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Spatial transcriptomics reveals the mechanistic role of lactate metabolism in the pancreatic ductal adenocarcinoma microenvironment

Front Immunol. 2026 Feb 13;17:1743187. doi: 10.3389/fimmu.2026.1743187. eCollection 2026.

ABSTRACT

BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC), an aggressive cancer with poor prognosis, poses major challenges owing to late diagnosis and limited response to current therapies. However, the identification of candidate drugs through multi-omics analyses and therapeutic peptides targeting key molecular pathways may provide improved outcomes. Although lactate metabolism is a critical factor in tumor progression, affecting cell proliferation, metastasis, and immune evasion, its role in PDAC-particularly within the tumor microenvironment, remains underexplored.

OBJECTIVES: This study investigated lactate metabolism in PDAC using high-throughput transcriptomic sequencing and single-cell transcriptomic analysis.

METHODS: Lactate metabolism-related gene expression was analyzed in tumor cells and their microenvironment, and correlations with patient prognosis were determined. Additionally, a machine learning-based prognostic model was established to identify lactate metabolism biomarkers for early diagnosis and personalized therapy.

RESULTS: Lactate metabolism significantly impacted the survival of patients with PDAC (n = 92; log-rank test, p < 0.05). Single-cell RNA and spatial transcriptomics analyses of 50, 795 cells from 8 PDAC samples revealed that 521 malignant cells exhibited hyperactive lactate metabolism (AUCell score comparison, p < 0.001). A prognostic model constructed from lactate metabolism-related genes using ensemble machine learning (StepCox + Enet, α = 0.5) effectively stratified patients into high- and low-risk groups across multiple cohorts (ICGC: n = 92; GSE28735: n = 45; GSE62452: n = 69; GSE183795: n = 139; all log-rank p < 0.05). Key prognostic genes identified included lysozyme (LYZ) and polymeric immunoglobulin receptor, which were significantly associated with patient survival (univariate Cox regression, p < 0.05). These genes may serve as clinical biomarkers of PDAC.

CONCLUSIONS: This study provides insights into PDAC metabolic features and highlights lactate metabolism as a potential therapeutic target. The identified biomarkers could facilitate early diagnosis and improve treatment strategies, ultimately enhancing patient outcomes.

PMID:41766855 | PMC:PMC12946077 | DOI:10.3389/fimmu.2026.1743187

Radiologist Copilot: An Agentic Assistant with Orchestrated Tools for Radiology Reporting with Quality Control

arXiv:2512.02814v1 Announce Type: new Abstract: Radiology reporting is an essential yet time-consuming and error-prone task for radiologists in clinical examinations, especially for volumetric medical images. Rigorous quality control is also critical but tedious, ensuring that the final report meets clinical standards. Existing automated approaches, including radiology report generation methods and medical vision-language models, focus mainly on the report generation phase and neglect the crucial quality control procedure, limiting their capability to provide comprehensive support to radiologists. We propose Radiologist Copilot, an agentic AI assistant equipped with orchestrated tools designed for automated radiology reporting with quality control. Leveraging large language models as the reasoning backbone, the agentic system autonomously selects tools, plans, and executes actions, emulating the behavior of radiologists throughout the holistic radiology reporting process. The orchestrated tools include region localization, think with image paradigm directed region analysis planning, strategic template selection for report generation, quality assessment and feedback-driven adaptive refinement for quality control. Therefore, Radiologist Copilot facilitates accurate, complete, and efficient radiology reporting, assisting radiologists and improving clinical efficiency. Experimental results demonstrate that Radiologist Copilot significantly surpasses other state-of-the-art methods in radiology reporting. The source code will be released upon acceptance.

Molecular characterization of breast cancer and multiple primary malignancies: the latest application using unmarked quantitative proteomics

Int J Surg. 2025 Jul 22. doi: 10.1097/JS9.0000000000002999. Online ahead of print.

ABSTRACT

BACKGROUND: Breast cancer remains the most prevalent malignancy among women, and patients presenting with both breast and lung cancer pose significant challenges in clinical diagnosis and treatment. Currently, comprehensive multi-omics analyses for such multiple malignancies are lacking.

METHODS: An integrated multi-omics analysis was performed, incorporating quantitative proteomics and radiomics data from patients with single primary breast cancer as well as those with multiple primary tumors (breast and lung cancer).

RESULTS: Quantitative proteomics analysis revealed four distinct molecular signatures (Types I-IV). Patients with single breast cancer exhibited driving pathways primarily linked to cell proliferation (e.g., HER2), whereas those with multiple breast cancers showed enrichment in ER-related and proliferative pathways. In contrast, patients with multiple lung cancers displayed pathways associated with immune response and immune escape. Additionally, immune subtyping identified three distinct immune landscapes (Types I-III). Radiomic analysis demonstrated strong correlations between these molecular/immune subtypes and imaging findings. Patients with high imaging information scores exhibited pronounced tumor heterogeneity and reduced immune infiltration.

CONCLUSIONS: This study provides new insights into the molecular pathogenesis of multiple primary malignancies, particularly breast and lung cancer.

PMID:40694032 | DOI:10.1097/JS9.0000000000002999

An organoid co-culture model for probing systemic anti-tumor immunity in lung cancer

Cell Stem Cell. 2025 Jun 6:S1934-5909(25)00191-2. doi: 10.1016/j.stem.2025.05.011. Online ahead of print.

ABSTRACT

Deciphering interactions between tumor micro- and systemic immune macroenvironments is essential for developing more effective cancer diagnosis and therapeutic strategies. Here, we established a gel-liquid interface (GLI) co-culture model of lung cancer organoids (LCOs) and paired peripheral-blood mononuclear cells (PBMCs), featuring enhanced interactions between immune cells and tumor organoids for optimized simulation of in vivo systemic anti-tumor immunity. By constructing a cohort of lung cancer patients, we demonstrated that the responses of GLI models under αPD1 treatment reflected the immunotherapy outcomes of the corresponding patients precisely. Furthermore, we dissected the various tumor immune processes mediated by PBMC-derived T cells within GLI models through functional multi-omics analyses, along with the characterization of circulating tumor-reactive T cells (GNLY+CD44+CD9+) with effector memory-like phenotypes as a potential indicator of immunotherapy efficacy. Our findings indicate that the GLI co-culture model can be used to develop diagnostic strategies for precision immunotherapies, as well as understanding the underlying mechanisms.

PMID:40513558 | DOI:10.1016/j.stem.2025.05.011

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