 1/18 (5.6) 8/37 (21.6) 0.166
Anti-SSA antibody (n, %) 0/18 (0) 5/37 (13.5) 0.121
Anti-mitochondrial antibody type 2 antibody IgG (n, %) 1/18 (5.6) 1/37 (2.7) 0.56
Anti-ScL-70 antibody (n, %) 0/18 (0) 2/37 (5.4) 0.343
MSA and MAA
Anti-JO-1 antibody IgG (n, %) 2/19 (10.5) 2/39 (5.1) 0.472
Anti-MDA5 antibody IgG (n, %) 1/19 (5.26) 0/39 (0) 0.159
Anti-RO-52 antibody (n, %) 9/19 (47.4) 11/39 (28.2) 0.129
Anti-Mi-2α antibody IgG (n, %) 2/19 (10.5) 0/39 (0) 0.042
Anti-PL-7 antibody IgG (n, %) 1/19 (5.26) 7/39 (17.9) 0.184
Anti-NXP2 antibody IgG (n, %) 1/19 (5.26) 0/39 (0) 0.159
Anti-EJ antibody IgG (n, %) 1/19 (5.26) 2/39 (5.1) 0.983
Anti-Mi-2β antibody IgG (n, %) 1/19 (5.26) 2/39 (5.1) 0.983
Anti-SAE1 antibody IgG (n, %) 1/19 (5.26) 1/39 (2.56) 0.618
Anti-PM-Scl75 antibody IgG (n, %) 1/19 (5.26) 0/39 (0) 0.159
Anti-TIF1γ antibody IgG (n, %) 1/19 (5.26) 1/39 (2.56) 0.618
Anti-PL-12 antibody IgG (n, %) 0/19 (0) 2/39 (5.1) 0.317
Anti-PM-Scl100 antibody IgG (n, %) 0/19 (5.26) 3/39 (7.69) 0.215
Anti-SRP antibody IgG (n, %) 0/19 (0) 3/39 (7.69) 0.215
Anti-Ku antibody IgG (n, %) 0/19 (0) 1/39 (2.56) 0.484
Radiology
UIP (n, %) 8/19 (42.1) 22/39 (56.4) 0.315
Non-UIP (n, %) 11/19 (57.9) 17/39 (43.6) 0.315

We compared and analyzed the myositis spectrum in both groups of patients. Among them, anti-Mi-2α antibody IgG (2 vs 0, P < 0.05) was present only in cancer patients; however, due to the small sample size, this finding was not considered statistically significant. In other myositis spectrums, we observed the highest incidence of anti-RO-52 antibodies, totaling 20 cases. Among non-tumor and tumor patients, there were 11 (28.2%) and 9 (47.4%) cases, respectively. The results showed that anti-RO-52 antibodies were present in a higher percentage of cancer patients.

3.3 Situation of patients with tumors complicated by imaging changes in lung interstitial pneumonia

3.3.1 General characteristics of patients with tumors and ILD

To determine whether the occurrence of ILD in tumor patients is associated with a specific myositis spectrum, we re-analyzed the tumor patients, with results shown in Table 2. Among the 27 tumor patients, 19 had ILD and 8 had non-ILD. In the ILD group, there were 12 male and 7 female patients, with an age range of 63.1 (34–88) years. Six cases had UIP and 13 had non-UIP. Among the 27 tumor patients, lung cancer was the most common (twelve cases), followed by breast cancer (six cases) and colorectal cancer (three cases). ILD occurred in 15 of the tumor patients after treatment (53.37%), with 3 cases following radiotherapy, 4 cases each after surgery and immunotherapy, and 1 case each after targeted therapy, endocrine therapy, targeted combined chemotherapy, and radiotherapy combined chemotherapy. Except for gender, there were no statistically significant differences in the basic characteristics between the two groups (P > 0.05).

Table 2

Baseline characteristics of tumor patients

Characteristic Interstitial pneumonia (n = 19) Non-interstitial pneumonia (n = 8) P
Gender 0.033
Male 12 (63.16) 1 (12.50)
Female 7 (36.84) 7 (87.50)
Age 63.1 (34–88) 64.63 (47–82) 0.775
Tumor type 0.483
Lung cancer 9 (47.37) 3 (37.50)
Breast cancer 5 (26.32) 1 (12.50)
Colorectal cancer 1 (5.26) 2 (25.00)
Others 4 (21.05) 2 (25.00)
Stage 0.078
I–II 2 (10.53) 4 (50.00)
III–IV 10 (52.63) 3 (37.50)
Unknown 7 (36.84) 1 (12.50)
Treatment history before onset 0.152
None 4 (21.05) 1 (12.50)
Surgery 4 (21.05) 3 (37.50)
Chemotherapy 0 2 (25.00)
Radiotherapy 3 (15.79) 0
Targeted therapy 1 (5.26) 0
Immunotherapy 4 (21.05) 1 (12.50)
Endocrine therapy 1 (5.26) 0
Radiotherapy + chemotherapy 1 (5.26) 0
Targeted + chemotherapy 1 (5.26) 0
Immunotherapy + radiotherapy 0 1 (12.50)
Type of ILD —
UIP 6/19 (31.58) —
Non-UIP 13/19 (68.42) —

Others include esophageal cancer, pharyngeal cancer, cholangiocarcinoma, bladder cancer, and kidney cancer.

When categorized by tumor type, the results indicated a relative higher incidence of ILD in breast cancer patients (83.33%), all of whom presented with the non-UIP type. Additionally, a higher proportion of ILD was noted in stage III–IV lung cancer patients, suggesting a potential correlation between disease progression and pulmonary complications (Table 3).

Table 3

Status of interstitial pneumonia in different tumor patients

Characteristic Lung cancer (n = 12) Breast cancer (n = 6) Colorectal cancer (n = 3) Others (n = 6) P
Gender 0.014
Male 8 (66.67) — 1 (33.33) 4 (66.67)
Female 4 (33.33) 6 (100.00) 2 (66.67) 2 (33.33)
Age 64.8 (34–88) 57.2 (47–70) 62.7 (47–75) 65.5 (57–82) 0.572
Stage 0.088
I–II 3 (25.00) 1 (16.67) 1 (33.33) 1 (16.67)
III–IV 5 (41.67) 5 (83.33) 2 (66.67) 1 (16.67)
Unknown 4 (33.33) 0 0 4 (66.67)
Treatment history before onset 0.190
None 4 (33.33) 0 0 1 (16.67)
Surgery 4 (33.33) 0 1 (33.33) 2 (33.33)
Chemotherapy 0 1 (16.67) 1 (33.33) 0
Radiotherapy 2 (16.67) 0 0 1 (16.67)
Targeted therapy 0 1 (16.67) 0 0
Immunotherapy 2 (16.67) 2 (40.00) 0 1 (16.67)
Endocrine therapy 0 1 (16.67) 0 0
Radiotherapy + chemotherapy 0 1 (16.67) 0 0
Targeted + chemotherapy 0 0 1 (33.33) 0
Immunotherapy + radiotherapy 0 0 0 1 (16.67)
Is ILD 0.483
Yes 9 (75.00) 5 (83.33) 1 (33.33) 4 (66.67)
No 3 (25.00) 1 (16.67) 2 (66.67) 2 (33.33)
Type of ILD 0.122
UIP 4/9 (44.44) 0/5 0/1 2/4 (50.00)
Non-UIP 5/9 (55.56) 5/5 (100.00) 1/1 (100.00) 2/4 (50.00)

Others include esophageal cancer, pharyngeal cancer, cholangiocarcinoma, bladder cancer, and kidney cancer.

3.3.2 Analysis of laboratory indices in patients with tumors complicated by interstitial pneumonia

The average value for patients with malignant tumors complicated by interstitial pneumonia was significantly higher than that for patients with malignant tumors without interstitial pneumonia (1,125 U/mL vs 415 U/mL, P < 0.05). However, the ESR between the two groups (42.7 vs 52.7, P > 0.05) was not statistically significant (Table 4). All patients underwent tests for 22 types of serum autoantibodies. ANCA titer ≥ 1:100 was considered positive. In the group with malignant tumors and interstitial pneumonia, the positive rate of ANCA was 31.58% (six cases). In the group of malignant tumors without ILD, the positive rate of ANCA was 50% (four cases). There was no statistically significant difference in the ANCA positive rates between the two groups (P > 0.05).

Table 4

Laboratory diagnosis and 22 autoantibodies of the two groups

Index characteristics of ILD Tumor with interstitial pneumonia patient group (N = 19) Tumor with non-interstitial pneumonia group (N = 8) P
Laboratory diagnosis
KL-6 1,125 (361–3,309) 415 (197–480) 0.042
MPO 6.7 (0.1–64.2) 1.1 (0.1–4.2) 0.578
PR3 20.2 (0.5–185.7) 6.8 (3.5–14.6) 0.642
CCP 4.6 (0.5–42.6) 0.7 (0.5–1.1) 0.497
CRP 60.7 (2.2–182) 33.5 (1.7–102) 0.369
ESR 52.7 (8–104) 42.7 (8–87) 0.411
RF 22 (3.2–76.8) 14.7 (8.6–38.7) 0.515
ASO 4,844 (4.7–130.2) 28.1 (12.3–45.4) 0.292
22 autoantibodies
ANCA 6 4 0.345
Antineutrophil perinucleus antibody 1 0 0.533
Antineutrophil cytoplasmic antibody 0 1 0.121
Ribosomal P protein antibody 0 1 0.121
Anti-mitochondrial antibody type 2 antibody IgG 1 0 0.533
Anti-ScL-70 antibody 0 1 0.121
MAS and MAA
Anti-JO-1 antibody IgG 2 0 0.392
Anti-MDA5 antibody IgG 1 0 0.555
Anti-RO-52 antibody 9 0 0.024
Anti-Mi-2α antibody IgG 2 0 0.392
Anti-PL-7 antibody IgG 1 0 0.555
Anti-NXP2 antibody IgG 1 0 0.555
Anti-EJ antibody IgG 1 0
Anti-Mi-2β antibody IgG 1 0 0.392
Anti-SAE1 antibody IgG 1 0 0.555
Anti-PM-Scl75 antibody IgG 1 0 0.555
Anti-TIF1γ antibody IgG 1 0 0.555
Anti-PL-12 antibody IgG 0 0
Anti-PM-Scl100 antibody IgG 0 0
Anti-Ku antibody IgG 0 0
Anti-EJ antibody IgG 0 0
Anti-PM-Scl100 antibody IgG 0 0
Anti-SRP antibody IgG 1 0 0.555

3.3.3 Predictive value of 16 items in the spectrum of idiopathic inflammatory myopathy in patients with tumors and interstitial inflammation

We tested the myositis spectrum for all enrolled patients. Of the 19 enrolled patients with tumors and interstitial pneumonia, 16 exhibited positive antibody profiles (84.21%) and 3 cases showed no positive antibody profiles (15.79%). Among these, nine patients tested positive for anti-RO-52 antibody; two cases each were positive for anti-JO-1 antibody IgG and anti-Mi-2α antibody IgG; and one case each was positive for anti-Mi-2β antibody IgG, anti-MDA5 antibody IgG, anti-PL-7 antibody IgG, anti-NXP2 antibody IgG, anti-EJ antibody IgG, anti-PM-Scl75 antibody IgG, and anti-TIF1γ antibody IgG; other antibodies (such as anti-ANA, anti-Sm, anti-dsDNA, anti-RNP, anti-Scl-70, and anti-ACA antibody IgG) were not detected. Notably, anti-RO-52 positivity was most frequently observed in patients with tumors and interstitial pneumonia (47.37%), and the positive rate among patients with interstitial pneumonia following treatment reached 73.73% (Table 4).

In addition, we observed that 15 of the 19 patients with tumors and interstitial pneumonia received tumor-related treatments, of which 13 cases (86.67%) were positive for the spectrum of specific inflammatory diseases. Four tumor patients did not receive tumor-related treatment for various reasons and three cases (75%) showed a positive myositis spectrum. Among patients with tumors without interstitial pneumonia, all eight patients underwent cancer treatment, and none exhibited positivity for a specific inflammatory disease spectrum.

4 Discussion

In this study, we found that compared with tumor patients who did not develop interstitial pneumonia, the positive rate of myositis spectrum in tumor patients who developed ILD after treatment was significantly higher. In addition, patients with positive myositis spectrum had a significantly shorter time for interstitial pneumonia after tumor treatment.

At present and in the future, to reduce the adverse reactions of tumor patients after treatment, everyone has gradually paid attention to it. We reviewed previous literature studies and found that there have been related reports on the relationship between tumors and ILD, especially between lung cancer and ILD, considering that the two have common risk factors, such as smoking or exposure to chemicals [16,17]. The pathophysiology of ILD is similar to the development process of cancer, including epithelial cell abnormalities, bioenergetics from metaplasia to cancerous cells, soluble media release, genetic changes, and telomere wear that lead to aging and abnormal development pathways [18].

The current treatment methods for tumors are mostly surgery, radiotherapy and chemotherapy, immune and targeted therapy, and the occurrence of interstitial pneumonia or the acute progress of the original interstitial pneumonia can be observed in these treatment methods [19,20], there are also non-A case report of ILD after lung cancer immunotherapy and radiotherapy [19], Kobayashi et al. [21] retrospectively analyzed ILD patients receiving locally advanced non-small cell lung cancer (LA-NSCLC) radiotherapy and chemotherapy. Among 37 patients, 17 patients (46%) had acute exacerbations of ILD greater than or equal to grade 3 within 1 year after radiotherapy. The incidence of acute exacerbations of ILD in non-UIP patients was lower than that in UIP patients. There are also reports of severe pulmonary toxicity and even death for immunotherapy, especially drugs targeting the PD-1/PD-L1 axis [1,2,20]. The diagnosis of immune-related interstitial pneumonia (ICI-ILD) is not straightforward. Clinicians should remain highly skeptical if new respiratory symptoms appear while receiving ICI. As we all know, most of these ILD cases occur in the first few months of treatment (median time to onset is 2.3 months) [22,23]. In a meta-analysis, the incidence of ILD in NSCLC was significantly higher, providing evidence for this hypothesis [24]. Targeted therapy, such as ErbB receptor tyrosine kinase inhibitor (EGFR-TKI), although the incidence of ILD caused by EGFR-TKI is not high, once it occurs, it can seriously threaten the life of patients [25]. There are also related reports and studies on chemotherapy; for instance, bleomycin can cause pulmonary fibrosis [26].

The spectrum of specific inflammatory diseases includes serum MSA and serum MAA, which are the diagnostic markers of many systemic autoimmune rheumatic diseases. More and more related articles have been published and confirmed that it has predictive significance for the severity and progression of the disease and tumors in idiopathic inflammatory myopathy-related ILD [27]. Many studies have stated that idiopathic pulmonary fibrosis (IPF) and lung cancer have common risk factors, such as smoking or exposure to chemicals [16,17]. The positive rate of myositis spectrum in patients with qualitative pneumonia accounted for 84.21%, and the positive rate of myositis spectrum in patients after tumor treatment reached 90.91%. Therefore, we believe the spectrum of specific inflammatory diseases is important for ILD after tumor treatment. Occurrence has certain predictive significance.

Acute interstitial pneumonia (AIP) is a rapid progressive ILD whose pathological features are extensive pulmonary septal edema and type I and type II lung cell desquamation. Now, more and more pieces of literature focus on the acute exacerbation of ILD other than IPF [28].

In this article, we observed that anti-RO-52 antibody-positive patients were common in patients with tumors with interstitial pneumonia. The positive rate of patients with tumors with interstitial pneumonia accounted for 47.37%. For the antibody myositis spectrum in patients after tumor treatment, the positive rate reached 72.73%, and we compared patients with interstitial pneumonia anti-RO-52 antibody positive after tumor treatment and patients with untreated interstitial pneumonia, compared with the average lung time from symptom onset to diagnosis. Based on the above observations, we hypothesize that anti-RO-52 antibodies have a certain predictive value in patients with AIP after tumor treatment, but our clinical data are limited, and more data are needed to verify later.

KL-6 is a mucin-like molecule expressed in type II lung cells and respiratory bronchiolar epithelial cells in normal lungs [29]. KL-6 levels reflect the condition of parenchymal cells in lung tissue surrounding tissue damage and can serve as a serum biomarker for the diagnosis and monitoring of ILD. In this article, we observed that KL-6 in patients with interstitial pneumonia was significantly higher than that in patients with non-interstitial pneumonia. A study by Kohnet and others considers that in the context of interstitial pneumonia, the elevation of KL-6 in the patient’s serum is caused by damaged or regenerated epithelial cells in the lower respiratory tract. Similar results have also been reported in lung cancer patients who developed radiation pneumonitis [29]. Therefore, we can monitor the KL-6 value to predict the occurrence of radiation pneumonitis in patients after tumor treatment, especially after radiotherapy.

However, there are certain limitations in this study. First, monitoring KL-6 levels may provide some indication of ILD development, but due to our small sample size, statistical errors may exist. Second, although we preliminarily observed that CRP levels may be related to cancer prognosis, different types of cancer are associated with varying degrees of inflammatory response. However, since this study is a retrospective analysis with a limited sample size, we cannot draw universally applicable conclusions. Finally, due to the retrospective design of this study, detailed clinical features of some patients (such as muscle enzyme levels, skin changes, etc.) were not adequately collected, so we cannot determine whether they meet the classification criteria for immune-mediated myopathy. This missing data limits our comprehensive assessment of the patient’s condition. Future large-scale, prospective studies are needed to verify the potential of KL-6 as an early biomarker for ILD and further explore the relationship between CRP levels and cancer prognosis. We also recommend conducting long-term follow-up studies to assess the predictive role of anti-Ro-52 antibody positivity in cancer treatment-related AIP. Additionally, more clinical data, particularly muscle enzyme levels and skin changes, should be collected to more accurately evaluate whether cancer patients meet the diagnostic criteria for immune-mediated myopathy, thus providing more comprehensive guidance for clinical treatment.

In conclusion, the mechanism of ILD combined with interstitial pneumonia in cancer treatment is still unclear, but we speculate that it may involve the disruption of pulmonary interstitial T cells, triggering an immune response. We believe that specific inflammatory disease profiles may have a predictive role in cancer patients prone to interstitial pneumonia, with anti-RO-52 antibody positivity potentially associated with an increased risk of AIP after cancer treatment. This finding may provide a reference for patient care during cancer treatment.

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  1. Funding information: This research received no specific grant from any funding agency in the public, commercial, or not for profit sectors.

  2. Author contributions: Z.Y.L. conceived the study, participated in its design and interpretation, and helped to draft the manuscript. L.Y. and Y.Z. participated in the design and interpretation of the data and drafting/revising the manuscript. S.L.Y., X.F., and Q.P.X. performed the statistical analysis and revised the manuscript critically. All the authors read and approved the final manuscript.

  3. Conflict of interest: The authors state no conflict of interest.

  4. Data availability statement: The data and materials in the current study are available from the corresponding author on reasonable request.

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Received: 2024-07-25
Revised: 2025-01-23
Accepted: 2025-03-25
Published Online: 2025-08-04

© 2025 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  5. Risk factors for severe adverse drug reactions in hospitalized patients
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https://doi.org/10.1515/med-2025-1190
Keywords for this article
malignant tumors; anti-RO-52; interstitial lung disease; predictive
Creative Commons
BY 4.0

Articles in the same Issue

  1. Research Articles
  2. Network pharmacological analysis and in vitro testing of the rutin effects on triple-negative breast cancer
  3. Impact of diabetes on long-term survival in elderly liver cancer patients: A retrospective study
  4. Knockdown of CCNB1 alleviates high glucose-triggered trophoblast dysfunction during gestational diabetes via Wnt/β-catenin signaling pathway
  5. Risk factors for severe adverse drug reactions in hospitalized patients
  6. Analysis of the effect of ALA-PDT on macrophages in footpad model of mice infected with Fonsecaea monophora based on single-cell sequencing
  7. Development and validation of headspace gas chromatography with a flame ionization detector method for the determination of ethanol in the vitreous humor
  8. CMSP exerts anti-tumor effects on small cell lung cancer cells by inducing mitochondrial dysfunction and ferroptosis
  9. Predictive value of plasma sB7-H3 and YKL-40 in pediatric refractory Mycoplasma pneumoniae pneumonia
  10. Antiangiogenic potential of Elaeagnus umbellata extracts and molecular docking study by targeting VEGFR-2 pathway
  11. Comparison of the effectiveness of nurse-led preoperative counseling and postoperative follow-up care vs standard care for patients with gastric cancer
  12. Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis
  13. Adhered macrophages as an additional marker of cardiomyocyte injury in biopsies of patients with dilated cardiomyopathy
  14. Association between statin administration and outcome in patients with sepsis: A retrospective study
  15. Exploration of the association between estimated glucose disposal rate and osteoarthritis in middle-aged and older adults: An analysis of NHANES data from 2011 to 2018
  16. A comparative analysis of the binary and multiclass classified chest X-ray images of pneumonia and COVID-19 with ML and DL models
  17. Lysophosphatidic acid 2 alleviates deep vein thrombosis via protective endothelial barrier function
  18. Transcription factor A, mitochondrial promotes lymph node metastasis and lymphangiogenesis in epithelial ovarian carcinoma
  19. Serum PM20D1 levels are associated with nutritional status and inflammatory factors in gastric cancer patients undergoing early enteral nutrition
  20. Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study
  21. Vitamin D replacement therapy may regulate sleep habits in patients with restless leg syndrome
  22. The first-line antihypertensive nitrendipine potentiated the therapeutic effect of oxaliplatin by downregulating CACNA1D in colorectal cancer
  23. Health literacy and health-related quality of life: The mediating role of irrational happiness
  24. Modulatory effects of Lycium barbarum polysaccharide on bone cell dynamics in osteoporosis
  25. Mechanism research on inhibition of gastric cancer in vitro by the extract of Pinellia ternata based on network pharmacology and cellular metabolomics
  26. Examination of the causal role of immune cells in non-alcoholic fatty liver disease by a bidirectional Mendelian randomization study
  27. Clinical analysis of ten cases of HIV infection combined with acute leukemia
  28. Investigating the cardioprotective potential of quercetin against tacrolimus-induced cardiotoxicity in Wistar rats: A mechanistic insights
  29. Clinical observation of probiotics combined with mesalazine and Yiyi Baitouweng Decoction retention enema in treating mild-to-moderate ulcerative colitis
  30. Diagnostic value of ratio of blood inflammation to coagulation markers in periprosthetic joint infection
  31. Sex-specific associations of sex hormone binding globulin and risk of bladder cancer
  32. Core muscle strength and stability-oriented breathing training reduces inter-recti distance in postpartum women
  33. The ERAS nursing care strategy for patients undergoing transsphenoidal endoscopic pituitary tumor resection: A randomized blinded controlled trial
  34. The serum IL-17A levels in patients with traumatic bowel rupture post-surgery and its predictive value for patient prognosis
  35. Impact of Kolb’s experiential learning theory-based nursing on caregiver burden and psychological state of caregivers of dementia patients
  36. Analysis of serum NLR combined with intraoperative margin condition to predict the prognosis of cervical HSIL patients undergoing LEEP surgery
  37. Commiphora gileadensis ameliorate infertility and erectile dysfunction in diabetic male mice
  38. The correlation between epithelial–mesenchymal transition classification and MMP2 expression of circulating tumor cells and prognosis of advanced or metastatic nasopharyngeal carcinoma
  39. Tetrahydropalmatine improves mitochondrial function in vascular smooth muscle cells of atherosclerosis in vitro by inhibiting Ras homolog gene family A/Rho-associated protein kinase-1 signaling pathway
  40. A cross-sectional study: Relationship between serum oxidative stress levels and arteriovenous fistula maturation in maintenance dialysis patients
  41. A comparative analysis of the impact of repeated administration of flavan 3-ol on brown, subcutaneous, and visceral adipose tissue
  42. Identifying early screening factors for depression in middle-aged and older adults: A cohort study
  43. Perform tumor-specific survival analysis for Merkel cell carcinoma patients undergoing surgical resection based on the SEER database by constructing a nomogram chart
  44. Unveiling the role of CXCL10 in pancreatic cancer progression: A novel prognostic indicator
  45. High-dose preoperative intraperitoneal erythropoietin and intravenous methylprednisolone in acute traumatic spinal cord injuries following decompression surgeries
  46. RAB39B: A novel biomarker for acute myeloid leukemia identified via multi-omics and functional validation
  47. Impact of peripheral conditioning on reperfusion injury following primary percutaneous coronary intervention in diabetic and non-diabetic STEMI patients
  48. Clinical efficacy of azacitidine in the treatment of middle- and high-risk myelodysplastic syndrome in middle-aged and elderly patients: A retrospective study
  49. The effect of ambulatory blood pressure load on mitral regurgitation in continuous ambulatory peritoneal dialysis patients
  50. Expression and clinical significance of ITGA3 in breast cancer
  51. Single-nucleus RNA sequencing reveals ARHGAP28 expression of podocytes as a biomarker in human diabetic nephropathy
  52. rSIG combined with NLR in the prognostic assessment of patients with multiple injuries
  53. Toxic metals and metalloids in collagen supplements of fish and jellyfish origin: Risk assessment for daily intake
  54. Exploring causal relationship between 41 inflammatory cytokines and marginal zone lymphoma: A bidirectional Mendelian randomization study
  55. Gender beliefs and legitimization of dating violence in adolescents
  56. Effect of serum IL-6, CRP, and MMP-9 levels on the efficacy of modified preperitoneal Kugel repair in patients with inguinal hernia
  57. Effect of smoking and smoking cessation on hematological parameters in polycythemic patients
  58. Pathogen surveillance and risk factors for pulmonary infection in patients with lung cancer: A retrospective single-center study
  59. Necroptosis of hippocampal neurons in paclitaxel chemotherapy-induced cognitive impairment mediates microglial activation via TLR4/MyD88 signaling pathway
  60. Celastrol suppresses neovascularization in rat aortic vascular endothelial cells stimulated by inflammatory tenocytes via modulating the NLRP3 pathway
  61. Cord-lamina angle and foraminal diameter as key predictors of C5 palsy after anterior cervical decompression and fusion surgery
  62. GATA1: A key biomarker for predicting the prognosis of patients with diffuse large B-cell lymphoma
  63. Influencing factors of false lumen thrombosis in type B aortic dissection: A single-center retrospective study
  64. MZB1 regulates the immune microenvironment and inhibits ovarian cancer cell migration
  65. Integrating experimental and network pharmacology to explore the pharmacological mechanisms of Dioscin against glioblastoma
  66. Trends in research on preterm birth in twin pregnancy based on bibliometrics
  67. Four-week IgE/baseline IgE ratio combined with tryptase predicts clinical outcome in omalizumab-treated children with moderate-to-severe asthma
  68. Single-cell transcriptomic analysis identifies a stress response Schwann cell subtype
  69. Acute pancreatitis risk in the diagnosis and management of inflammatory bowel disease: A critical focus
  70. Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients
  71. Interleukin-37 mediates the anti-oral tumor activity in oral cancer through STAT3
  72. CA199 and CEA expression levels, and minimally invasive postoperative prognosis analysis in esophageal squamous carcinoma patients
  73. Efficacy of a novel drainage catheter in the treatment of CSF leak after posterior spine surgery: A retrospective cohort study
  74. Comprehensive biomedicine assessment of Apteranthes tuberculata extracts: Phytochemical analysis and multifaceted pharmacological evaluation in animal models
  75. Relation of time in range to severity of coronary artery disease in patients with type 2 diabetes: A cross-sectional study
  76. Dopamine attenuates ethanol-induced neuronal apoptosis by stimulating electrical activity in the developing rat retina
  77. Correlation between albumin levels during the third trimester and the risk of postpartum levator ani muscle rupture
  78. Factors associated with maternal attention and distraction during breastfeeding and childcare: A cross-sectional study in the west of Iran
  79. Mechanisms of hesperetin in treating metabolic dysfunction-associated steatosis liver disease via network pharmacology and in vitro experiments
  80. The law on oncological oblivion in the Italian and European context: How to best uphold the cancer patients’ rights to privacy and self-determination?
  81. The prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutritional index for survival in patients with colorectal cancer
  82. Factors affecting the measurements of peripheral oxygen saturation values in healthy young adults
  83. Comparison and correlations between findings of hysteroscopy and vaginal color Doppler ultrasonography for detection of uterine abnormalities in patients with recurrent implantation failure
  84. The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
  85. Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
  86. Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
  87. Correlation of serum calprotectin with outcome of acute cerebral infarction
  88. Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
  98. METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
  101. Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
  102. Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Lateral transperitoneal laparoscopic adrenalectomy: A single-centre experience of 21 procedures
  118. Petunidin attenuates lipopolysaccharide-induced retinal microglia inflammatory response in diabetic retinopathy by targeting OGT/NF-κB/LCN2 axis
  119. Procalcitonin and C-reactive protein as biomarkers for diagnosing and assessing the severity of acute cholecystitis
  120. Factors determining the number of sessions in successful extracorporeal shock wave lithotripsy patients
  121. Development of a nomogram for predicting cancer-specific survival in patients with renal pelvic cancer following surgery
  122. Inhibition of ATG7 promotes orthodontic tooth movement by regulating the RANKL/OPG ratio under compression force
  123. A machine learning-based prognostic model integrating mRNA stemness index, hypoxia, and glycolysis‑related biomarkers for colorectal cancer
  124. Glutathione attenuates sepsis-associated encephalopathy via dual modulation of NF-κB and PKA/CREB pathways
  125. FAHD1 prevents neuronal ferroptosis by modulating R-loop and the cGAS–STING pathway
  126. Association of placenta weight and morphology with term low birth weight: A case–control study
  127. Review Articles
  128. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  129. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  130. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  131. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  132. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  133. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  134. The application of augmented reality in robotic general surgery: A mini-review
  135. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  136. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  137. Plant polyphenols, terpenes, and terpenoids in oral health
  138. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  139. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  140. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  141. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  142. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  143. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  144. Giant borderline ovarian tumours – review of the literature
  145. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  146. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  147. Risk factors of frailty/sarcopenia in community older adults: Meta-analysis
  148. Supplement strategies for infertility in overweight women: Evidence and legal insights
  149. Scurvy, a not obsolete disorder: Clinical report in eight young children and literature review
  150. Case Reports
  151. Delayed graft function after renal transplantation
  152. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  153. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  154. Giant right atrial hemangioma presenting with ascites: A case report
  155. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  156. EsoFLIP-assisted dilation for dysphagia in systemic sclerosis: Highlighting the role of multimodal esophageal evaluation
  157. Rapid Communication
  158. Biological properties of valve materials using RGD and EC
  159. Letter to the Editor
  160. Role of enhanced external counterpulsation in long COVID
  161. Expression of Concern
  162. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  163. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  164. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  165. Corrigendum
  166. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  167. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  168. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  169. Retraction
  170. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  171. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  172. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  173. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  174. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  175. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  176. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  177. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  178. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  179. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  180. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  181. The mRNA MOXD1: Link to oxidative stress and prognostic significance in gastric cancer
  182. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  183. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  184. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  185. Special Issue Diabetes
  186. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  187. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  188. A discussion on the application of fluorescence micro-optical sectioning tomography in the research of cognitive dysfunction in diabetes
  189. A review of brain research on T2DM-related cognitive dysfunction
  190. Special Issue Biomarker Discovery and Precision Medicine
  191. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
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