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Chinese national clinical practice guidelines on the prevention,diagnosis,and treatment of early gastric cancer

Chinese Medical Journal 2024年第8期137卷 887-908页

作者： Peng Li Ziyu Li Enqiang Linghu Jiafu Ji Society of Digestive Endoscopy of the Chinese Medical Association Colorectal Surgery Group of the Chinese Medical Association Chinese Association of Gastroenterologists&Hepatologists National Clinical Research Center for Digestive Diseases Chinese Medical Journal Clinical Practice Guideline Collaborative Department of Gastroenterology Beijing Friendship HospitalCapital Medical UniversityNational Clinical Research Center for Digestive DiseaseBeijing 100050China Department of gastrointestinal Surgery Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education)Peking University Cancer Hospital and InstituteBeijing 100142China Department of Gastroenterology and Hepatology the First Medical CenterChinese People’s Liberation Army General HospitalBeijing 100853China 不详

Background:Gastric cancer is one of the most common malignant tumors in the digestive system in *** comprehensive practice guidelines for early gastric cancer in China are currently ***,we created the Chinese national clinical practice guideline for the prevention,diagnosis,and treatment of early gastric ***:This clinical practice guideline(CPG)was developed in accordance with the World Health Organization’s recommended process and with the Grading of Recommendations Assessment,Development,and Evaluation(GRADE)in assessing evidence *** used the Evidence to Decision framework to formulate clinical recommendations to minimize bias and increase transparency in the CPG development *** used the Reporting Items for practice Guidelines in HealThcare(RIGHT)statement and the Appraisal of Guidelines for Research and Evaluation II(AGREE II)as reporting and conduct guidelines to ensure completeness and transparency of the ***:This CPG contains 40 recommendations regarding the prevention,screening,diagnosis,treatment,and follow-up of early gastric cancer based on available clinical studies and *** provide recommendations for the timing of Helicobacter pylori eradication,screening populations for early gastric cancer,indications for endoscopic resection and surgical gastrectomy,follow-up interval after treatment,and other ***:This CPG can lead to optimum care for patients and populations by providing up-to-date medical *** intend this CPG for widespread adoption to increase the standard of prevention,screening,diagnosis,treatment,and follow-up of early gastric cancer;thereby,contributing to improving national health care and patient quality of life.

关键词： Early gastric cancer Prevention Screening Diagnosis Treatment Follow-up

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Indication of conservative treatment by antibiotics for uncomplicated and complicated acute appendicitis

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World Journal of gastrointestinal Surgery 2024年第8期16卷 2538-2545页

作者： Yuichi Hosokawa Masato Moritani Yosuke Makuuchi Yuichi Nagakawa Department of Surgery Nishitokyo Central General HospitalTokyo 188-0014Japan Department of gastrointestinal and Pediatric Surgery Tokyo Medical UniversityTokyo 166-0023Japan

BACKGROUND Acute appendicitis is one of the most common emergency abdominal disease,and recent studies have evaluated conservative treatment using antibiotics for uncomplicated *** the efficacy of conservative treatment for uncomplicated appendicitis is known,its efficacy for complicated appendicitis remains unknown,so are risk factors for the conservative treatment of *** our institution,conservative treatment has long been the first choice for most appendicitis cases,except for ***,this novel study inves-tigated the outcomes of conservative treatment for uncomplicated and compli-cated acute appendicitis and the risk factors associated with conservative *** significant and independent predictors of resistance to conservative treatment were body temperature≥37.3°C,appendicolith and Douglas sinus fluid visible on computed tomography(CT).The rate of resistance to conservative treatment was 66.7%(6/9)for patients with the above three factors,22.9%(8/35)for patients with two factors(appendicolith and body temperature≥37.3°C),16.7%(2/12)for patients with two factors(Douglas sinus fluid and appendicolith)and 11.1%(1/9)for patients with two factors(Douglas sinus fluid and body temperature≥37.3°C).CONCLUSION A temperature≥37.3°C,appendicolith and Douglas sinus fluid on CT might be clinical risk factors of resistance to conservative treatment for acute appendicitis.

关键词： Acute appendicitis Conservative treatment Antibiotics Appendicolith Uncomplicated appendicitis

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Evaluating the influence of sarcopenia and myosteatosis on clinical outcomes in gastric cancer patients undergoing immune checkpoint inhibitor

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World Journal of Gastroenterology 2024年第8期30卷 863-880页

作者： Gui-Ming Deng Hai-Bin Song Zhong-Ze Du Ying-Wei Xue Hong-Jiang Song Yuan-Zhou Li Department of gastrointestinal Surgery Harbin Medical University Cancer HospitalHarbin 150081Heilongjiang ProvinceChina Department of Radiology Harbin Medical University Cancer HospitalHarbin 150081Heilongjiang ProvinceChina

BACKGROUND The development and progression of gastric cancer(GC)are closely linked to the nutritional status of *** immunotherapy has been demonstrated to be clinically effective,the relationships of sarcopenia and myosteatosis with the use of immune checkpoint inhibitors(ICIs)in patients with gastric cancer remain to be *** We performed a retrospective study of patients who were undergoing immuno-therapy for *** the evaluation of sarcopenia,the optimal cut-off value for the skeletal muscle index was established using receiver operating characteristic analysis of data obtained from pre-treatment computed tomography images at the L3 vertebral *** was defined using the mean skeletal muscle density(SMD),with a threshold value of<41 Hounsfield units(HU)for patients with a body mass index(BMI)<25 kg/m^(2)and<33 HU for those with a BMI≥25 kg/m^(2).The log-rank test was used to compare progression-free survival(PFS)and overall survival(OS),and a Cox proportional hazard model was used to identify prognostic *** were developed to predict the PFS and OS of patients on the basis of the results of multivariate *** We studied 115 patients who were undergoing ICI therapy for GC,of whom 27.4%had sarcopenia and 29.8%had *** with sarcopenia or myosteatosis had significantly shorter PFS and OS than those without these ***,both sarcopenia and myosteatosis were found to be independent predictors of PFS and OS in patients with GC administering an *** prediction models created for PFS and OS were associated with C-indexes of 0.758 and 0.781,*** The presence of sarcopenia or myosteatosis is a reliable predictor of the clinical outcomes of patients with GC who are undergoing treatment with an ICI.

关键词： Gastric cancer Sarcopenia Myosteatosis,Immune checkpoint inhibitor Prognostic factor Overall survival Progression-free survival

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Development and validation of a prognostic immunoinflammatory index for patients with gastric cancer

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World Journal of Gastroenterology 2024年第24期30卷 3059-3075页

作者： Zhi-Chang Ba Xi-Qing Zhu Zhi-Guo Li Yuan-Zhou Li Department of Radiology Harbin Medical University Cancer HospitalHarbin 150081Heilongjiang ProvinceChina Department of gastrointestinal Surgery Harbin Medical University Cancer HospitalHarbin 150081Heilongjiang ProvinceChina

BACKGROUND Studies have demonstrated the influence of immunity and inflammation on the development of *** single biomarkers of immunity and inflam-mation have been shown to be clinically predictive,the use of biomarkers integrating both to predict prognosis in patients with gastric cancer remains to be *** To investigate the prognostic and clinical significance of inflammatory biomarkers and lymphocytes in patients undergoing surgical treatment for gastric *** Univariate COX regression analysis was performed to identify potential prognostic factors for patients with gastric cancer undergoing surgical *** absolute shrinkage and selection operator-COX(LASSO-COX)regression analysis was performed to integrate these factors and formulate a new prognostic immunoinflammatory index(PII).The correlation between PII and clinical charac-teristics was statistically *** incorporating the PII score were devised and validated based on the time-dependent area under the curve and decision curve *** Patients exhibiting elevated neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,and systemic immune inflammatory index displayed inferior progression-free survival(PFS)and overall survival(OS).Conversely,low levels of CD3(+),CD3(+)CD8(+),CD4(+)CD8(+),and CD3(+)CD16(+)CD56(+)T lymphocytes were associated with improved PFS and OS,while high CD19(+)T lymphocyte levels were linked to worse PFS and *** PII score demonstrated associations with tumor characteristics(primary tumor site and tumor size),establishing itself as an independent prognostic factor for both PFS and ***-dependent area under the curve and decision curve analysis affirmed the effectiveness of the PII-based nomogram as a robust prognostic predictive *** PII may be a reliable predictor of prognosis in patients with gastric cancer undergoing surgical treatment,and it offers insights into cancer-related immune-inflammatory re

关键词： Gastric cancer Immunity Inflammation Prognosis Nomogram

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Colon cancer-associated transcript 1 ( CCAT1): A potential novel target in cancer therapy

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中华医学杂志(英文版) 2024年第17期137卷 2128-2130页

作者： Ma Jinjie Pei Junpeng Zhang Xueping Bai Xiao Ding Siqi Dai Dongqiu Department of gastrointestinal Surgery The Fourth Affiliated Hospital of China Medical University Shenyang Liaoning China Cancer Center The Fourth Affiliated Hospital of China Medical University Shenyang Liaoning China

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The effect of intraoperative goal-directed fluid therapy in patients under anesthesia for gastrointestinal surgery

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World Journal of gastrointestinal Surgery 2024年第9期16卷 2815-2822页

作者： Jun Zhang Xiao-Wen Li Bing-Feng Xie Department of Anesthesiology The Second Hospital of LongyanLongyan 364000Fujian ProvinceChina Department of gastrointestinal Surgery Longyan First HospitalLongyan 364000Fujian ProvinceChina

BACKGROUND Intraoperative fluid management is an important aspect of anesthesia mana-gement in gastrointestinal *** goal-directed fluid therapy(GDFT)is a method for optimizing a patient's physiological state by monitoring and regulating fluid input in *** To evaluate the efficacy of intraoperative GDFT in patients under anesthesia for gastrointestinal *** This study utilized a retrospective comparative study design and included 60 patients who underwent gastrointestinal surgery at a *** experimental group(GDFT group)and the control group,each comprising 30 patients,received intraoperative GDFT and traditional fluid management strategies,*** effect of GDFT was evaluated by comparing postoperative recovery,com-plication rates,hospitalization time,and other indicators between the two patient *** Intraoperative blood loss in the experimental and control groups was 296.64±46.71 mL and 470.05±73.26 mL(Pgastrointestinal surgery is one of the most common procedures in the field of general surgery[1],involving the stomach,intestines,liver,pancreas,spleen,and other internal abdominal organs[2,3].With advancements in surgical technology and anesthesia methods,the safety and success rates of surgery have significantly improved[4,5].However,intraop-erative fluid management remains a critical challenge[6].Traditional fluid management strategies often rely on experience and basic physiological parameters,which may lead to excessive or insufficient fluid input,thereby affecting p

关键词： Intraoperative goal-directed fluid therapy gastrointestinal surgery Anesthesia management Postoperative recovery Complications Length of stay

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Comprehensive analysis of gene mutations and mismatch repair in Chinese colorectal cancer patients

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World Journal of gastrointestinal Oncology 2024年第6期16卷 2673-2682页

作者： Huang Chen Rui-Ying Jiang Zhan Hua Xiao-Wei Wang Xiao-Li Shi Ye Wang Qian-Qian Feng Jie Luo Wu Ning Yan-Fen Shi Da-Kui Zhang Bei Wang Jian-Zheng Jie Ding-Rong Zhong Department of Pathology China-Japan Friendship HospitalBeijing 100029China Department of gastrointestinal Surgery China-Japan Friendship HospitalBeijing 100029China Department of Scientific Research GeneisBeijing 100012China

BACKGROUND RAS,BRAF,and mismatch repair(MMR)/microsatellite instability(MSI)are crucial biomarkers recommended by clinical practice guidelines for colorectal cancer(CRC).However,their characteristics and influencing factors in Chinese patients have not been thoroughly *** To analyze the clinicopathological features of KRAS,NRAS,BRAF,and PIK3CA mutations and the DNA MMR status in *** We enrolled 2271 Chinese CRC patients at the China-Japan Friendship *** proteins were tested using immunohistochemical analysis,and the KRAS/NRAS/BRAF/PIK3CA mutations were determined using quantitative polymerase chain *** status was determined using an MSI detection *** analyses were conducted using SPSS software and logistic *** The KRAS,NRAS,BRAF,and PIK3CA mutations were detected in 44.6%,3.4%,3.7%,and 3.9% of CRC patients,*** mutations were more likely to occur in patients with moderate-to-high *** mutations were more likely to occur in patients with right-sided CRC,poorly differentiated,or no perineural *** MMR(dMMR)was detected in 7.9% of all patients and 16.8% of those with mucinous ***,NRAS,BRAF,and PIK3CA mutations were detected in 29.6%,1.1%,8.1%,and 22.3% of patients with dMMR,*** dMMR was more likely to occur in patients with a family history of CRC,aged<50 years,right-sided CRC,poorly differentiated histology,no perineural invasion,and with carcinoma in situ,stage I,or stage II *** This study analyzed the molecular profiles of KRAS,NRAS,BRAF,PIK3CA,and MMR/MSI in CRC,identifying key influencing factors,with implications for clinical management of CRC.

关键词： Colorectal cancer Deficient mismatch repair Microsatellite instability Gene mutation Comprehensive analysis

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Prioritization of risk genes in colorectal cancer by integrative analysis of multi-omics data and gene networks

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Science China(Life Sciences) 2024年第1期67卷 132-148页

作者： Ming Zhang Xiaoyang Wang Nan Yang Xu Zhu Zequn Lu Yimin Cai Bin Li Ying Zhu Xiangpan Li Yongchang Wei Shaokai Zhang Jianbo Tian Xiaoping Miao Department of Epidemiology and Biostatistics School of Public HealthDepartment of Gastrointestinal OncologyZhongnan Hospital of Wuhan UniversityDepartment of Radiation OncologyRenmin Hospital of Wuhan UniversityTaiKang Center for Life and Medical SciencesWuhan UniversityWuhan 430071China Research Center of Public Health Renmin hospital of Wuhan UniversityWuhan UniversityWuhan 430060China Department of Cancer Epidemiology The Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer HospitalHenan Engineering Research Center of Cancer Prevention and ControlHenan International Joint Laboratory of Cancer PreventionZhengzhou 450008China Department of gastrointestinal Surgery Renmin Hospital of Wuhan UniversityWuhan 430060China Department of Radiation Oncology Renmin Hospital of Wuhan UniversityWuhan 430060China Department of gastrointestinal Oncology Hubei Cancer Clinical Study CenterZhongnan Hospital of Wuhan UniversityWuhan 430062China Department of Epidemiology and Biostatistics School of Public HealthTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430073China Jiangsu Collaborative Innovation Center for Cancer Personalized Medicine Nanjing Medical UniversityNanjing 211166China

Genome-wide association studies(GWASs)have identified over 140 colorectal cancer(CRC)-associated loci;however,target genes at the majority of loci and underlying molecular mechanisms are poorly ***,we utilized a Bayesian approach,integrative risk gene selector(iRIGS),to prioritize risk genes at CRC GWAS loci by integrating multi-omics *** a result,a total of 105 high-confidence risk genes(HRGs)were identified,which exhibited strong gene dependencies for CRC and enrichment in the biological processes implicated in *** the 105 HRGs,CEBPB,located at the 20q13.13 locus,acted as a transcription factor playing critical roles in *** subsequent assays indicated the tumor promoter function of CEBPB that facilitated CRC cell proliferation by regulating multiple oncogenic pathways such as MAPK,PI3K-Akt,and Ras ***,by integrating a fine-mapping analysis and three independent case-control studies in Chinese populations consisting of 8,039 cases and 12,775 controls,we elucidated that rs1810503,a putative functional variant regulating CEBPB,was associated with CRC risk(OR=0.90,95%CI=0.86–0.93,P=1.07×10^(−7)).The association between rs1810503 and CRC risk was further validated in three additional multi-ancestry populations consisting of 24,254 cases and 58,741 ***,the rs1810503 A to T allele change weakened the enhancer activity in an allele-specific manner to decrease CEBPB expression via longrange promoter-enhancer interactions,mediated by the transcription factor,REST,and thus decreased CRC *** summary,our study provides a genetic resource and a generalizable strategy for CRC etiology investigation,and highlights the biological implications of CEBPB in CRC tumorigenesis,shedding new light on the etiology of CRC.

关键词： susceptibility genes gene screening models multi-omics GWAS CEBPB long-range promoter-enhancer interactions

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Identification of breath volatile organic compounds to distinguish pancreatic adenocarcinoma,pancreatic cystic neoplasm,and patients without pancreatic lesions

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World Journal of gastrointestinal Oncology 2024年第3期16卷 894-906页

作者： Kasenee Tiankanon Nuttanit Pungpipattrakul Thanikan Sukaram Roongruedee Chaiteerakij Rungsun Rerknimitr Division of Gastroenterology Faculty of MedicineChulalongkorn UniversityBangkok 10330Thailand Center of Excellence for Innovation and Endoscopy in gastrointestinal Oncology King Chulalongkorn Memorial HospitalThai Red Cross SocietyBangkok 10330Thailand

BACKGROUND Volatile organic compounds(VOCs)are a promising potential biomarker that may be able to identify the presence of *** To identify exhaled breath VOCs that distinguish pancreatic ductal adenocar-cinoma(PDAC)from intraductal papillary mucinous neoplasm(IPMN)and healthy *** We collected exhaled breath from histologically proven PDAC patients,radiological diagnosis IPMN,and healthy volunteers using the ReCIVA®device between 10/2021-11/*** were identified by thermal desorption-gas chromatography/field-asymmetric ion mobility spectrometry and compared between *** A total of 156 participants(44%male,mean age 62.6±10.6)were enrolled(54 PDAC,42 IPMN,and 60 controls).Among the nine VOCs identified,two VOCs that showed differences between groups were dimethyl sulfide[0.73 vs 0.74 vs 0.94 arbitrary units(AU),respectively;P=0.008]and acetone dimers(3.95 vs 4.49 vs 5.19 AU,respectively;P<0.001).After adjusting for the imbalance parameters,PDAC showed higher dimethyl sulfide levels than the control and IPMN groups,with adjusted odds ratio(aOR)of 6.98(95%CI:1.15-42.17)and 4.56(1.03-20.20),respectively(P<0.05 both).Acetone dimer levels were also higher in PDAC compared to controls and IPMN(aOR:5.12(1.80-14.57)and aOR:3.35(1.47-7.63),respectively(P<0.05 both).Acetone dimer,but not dimethyl sulfide,performed better than CA19-9 in PDAC diagnosis(AUROC 0.910 vs 0.796).The AUROC of acetone dimer increased to 0.936 when combined with CA19-9,which was better than CA19-9 alone(P<0.05).CONCLUSION Dimethyl sulfide and acetone dimer are VOCs that potentially distinguish PDAC from IPMN and healthy *** prospective studies are required to validate these findings.

关键词： Volatile organic compound Pancreas Adenocarcinoma Pancreatic intraductal neoplasms Breathing

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N6-methyladenosine methylation regulates the tumor microenvironment of Epstein-Barr virus-associated gastric cancer

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World Journal of gastrointestinal Oncology 2024年第6期16卷 2555-2570页

作者： Yu Zhang Fang Zhou Ming-Yu Zhang Li-Na Feng Jia-Lun Guan Ruo-Nan Dong Yu-Jie Huang Su-Hong Xia Jia-Zhi Liao Kai Zhao Department of Gastroenterology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina Institute of Liver and gastrointestinal Diseases Hubei Key Laboratory of Hepato-Pancreato-Biliary DiseasesTongji Hospital of Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina Department of Pharmacy Wuhan Fourth HospitalWuhan 430030Hubei ProvinceChina

BACKGROUND N6-methyladenosine(m6A)methylation modification exists in Epstein-Barr virus(EBV)primary infection,latency,and lytic *** also modifies EBV latent genes and lytic ***-associated gastric cancer(EBVaGC)is a distinctive molecular subtype of *** hypothesized EBV and m6A methylation regulators interact with each other in EBVaGC to differentiate it from other types of *** To investigate the mechanisms of m6A methylation regulators in EBVaGC to determine the differentiating factors from other types of *** First,The Cancer Gene Atlas and Gene Expression Omnibus databases were used to analyze the expression pattern of m6A methylation regulators between EBVaGC and EBV-negative GC(EBVnGC).Second,we identified Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)functional enrichment of m6A-related differentially expressed *** quantified the relative abundance of immune cells and inflammatory factors in the tumor microenvironment(TME).Finally,cell counting kit-8 cell proliferation test,transwell test,and flow cytometry were used to verify the effect of insulin-like growth factor binding protein 1(IGFBP1)in EBVaGC cell *** m6A methylation regulators were involved in the occurrence and development of *** with EBVnGC,the expression levels of m6A methylation regulators Wilms tumor 1-associated protein,RNA binding motif protein 15B,CBL proto-oncogene like 1,leucine rich pentatricopeptide repeat containing,heterogeneous nuclear ribonucleoprotein A2B1,IGFBP1,and insulin-like growth factor 2 binding protein 1 were significantly downregulated in EBVaGC(P<0.05).The overall survival rate of EBVaGC patients with a lower expression level of IGFBP1 was significantly higher(P=0.046).GO and KEGG functional enrichment analyses showed that the immunity pathways were significantly activated and rich in immune cell infiltration in *** with EBVnGC,the infiltration of activated CD4+T cells,activated CD8+T cel

关键词： N6-methyladenosine methylation Tumor microenvironment Epstein-Barr virus Gastric cancer Insulin-like growth factor binding protein 1

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