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Integrated radiopathomics nomogram for predicting angiogenic microvascular patterns in NSCLC: a dual-center validation study

Ann Med. 2026 Dec;58(1):2654291. doi: 10.1080/07853890.2026.2654291. Epub 2026 Apr 17.

ABSTRACT

BACKGROUND: To develop and validate an integrated radiopathomics nomogram combining multiphase CT images, H&E-stained slides, and clinicopathological variables for predicting microvascular patterns (MVPs) in non-small cell lung cancer (NSCLC).

METHODS: We retrospectively included consecutive surgically resected NSCLC patients from two centers (n = 258). Patients from center 1 were randomly divided into training and internal validation cohorts, while patients from center 2 formed external validation cohort. CD34-immunohistochemistry was used as the reference standard for MVPs to classify patients into non-angiogenic alveolar (NAA) and non-NAA groups. Radiomics and pathomics features were extracted to construct single-phase radiomics, combined radiomics, and pathomics models. Rad-score and Path-score were derived from combined radiomics and pathomics models, respectively. Rad-score, Path-score, and clinicopathological independent predictors were integrated to develop a nomogram. Model performance was assessed by area under the curve (AUC), calibration curve, decision curve analysis (DCA), and DeLong test.

RESULTS: On multivariable analysis, histological grade was an independent predictor of NAA MVP. Combined radiomics model for predicting MVPs achieved AUCs of 0.863, 0.856, and 0.849 in training, internal validation, and external validation cohorts, showing better performance than single-phase models. Pathomics model yielded AUCs of 0.878, 0.860, and 0.833, however, its specificity markedly decreased in validation cohorts. Nomogram model achieved the superior performance across all cohorts, with AUCs of 0.911, 0.903, and 0.901, outperforming single-modality models (DeLong test: all p < 0.05).

CONCLUSION: The nomogram demonstrated high accuracy and robustness in predicting MVPs in NSCLC, offering a promising tool for characterizing the tumor microenvironment and supporting individualized treatment.

PMID:41992828 | DOI:10.1080/07853890.2026.2654291

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TRIM36 and CAMK2N2 regulate ferroptosis and antigen presentation in small cell lung cancer

iScience. 2026 Mar 11;29(4):115310. doi: 10.1016/j.isci.2026.115310. eCollection 2026 Apr 17.

ABSTRACT

Small cell lung cancer (SCLC) is a highly aggressive tumor with poor prognosis. Ferroptosis is closely linked to tumor antigen presentation: it affects antigen presentation efficiency via immunostimulatory signals, while CD8+ T cell activation induced by antigen presentation promotes tumor cell ferroptosis by secreting IFNΞ³. This study used multi-omics analyses and machine learning to screen key genes, verified by in vitro/in vivo experiments. TRIM36 and CAMK2N2 were significantly upregulated in SCLC, negatively correlating with patient survival, effector memory CD8+ T cell infiltration, and tumor MHC I expression. They suppress SCLC antigen presentation via ferroptosis-dependent/independent mechanisms, limiting T cell function. TRIM36 and CAMK2N2 are promising SCLC biomarkers and therapeutic targets, providing clues to unravel ferroptosis-antigen presentation associations in tumor cells and optimize immunotherapeutic strategies.

PMID:41940332 | PMC:PMC13049528 | DOI:10.1016/j.isci.2026.115310

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