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World Journal of gastroenterology 2024年第8期30卷 811-816页

作者： Mike de Jong Foke van Delft Christine Roozen Erwin-Jan van Geenen Tanya Bisseling Peter Siersema Marco Bruno Department of gastroenterology and hepatology Radboud University Medical CenterNijmegen 6525 GANetherlands Department of gastroenterology and hepatology Erasmus University Medical CenterRotterdam 3015 GDNetherlands

Endoscopic ultrasound(EUS)with fine needle aspiration or fine needle biopsy is the gold standard for sampling tissue to diagnose pancreatic cancer and auto-immune pancreatitis or to analyze cyst fluid.The most common reported adverse event of fine needle aspiration and/or fine needle biopsy is acute pancreatitis,which is likely induced by the same pathophysiological mechanisms as after en-doscopic retrograde cholangiopancreatography(ERCP).According to the current European Society of Gastrointestinal Endoscopy guideline,nonsteroidal anti-inflammatory drugs are administered prior to ERCP as a scientifically proven treatment to reduce post-ERCP pancreatitis incidence rate.A single suppository of diclofenac or indomethacin prior to EUS guided tissue acquisition(TA)is harm-less in healthy adults.Since it is associated with low costs and,most important,may prevent a dreadsome complication,we strongly recommend the adminis-tration of 100 mg diclofenac rectally prior to EUS-TA.We will explain this recom-mendation in more detail in this review as well as the risk and pathophysiology of post-EUS TA pancreatitis.

关键词： Pancreatitis Endoscopic ultrasound Tissue acquisition Nonsteroidal antiinflammatory drugs Pancreatic cancer

Intestinal microecological transplantation for a patient with chronic radiation enteritis:A case report

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World Journal of gastroenterology 2024年第19期30卷 2603-2611页

作者： Lin Wang Yan Li Yu-Jing Zhang Li-Hua Peng Department of gastroenterology and hepatology The First Medical CenterChinese PLA General HospitalBeijing 100853China Department of gastroenterology and hepatology Chinese PLA Medical SchoolBeijing 100853China

BACKGROUND The gut microbiota is strongly associated with radiation-induced gut damage.This study aimed to assess the effectiveness and safety of intestinal microecological transplantation for treating patients with chronic radiation enteritis.CASE SUMMARY A 64-year-old female with cervical cancer developed abdominal pain,diarrhea,and blood in the stool 1 year after radiotherapy.An electronic colonoscopy was performed to diagnose chronic radiation enteritis.Two courses of intestinal microecological transplantation and full-length 16S rRNA microbiological analysis were performed.The patient experienced short-and long-term relief from symptoms without adverse effects.Whole 16S rRNA sequencing revealed significant differences in the intestinal flora’s composition between patient and healthy donors.Pathogenic bacteria,such as Escherichia fergusonii and Romboutsia timonensis,were more in the patient.Beneficial bacteria such as Faecalibacterium prausnitzii,Fusicatenibacter saccharivorans,Ruminococcus bromii,and Bifidobacterium longum were more in the healthy donors.Intestinal microbiota transplantation resulted in a significant change in the patient's intestinal flora composition.The composition converged with the donor's flora,with an increase in core beneficial intestinal bacteria,such as Eubacterium rectale,and a decrease in pathogenic bacteria.Changes in the intestinal flora corresponded with the patients'alleviating clinical symptoms.CONCLUSION Intestinal microecological transplantation is an effective treatment for relieving the clinical symptoms of chronic radiation enteritis by altering the composition of the intestinal flora.This study provides a new approach for treating patients with chronic radiation enteritis.

关键词： Chronic radiation enteritis Gut microbial transplantation Intestinal microecology Cancer Quality of life Case report

Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

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World Journal of Transplantation 2024年第1期14卷 141-153页

作者： Hirak Pahari Amruth Raj Ambreen Sawant Dipak S Ahire Raosaheb Rathod Chetan Rathi Tushar Sankalecha Sachin Palnitkar Vikram Raut Department of Liver Transplant and HPB Surgery Medicover HospitalsNavi Mumbai 410210MaharashtraIndia Department of Liver Transplant Anaesthesia Medicover HospitalsNavi Mumbai 410210MaharashtraIndia Department of gastroenterology and hepatology Medicover HospitalsNavi Mumbai 410210India Department of gastroenterology and hepatology Medicover HospitalsNavi Mumbai 410210MaharashtraIndia Department of gastroenterology and hepatology Medicover HospitalsAurangabad 431003India Department of gastroenterology and hepatology Medicover HospitalsNashik 422009India Department of gastroenterology and hepatology Medicover HospitalsPune 411026India

BACKGROUND Liver transplantation(LT)for hepatocellular carcinoma(HCC)has been widely researched and is well established worldwide.The cornerstone of this treatment lies in the various criteria formulated by expert consensus and experience.The variations among the criteria are staggering,and the short-and long-term outcomes are controversial.AIM To study the differences in the current practices of LT for HCC at different centers in India and discuss their clinical implications in the future.METHODS We conducted a survey of major centers in India that performed LT in December 2022.A total of 23 responses were received.The centers were classified as high-and low-volume,and the current trend of care for patients undergoing LT for HCC was noted.RESULTS Of the 23 centers,35%were high volume center(>500 Liver transplants)while 52%were high-volume centers that performed more than 50 transplants/year.Approximately 39%of centers had performed>50 LT for HCC while the percent distribution for HCC in LT patients was 5%–15%in approximately 73%of the patients.Barring a few,most centers were divided equally between University of California,San Francisco(UCSF)and center-specific criteria when choosing patients with HCC for LT,and most(65%)did not have separate transplant criteria for deceased donor LT and living donor LT(LDLT).Most centers(56%)preferred surgical resection over LT for a Child A cirrhosis patient with a resectable 4 cm HCC lesion.Positron-emission tomography-computed tomography(CT)was the modality of choice for metastatic workup in the majority of centers(74%).Downstaging was the preferred option for over 90%of the centers and included transarterial chemoembolization,transarterial radioembolization,stereotactic body radiotherapy and atezolizumab/bevacizumab with varied indications.The alphafetoprotein(AFP)cut-off was used by 74%of centers to decide on transplantation as well as to downstage tumors,even if they met the criteria.The criteria for successful downstaging varied,but most centers conformed to the UCSF or

关键词： Hepatocellular carcinoma Liver transplant India Downstaging Survey Milan University of California,San Francisco Portal vein tumor thrombus Expanded criteria

Novel milestones for early esophageal carcinoma:From bench to bed

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1104-1118页

作者： Ji-Han Qi Shi-Ling Huang Shi-Zhu Jin Department of gastroenterology and hepatology The Second Affiliated Hospital of Harbin Medical UniversityHarbin 150086Heilongjiang ProvinceChina

Esophageal cancer(EC)is the seventh most common cancer worldwide,and esophageal squamous cell carcinoma(ESCC)accounts for the majority of cases of EC.To effectively diagnose and treat ESCC and improve patient prognosis,timely diagnosis in the initial phase of the illness is necessary.This article offers a detailed summary of the latest advancements and emerging technologies in the timely identification of ECs.Molecular biology and epigenetics approaches involve the use of molecular mechanisms combined with fluorescence quanti-tative polymerase chain reaction(qPCR),high-throughput sequencing technology(next-generation sequencing),and digital PCR technology to study endogenous or exogenous biomolecular changes in the human body and provide a decision-making basis for the diagnosis,treatment,and prognosis of diseases.The invest-igation of the microbiome is a swiftly progressing area in human cancer research,and microorganisms with complex functions are potential components of the tumor microenvironment.The intratumoral microbiota was also found to be connected to tumor progression.The application of endoscopy as a crucial technique for the early identification of ESCC has been essential,and with ongoing advancements in technology,endoscopy has continuously improved.With the advancement of artificial intelligence(AI)technology,the utilization of AI in the detection of gastrointestinal tumors has become increasingly prevalent.The implementation of AI can effectively resolve the discrepancies among observers,improve the detection rate,assist in predicting the depth of invasion and differentiation status,guide the pericancerous margins,and aid in a more accurate diagnosis of ESCC.

关键词： Early esophageal squamous cell carcinoma Epidemiology and risk factors Molecular biology Epigenetic Microbiology Endoscopy and artificial intelligence

Pretreating and normalizing metabolomics data for statistical analysis

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Genes & Diseases 2024年第3期11卷 188-205页

作者： Jun Sun Yinglin Xia Division of gastroenterology and hepatology Department of MedicineDepartment of Microbiology/ImmunologyUIC Cancer CenterUniversity of Illinois ChicagoJesse Brown VA Medical Center Chicago(537)ChicagoIL 60612USA Division of gastroenterology and hepatology Department of MedicineUniversity of Illinois ChicagoChicagoIL 60612USA

Metabolomics as a research field and a set of techniques is to study the entire small molecules in biological samples.Metabolomics is emerging as a powerful tool generally for pre-cision medicine.Particularly,integration of microbiome and metabolome has revealed the mechanism and functionality of microbiome in human health and disease.However,metabo-lomics data are very complicated.Preprocessing/pretreating and normalizing procedures on metabolomics data are usually required before statistical analysis.In this review article,we comprehensively review various methods that are used to preprocess and pretreat metabolo-mics data,including MS-based data and NMR-based data preprocessing,dealing with zero and/or missing values and detecting outliers,data normalization,data centering and scaling,data transformation.We discuss the advantages and limitations of each method.The choice for a suitable preprocessing method is determined by the biological hypothesis,the characteristics of the data set,and the selected statistical data analysis method.We then provide the perspective of their applications in the microbiome and metabolome research.

关键词： Data centering and scaling Data normalization Data transformation Missing values MS-Baseddata preprocessing NMRData preprocessing Outliers Preprocessing/pretreatment

Exploring non-curative endoscopic submucosal dissection:Current treatment optimization and future indication expansion

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World Journal of gastroenterology 2024年第9期30卷 1257-1260页

作者： Yi-Nong Zhu Xiang-Lei Yuan Wei Liu Yu-Hang Zhang Yi Mou Bing Hu Lian-Song Ye Department of gastroenterology and hepatology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

The increasing popularity of endoscopic submucosal dissection(ESD)as a treatment for early gastric cancer has highlighted the importance of quality assessment in achieving curative resections.This article emphasizes the significance of evaluating ESD quality,not only for curative cases but also for non-curative ones.Postoperative assessment relies on the endoscopic curability(eCura)classification,but management strategies for eCuraC-1 tumour with a positive horizontal margin are unclear.Current research primarily focuses on comparing additional surgical procedures in high-risk patients,while studies specifically targeting eCuraC-1 patients are limited.Exploring management strategies and follow-up outcomes for such cases could provide valuable insights.Furthermore,the application of molecular imaging using near-infrared fluorescent tracers holds promise for precise tumour diagnosis and navigation,potentially impacting the management of early-stage gastric cancer patients.Advancing research in these areas is essential for improving the overall efficacy of endoscopic techniques and refining treatment indications.

关键词： Early gastric cancer Endoscopic submucosal dissection Quality control Noncurative endoscopic submucosal dissection Near-infrared fluorescent tracer

Prospective study of hepatitis B and D epidemiology and risk factors in Romania:A 10-year update

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World Journal of hepatology 2024年第4期16卷 640-649页

作者： Speranta Iacob Liana Gheorghe Mirela Onica Laura Huiban Corina Silvia Pop Ciprian Brisc Roxana Sirli Carmen Ester Cristina Mihaela Brisc Sorina Diaconu Ion Rogoveanu Larisa Sandulescu Deiana Vuletici Anca Trifan Department of gastroenterology Carol Davila University of Medicine and PharmacyBucharest 050474Romania Department of gastroenterology and hepatology Fundeni Clinical InstituteBucharest 022328Romania Department of gastroenterology Grigore T Popa University of Medicine and PharmacyIasi 700115Romania Institute of gastroenterology and hepatology Saint Spiridon County HospitalIasi 700111Romania Department of gastroenterology and Medical Oncology University Emergency Clinical HospitalBucharest 050098Romania Faculty of Medicine and Pharmacy University of OradeaOradea 410087Romania Department of gastroenterology Emergency County HospitalOradea 410169Romania Center for Advanced Research in gastroenterology and hepatology Department of Gastroenterology and Hepatology“Victor Babeş”University of Medicine and PharmacyTimisoara 300041Romania Department of gastroenterology and hepatology TimişCounty Emergency Clinical Hospital"Pius Branzeu"Timisoara 300723Romania Department of Internal Medicine II and gastroenterology University Emergency Clinical HospitalBucharest 050098Romania Department of gastroenterology University of Medicine and PharmacyCraiova 200349Romania Department of Cardiology Emergency County HospitalCraiova 200642Romania Department of gastroenterology Research Center of Gastroenterology and HepatologyUniversity of Medicine and PharmacyCraiova 200349Romania Department of gastroenterology Emergency County HospitalCraiova 200642Romania Department of gastroenterology Faculty of MedicineGrigore T Popa University of Medicine and PharmacyIasi 700115Romania

BACKGROUND The global burden of hepatitis D virus(HDV)infection represents a major medical challenge and a public health crisis worldwide.However,there is a lack of accurate data on the epidemiology and risk factors for HDV.Hepatitis B virus(HBV)and HDV coinfection causes the most severe form of viral hepatitis,leading to a higher cumulative incidence of liver-related events compared with HBV monoinfection,including the need for liver transplantation and death.AIM To investigate the epidemiology,natural history,risk factors and clinical management of HBV and HDV coinfection in Romanian patients.METHODS This prospective study was conducted between January and July 2022 in six tertiary gastroenterology and hepatology referral centres in Romania.All consecutive adults admitted for any gastroenterology diagnosis who were HBV-positive were enrolled.Patients with acute hepatitis or incomplete data were excluded.Of the 25390 individuals who presented with any type of gastroenterology diagnosis during the study period,963 met the inclusion criteria.Testing for anti-HDV antibodies and HDV RNA was performed for all participants.Demographic and risk factor data were collected by investigators using medical charts and patient questionnaires.All data were stored in an anonymized online database during the study.RESULTS The prevalence of HBV was 3.8%;among these patients,the prevalence of HBV/HDV coinfection was 33.1%.The median age of the study population was 54.0 years,and it consisted of 55.1%men.A higher prevalence of HBV/HDV coinfection was observed in patients 50–69 years old.Patients with HBV/HDV coinfection were significantly older than those with HBV monoinfection(P=0.03).Multivariate multiple regression analysis identified female gender(P=0.0006),imprisonment(P<0.0001),older age at diagnosis(P=0.01)and sexual contact with persons with known viral hepatitis(P=0.0003)as significant risk factors for HDV.CONCLUSION This study shows that HDV infection among those with HBV remains endemic in Romania and updates our underst

关键词： Epidemiology Hepatitis B Hepatitis D Natural history Risk factors Romania

Drug-induced mucosal alterations observed during esophagogastroduodenoscopy

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World Journal of gastroenterology 2024年第16期30卷 2220-2232页

作者： Masaya Iwamuro Seiji Kawano Motoyuki Otsuka Department of gastroenterology and hepatology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan

Several features of drug-induced mucosal alterations have been observed in the upper gastrointestinal tract,i.e.,the esophagus,stomach,and duodenum.These include pill-induced esophagitis,desquamative esophagitis,worsening of gastroesophageal reflux,chemotherapy-induced esophagitis,proton pump inhibitor-induced gastric mucosal changes,medication-induced gastric erosions and ulcers,pseudomelanosis of the stomach,olmesartan-related gastric mucosal inflammation,lanthanum deposition in the stomach,zinc acetate hydrate tabletinduced gastric ulcer,immune-related adverse event gastritis,olmesartan-associated sprue-like enteropathy,pseudomelanosis of the duodenum,and lanthanum deposition in the duodenum.For endoscopists,acquiring accurate knowledge regarding these diverse drug-induced mucosal alterations is crucial not only for the correct diagnosis of these lesions but also for differential diag-nosis of other conditions.This minireview aims to provide essential information on druginduced mucosal alterations observed on esophagogastroduodenoscopy,along with representative endoscopic images.

关键词： Diagnosis Esophagogastroduodenoscopy Non-neoplastic lesions Esophageal lesions Gastric lesions Duodenal lesions

Metadherin promotes stem cell phenotypes and correlated with immune infiltration in hepatocellular carcinoma

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World Journal of gastroenterology 2024年第8期30卷 901-918页

作者： Yi-Ying Wang Mei-Mei Shen Jian Gao Department of gastroenterology The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010China Department of gastroenterology and hepatology The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400010China

BACKGROUND Metadherin(MTDH)is a key oncogene in most cancer types,including hepato-cellular carcinoma(HCC).Notably,MTDH does not affect the stemness pheno-type or immune infiltration of HCC.AIM To explore the role of MTDH on stemness and immune infiltration in HCC.METHODS MTDH expression in HCC tissues was detected using TCGA and GEO databases.Immunohistochemistry was used to analyze the tissue samples.MTDH was stably knocked down or overexpressed by lentiviral transfection in the two HCC cell lines.The invasion and migration abilities of HCC cells were evaluated using Matrigel invasion and wound healing assays.Next,we obtained liver cancer stem cells from the spheroids by culturing them in a serum-free medium.Gene expression was determined by western blotting and quantitative reverse transcri-ption PCR.Flow cytometry,immunofluorescence,and tumor sphere formation assays were used to characterize stem-like cells.The effects of MTDH inhibition on tumor growth were evaluated in vivo.The correlation of MTDH with immune cells,immunomodulators,and chemokines was analyzed using ssGSEA and TISIDB databases.RESULTS HCC tissues expressed higher levels of MTDH than normal liver tissues.High MTDH expression was associated with a poor prognosis.HCC cells overex-pressing MTDH exhibited stronger invasion and migration abilities,exhibited a stem cell-like phenotype,and formed spheres;however,MTDH inhibition attenuated these effects.MTDH inhibition suppressed HCC progression and CD133 expression in vivo.MTDH was positively correlated with immature dendritic,T helper 2 cells,central memory CD8^(+)T,memory B,activated dendritic,natural killer(NK)T,NK,activated CD4^(+)T,and central memory CD4^(+)T cells.MTDH was negatively correlated with activated CD8^(+)T cells,eosinophils,activated B cells,monocytes,macrophages,and mast cells.A positive correlation was observed between the MTDH level and CXCL2 expression,whereas a negative correlation was observed between the MTDH level and CX3CL1 and CXCL12 expression.CONCLUSION High levels of M

关键词： Metadherin Hepatocellular carcinoma Cancer stem cells Immune infiltration

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio:Markers predicting immune-checkpoint inhibitor efficacy and immune-related adverse events

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 577-582页

作者： Qiu-Yu Jiang Ru-Yi Xue Department of gastroenterology and hepatology Zhongshan HospitalShanghai Institute of Liver DiseaseFudan UniversityShanghai 200032China Department of gastroenterology and hepatology Shanghai Baoshan District Wusong Central Hospital(Zhongshan Hospital Wusong BranchFudan University)Shanghai 200940China

We conducted a comprehensive review of existing prediction models pertaining to the efficacy of immune-checkpoint inhibitor(ICI)and the occurrence of immune-related adverse events(irAEs).The predictive potential of neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in determining ICI effectiveness has been extensively investigated,while limited research has been conducted on predicting irAEs.Furthermore,the combined model incor-porating NLR and PLR,either with each other or in conjunction with additional markers such as carcinoembryonic antigen,exhibits superior predictive capabilities compared to individual markers alone.NLR and PLR are promising markers for clinical applications.Forthcoming models ought to incorporate established efficacious models and newly identified ones,thereby constituting a multifactor composite model.Furthermore,efforts should be made to explore effective clinical application approaches that enhance the predictive accuracy and efficiency.

关键词： Neutrophil-to-lymphocyte ratio Platelet-to-lymphocyte ratio Immunecheckpoint inhibitor Immune-related adverse event