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Topic highlight on texture and color enhancement imaging in gastrointestinal diseases

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World Journal of Gastroenterology 2024年第14期30卷 1934-1940页

作者： Osamu Toyoshima Toshihiro Nishizawa Keisuke Hata Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalNarita 286-8520Japan Department of Gastroenterology Nihonbashi Muromachi Mitsui Tower Midtown ClinicTokyo 103-0022Japan

Olympus Corporation developed texture and color enhancement imaging(TXI)as a novel image-enhancing endoscopic *** topic highlights a series of hot-topic articles that investigated the efficacy of TXI for gastrointestinal disease identification in the clinical setting.A randomized controlled trial demonstrated improvements in the colorectal adenoma detection rate(ADR)and the mean number of adenomas per procedure(MAP)of TXI compared with those of white-light imaging(WLI)observation(58.7%vs 42.7%,adjusted relative risk 1.35,95%CI:1.17-1.56;1.36 vs 0.89,adjusted incident risk ratio 1.48,95%CI:1.22-1.80,respectively).A cross-over study also showed that the colorectal MAP and ADR in TXI were higher than those in WLI(1.5 vs 1.0,adjusted odds ratio 1.4,95%CI:1.2-1.6;58.2%vs 46.8%,1.5,1.0-2.3,respectively).A randomized controlled trial demonstrated non-inferiority of TXI to narrow-band imaging in the colorectal mean number of adenomas and sessile serrated lesions per procedure(0.29 vs 0.30,difference for non-inferiority-0.01,95%CI:-0.10 to 0.08).A cohort study found that scoring for ulcerative colitis severity using TXI could predict relapse of ulcerative colitis.A cross-sectional study found that TXI improved the gastric cancer detection rate compared to WLI(0.71%vs 0.29%).A cross-sectional study revealed that the sensitivity and accuracy for active Helicobacter pylori gastritis in TXI were higher than those of WLI(69.2%vs 52.5%and 85.3%vs 78.7%,res-pectively).In conclusion,TXI can improve gastrointestinal lesion detection and qualitative ***,further studies on the efficacy of TXI in clinical practice are required.

关键词： Endoscopy Texture and color enhancement imaging White-light imaging Narrow-band imaging Colorectal neoplasm Gastric cancer Adenoma Ulcerative colitis Helicobacter infections Colonoscopy

Hemostatic radiotherapy for bleeding gastrointestinal

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World Journal of gastrointestinal Oncology 2024年第5期16卷 2261-2263页

作者： Vrushab Rao Soumya Singh Bhooshan Zade Department of Cyberknife Radiosurgery and Radiation Oncology Ruby Hall ClinicPune 411001MaharashtraIndia

Hemostatic radiotherapy is a non-invasive treatment for bleeding gastrointestinal(GI)tumors,promoting tumor shrinkage,blood supply reduction,and fibrotic tissue *** is effective in cases where traditional interventions are insufficient or contraindicated and can prevent recurrent bleeding in patients with GI bleeding *** schedules are also effective for tumor control and patient compliance.

关键词： gastrointestinal tumors Hemostatic radiotherapy Palliative radiotherapy Acute bleeding Hypofractionation

Importance of diet and intestinal microbiota in the prevention of colorectal cancer-colonoscopy early screening diagnosis

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World Journal of gastrointestinal Oncology 2024年第8期16卷 3428-3435页

作者： Miljana Z Jovandaric Department of Neonatology Clinic for Gynecology and ObstetricsUniversity Clinical Center of SerbiaBelgrade 11070Serbia

Colorectal cancer is a term used to describe colon and rectal cancer,which is the third most common type of cancer.A MEDLINE and PubMed search resulted in the inclusion of manuscripts written in the last 10 years,using keywords relevant to the topic of the *** analyzing the aim of the searched studies and manuscripts,adequate articles were included that described the stated *** frequency of colorectal cancer varies with climate,nutrition,and many other factors,primarily endogenous,hereditary,intestinal microbiome,as well as external factors,such as exposure of the individual to stress,and bad eating *** cancer and rectal cancer or colorectal cancer in general in the early stages of the disease,may not show symptoms or are barely *** cancer symptoms will most often not develop until the disease has progressed to stage 2 or *** screening tests for colon or rectal cancer,especially colonoscopy,are recommended as part of a regular checkup for people aged 50 years or younger who are at high risk due to a family history of the disease or other *** and colonoscopy as an early screening method play an important role in the prevention of colorectal cancer.

关键词： Colorectal cancer Causes Symptoms Screening Diet and colonoscopy

Sarcopenia in cirrhotic patients: Does frailty matter while waiting for a liver transplant?

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World Journal of gastrointestinal Surgery 2024年第1期16卷 257-259页

作者： Xing-Jie Li Kang He Division of Transplant Surgery Mayo Clinic ArizonaPhoenixAZ 85054United States Department of Liver Surgery Renji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China

Sarcopenia reflects patient frailty and should be routinely assessed due to its high prevalence in cirrhotic patients awaiting liver ***-transplant nutritional optimization should be tailored for patients with a definitive diagnosis of sarcopenia,therefore improving functional status at transplant and reducing posttransplant *** and transplant surgeons should have raised awareness regarding sarcopenia and the reflected frailty that hinder posttransplant *** policymakers should also take into account when modifying the organ allocation model that sarcopenia or frailty might become a decisive factor in allocating organs for cirrhotic patients,in order to ensure post-transplant survival and quality of life.

关键词： Sarcopenia Liver transplant Organ allocation policy Cirrhosis Frailty

Computed tomography radiogenomics:A potential tool for prediction of molecular subtypes in gastric stromal tumor

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World Journal of gastrointestinal Oncology 2024年第4期16卷 1296-1308页

作者： Xiao-Nan Yin Zi-Hao Wang Li Zou Cai-Wei Yang Chao-Yong Shen Bai-Ke Liu Yuan Yin Xi-Jiao Liu Bo Zhang Gastric Cancer Research Center West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Paediatric Surgery West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Radiology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of gastrointestinal Surgery Sichuan University West China HospitalChengdu 610041Sichuan ProvinceChina

BACKGROUND Preoperative knowledge of mutational status of gastrointestinal stromal tumors(GISTs)is essential to guide the individualized precision *** To develop a combined model that integrates clinical and contrast-enhanced computed tomography(CE-CT)features to predict gastric GISTs with specific genetic mutations,namely KIT exon 11 mutations or KIT exon 11 codons 557-558 *** A total of 231 GIST patients with definitive genetic phenotypes were divided into a training dataset and a validation dataset in a 7:3 *** models were constructed using selected clinical features,conventional CT features,and radiomics features extracted from abdominal CE-CT *** models were developed:ModelCT sign,modelCT sign+rad,and model CTsign+rad+*** diagnostic performance of these models was evaluated using receiver operating characteristic(ROC)curve analysis and the Delong *** The ROC analyses revealed that in the training cohort,the area under the curve(AUC)values for model_(CT sign),model_(CT sign+rad),and modelCT_(sign+rad+clinic)for predicting KIT exon 11 mutation were 0.743,0.818,and 0.915,*** the validation cohort,the AUC values for the same models were 0.670,0.781,and 0.811,*** predicting KIT exon 11 codons 557-558 deletions,the AUC values in the training cohort were 0.667,0.842,and 0.720 for model_(CT sign),model_(CT sign+rad),and modelCT_(sign+rad+clinic),*** the validation cohort,the AUC values for the same models were 0.610,0.782,and 0.795,*** on the decision curve analysis,it was determined that the model_(CT sign+rad+clinic)had clinical significance and *** Our findings demonstrate that the combined modelCT_(sign+rad+clinic)effectively distinguishes GISTs with KIT exon 11 mutation and KIT exon 11 codons 557-558 *** combined model has the potential to be valuable in assessing the genotype of GISTs.

关键词： gastrointestinal stromal tumor Radiomics Gene mutation Computed tomography Model

Neoadjuvant treatment of pancreatic ductal adenocarcinoma:Whom,when and how

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World Journal of gastrointestinal Surgery 2024年第5期16卷 1223-1230页

作者： Nebojsa Manojlovic Goran Savic Stevan Manojlovic clinic for Gastroenterology and Hepatology Military Medical AcademyFaculty of Medicine of the Military Medical AcademyUniversity of DefenceBelgrade 11000Serbia Military Medical Academy Faculty of Medicine of the Military Medical AcademyUniversity of DefenceBelgrade 11000Serbia Faculty of Medicine University of BelgradeBelgrade 11000Serbia

Pancreatic ductal adenocarcinoma(PDAC),which is notorious for its aggressiveness and poor prognosis,remains an area of great unmet medical need,with a 5-year survival rate of 10%-the lowest of all solid *** diagnosis,only 20%of patients have resectable pancreatic cancer(RPC)or borderline RPC(BRPC)disease,while 80%of patients have unresectable tumours that are locally advanced pancreatic cancer(LAPC)or have distant *** 60%of patients who undergo upfront surgery for RPC are unable to receive adequate adjuvant chemotherapy(CHT)because of postoperative complications and early cancer *** important paradigm shift to achieve better outcomes has been the sequence of therapy,with neoadjuvant CHT preceding *** surgical stages have emerged for the preoperative assessment of nonmetastatic pancreatic cancers:RPC,BRPC,and *** main goal of neoadjuvant treatment(NAT)is to improve postoperative outcomes through enhanced selection of candidates for curative-intent surgery by identifying patients with aggressive or metastatic disease during initial CHT,reducing tumour volume before surgery to improve the rate of margin-negative resection(R0 resection,a microscopic margin-negative resection),reducing the rate of positive lymph node occurrence at surgery,providing early treatment of occult micrometastatic disease,and assessing tumour chemosensitivity and tolerance to treatment as potential surgical *** this editorial,we summarize evidence concerning NAT of PDAC,providing insights into future practice and study *** research is needed to establish predictive biomarkers,measures of therapeutic response,and multidisciplinary stra tegies to improve patient-centered outcomes.

关键词： Pancreatic adenocarcinoma Neoadjuvant treatment Chemotherapy Upfront surgery Radiotherapy Response evaluation

To explore the mechanism of Yigong San anti-gastric cancer and immune regulation

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World Journal of gastrointestinal Oncology 2024年第5期16卷 1965-1994页

作者： Dou-Dou Lu Ling Yuan Zhao-Zhao Wang Jian-Jun Zhao Yu-Hua Du Na Ning Guo-Qing Chen Shi-Cong Huang Yi Yang Zhe Zhang Yi Nan School of clinical Medicine Ningxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina College of Pharmacy Ningxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina Traditional Chinese Medicine College Ningxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina Department of Chinese Medical gastrointestinal China-Japan Friendship HospitalBeijing 100029China Key Laboratory of Ningxia Minority Medicine Modernization Ministry of Education Ningxia Medical UniversityYinchuan 750004Ningxia Hui Autonomous RegionChina

BACKGROUND Yigong San(YGS)is a representative prescription for the treatment of digestive disorders,which has been used in clinic for more than 1000 ***,the mechanism of its anti-gastric cancer and regulate immunity are still remains *** To explore the mechanism of YGS anti-gastric cancer and immune *** Firstly,collect the active ingredients and targets of YGS,and the differentially expressed genes of gastric ***,constructed a protein-protein interaction network between the targets of drugs and diseases,and screened hub *** the clinical relevance,mutation and repair,tumor microenvironment and drug sensitivity of the hub gene were ***,molecular docking was used to verify the binding ability of YGS active ingredient and hub *** Firstly,obtained 55 common targets of gastric cancer and *** Kyoto Encyclopedia of Genes and Genomes screened the microtubule-associated protein kinase signaling axis as the key pathway and IL6,EGFR,MMP2,MMP9 and TGFB1 as the hub *** 5 hub genes were involved in gastric carcinogenesis,staging,typing and prognosis,and their mutations promote gastric cancer ***,molecular docking results confirmed that the components of YGS can effectively bind to therapeutic *** YGS has the effect of anti-gastric cancer and immune regulation.

关键词： Gastric cancer Yigong San Mechanism Immune

Micro-power negative pressure wound technique reduces risk of incision infection following loop ileostomy closure

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World Journal of gastrointestinal Surgery 2024年第1期16卷 186-195页

作者： Deng-Yong Xu Bing-Jun Bai Lina Shan Hui-Yan Wei Deng-Feng Lin Ya Wang Da Wang Department of Colorectal Surgery Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhou 310016Zhejiang ProvinceChina Department of Wound&Ostomy Care clinic Sir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhou 310016Zhejiang ProvinceChina Department of Hospital Infection Control Zhejiang Cancer HospitalHangzhou 310005Zhejiang ProvinceChina

BACKGROUND Prophylactic loop ileostomy is an effective way to reduce the clinical severity of anastomotic leakage following radical resection of rectal *** surgical site infection(SSI)is a common complication after ileostomy *** To evaluate the efficacy and safety of the micro-power negative pressure wound technique(MPNPWT)in preventing incisional *** This was a prospective,randomized controlled clinical trial conducted at a single center.A total of 101 consecutive patients who underwent ileostomy closure after rectal cancer surgery with a prophylactic ileostomy were enrolled from January 2019 to December *** were randomly allocated into an MPNPWT group and a control *** MPNPWT group underwent intermittent suturing of the surgical incision with 2-0 Prolene and was covered with a micro-power negative pressure *** surgical outcomes were compared between the MPNPWT(n=50)and control(n=51)*** factors for incisional SSI were identified using logistic *** There were no differences in baseline characteristics between the MPNPWT(n=50)and control groups(n=51).The incisional SSI rate was significantly higher in the control group than in the MPNPWT group(15.7%vs 2.0%,P=0.031).However,MPNPWT did not affect other surgical outcomes,including intra-abdominal complications,operative time,and blood *** hospital stay length and hospitalization costs did not differ significantly between the two groups(P=0.069 and 0.843,respectively).None of the patients experienced adverse effects of MPNPWT,including skin allergy,dermatitis,and *** also helped heal the infected *** study indicated that MPNPWT was an independent protective factor[odds ratio(OR)=0.005,P=0.025)]and diabetes was a risk factor(OR=26.575,P=0.029)for incisional *** MPNPWT is an effective and safe way to prevent incisional SSI after loop ileostomy closure.

关键词： Micro-power negative pressure technique Ileostomy closure Incisional surgical site infection Infection prevention Postoperative incision

Constipation and colonoscopy

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World Journal of gastrointestinal Endoscopy 2024年第5期16卷 244-249页

作者： Dusan Dj Popovic Branka Filipovic Faculty of Medicine University of BelgradeBelgrade 11000Serbia Department of Gastroenterology and Hepatology Clinic for Internal MedicineUniversity Clinical Hospital Center“Dr.Dragisa Misovic-Dedinje”Belgrade 11000Serbia

Constipation is a significant sociomedical problem,which can be caused by various *** the diagnostic approach to patients with constipation,the following data are usually sufficient:History,complete physical examination(including rectal examination),and additional diagnostic tests.A colonoscopy is not a necessary diagnostic method for all patients with ***,if patients have alarm symptoms/signs,that suggest an organic reason for constipation,a colonoscopy is *** most important alarm symptoms/signs are age>50 years,gastrointestinal bleeding,new-onset constipation,a palpable mass in the abdomen and rectum,weight loss,anemia,inflammatory bowel disease,and family history positive for colorectal *** endoscopists do not like to deal with patients with *** are two reasons for this,namely the difficulty of endoscopy and the adequacy of *** are adversely affected by *** improve the quality of colonoscopy in these patients,good examination techniques and often more extensive preparation are *** colonoscopy technique implies adequate psychological preparation of the patient,careful insertion of the endoscope with minimal insufflation,and early detection and resolution of *** preparation for colonoscopy often requires prolonged preparation and sometimes the addition of other laxatives.

关键词： Constipation Functional constipation Colonoscopy Bowel preparation Polyethylene glycol