BACKGROUND The ABCD stratification[combination of serum pepsinogen(PG)levels and titers of antibody(immunoglobulin G,IgG)against Helicobacter pylori(H.pylori)]is effective for the classification of individuals at risk...BACKGROUND The ABCD stratification[combination of serum pepsinogen(PG)levels and titers of antibody(immunoglobulin G,IgG)against Helicobacter pylori(H.pylori)]is effective for the classification of individuals at risk of developing gastric cancer(GC).The Kita–Kyushu lung cancer antigen-1(KK-LC-1)is a Cancer/Testis antigen frequently expressed in GC.AIM To evaluate the effectiveness of KK-LC-1 and ABCD stratification in the diagnosis of GC.METHODS We analyzed the gene expression of KK-LC-1 in surgical specimens obtained from GC tumors.The levels of serum PG I/PG II and IgG against H.pylori were measured.According to their serological status,the patients were classified into the four groups of the ABCD stratification.RESULTS Of the 77 examined patients,63(81.8%)expressed KK-LC-1.The IgG titers of H.pylori and PG II were significantly higher in patients expressing KK-LC-1 than those measured in patients not expressing KK-LC-1(P=0.0289 and P=0.0041,respectively).The expression of KK-LC-1 in group C[PG method(+)/H.pylori infection(+)]was as high as 93.9%high.KK-LC-1 was also detected in group A[-/-].CONCLUSION The KK-LC-1 expression in GC was associated with H.pylori infection and atrophic status,so that,KK-LC-1 may be a useful marker for the diagnosis of GC.展开更多
Prostate-associated gene 4 （PAGE4） is a remarkably prostate-specific Cancer/Testis Antigen that is highly upregulated in the human fetal prostate and its diseased states but not in the adult normal gland. PAGE4 is a...Prostate-associated gene 4 （PAGE4） is a remarkably prostate-specific Cancer/Testis Antigen that is highly upregulated in the human fetal prostate and its diseased states but not in the adult normal gland. PAGE4 is an intrinsically disordered protein （IDP） that functions as a stress-response protein to suppress reactive oxygen species as well as prevent DNA damage. In addition, PAGE4 is also a transcriptional regulator that potentiates transactivation by the oncogene c-Jun, c-Jun forms the AP-1 complex by heterodimerizing with members of the Fos family and plays an important role in the development and pathology of the prostate gland, underscoring the importance of the PAGE4/c-Jun interaction. HIPK1, also a component of the stress-response pathway, phosphorylates PAGE4 at T51 which is critical for its transcriptional activity. Phosphorylation induces conformational and dynamic switching in the PAGE4 ensemble leading to a new cellular function. Finally, bioinformatics evidence suggests that the PAGE4 mRNA could be alternatively spliced resulting in four potential isoforms of the polypeptide alluding to the possibility of a range of conformational ensembles with latent functions. Considered together, the data suggest that PAGE4 may represent the first molecular link between stress and prostate cancer （PCa）. Thus, pharmacologically targeting PAGE4 may be a novel opportunity for treating and managing patients with PCa, especially patients with low-risk disease.展开更多
The introduction of serum prostate-specific antigen （PSA） in the 1980s has dramatically altered and benefited the initial diagnosis of prostate cancer. However, the widespread use of PSA testing has resulted in over...The introduction of serum prostate-specific antigen （PSA） in the 1980s has dramatically altered and benefited the initial diagnosis of prostate cancer. However, the widespread use of PSA testing has resulted in overdetection and overtreatment of potentially indolent disease. Thus, a clinical dilemma today in the management of prostate cancer is to discern men with aggressive disease who need definitive treatment from men whose disease are not lethal. Although several serum and tissue biomarkers have been evaluated during the past decade, improved markers are still needed to enhance the accuracy, with which patients at risk can be discerned and treated more aggressively. The cancer/testis antigens （CTAs） are a group of proteins that are restricted to the testis in the normal adult, but are aberrantly expressed in several types of cancers. Because of their restricted expression pattern, the CTAs represent attractive biomarker candidates for cancer diagnosis/prognosis. Furthermore, several studies to date have reported the differential expression of CTAs in prostate cancer. Here, we review recent developments that demonstrate the potential of the CTAs as biomarkers to discern the a^ressive Dhenotvoe of orostate cancer.展开更多
Upper gastrointestinal cancers,mainly comprising esophageal and gastric cancers,are among the most prevalent cancers worldwide.There are many new cases of upper gastrointestinal cancers annually,and the survival rate ...Upper gastrointestinal cancers,mainly comprising esophageal and gastric cancers,are among the most prevalent cancers worldwide.There are many new cases of upper gastrointestinal cancers annually,and the survival rate tends to be low.Therefore,timely screening,precise diagnosis,appropriate treatment strategies,and effective prognosis are crucial for patients with upper gastrointestinal cancers.In recent years,an increasing number of studies suggest that artificial intelligence(AI)technology can effectively address clinical tasks related to upper gastrointestinal cancers.These studies mainly focus on four aspects:screening,diagnosis,treatment,and progno-sis.In this review,we focus on the application of AI technology in clinical tasks related to upper gastrointestinal cancers.Firstly,the basic application pipelines of radiomics and deep learning in medical image analysis were introduced.Furthermore,we separately reviewed the application of AI technology in the aforementioned aspects for both esophageal and gastric cancers.Finally,the current limitations and challenges faced in the field of upper gastrointestinal cancers were summarized,and explorations were conducted on the selection of AI algorithms in various scenarios,the popularization of early screening,the clinical applications of AI,and large multimodal models.展开更多
BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple pri...BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple primary cancers(MPC)has also increased.The rarity of MPC and the absence of sensitive and specific dia-gnostic markers often lead to missed or incorrect diagnoses.It is,therefore,of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease.Patients with GI malignancies face a higher relative risk of deve-loping additional primary malignant tumors compared to those with other systemic tumors.Vigilant monitoring and follow-up are crucial,especially for high-risk groups,which include older adults,men,those with addictions to alcohol and tobacco,those with a family history of tumors,and those who have undergone radiotherapy.CASE SUMMARY In this article,we report three cases of MPC,each involving malignant tumors of the GI tract as the initial primary carcinoma,offering insights that may aid in effectively managing similar cases.CONCLUSION Patients with GI malignancies face a higher MPC risk.Developing screening and follow-up protocols may enhance detection and treatment outcomes.展开更多
Hedgehog(HH)signaling has been researched for decades and Hedgehog has 3 homologs:Sonic Hedgehog(Shh),Indian Hedgehog(Ihh),and Desert Hedgehog(Dhh).Dhh is the one involved in male gonad and germ cell development.The d...Hedgehog(HH)signaling has been researched for decades and Hedgehog has 3 homologs:Sonic Hedgehog(Shh),Indian Hedgehog(Ihh),and Desert Hedgehog(Dhh).Dhh is the one involved in male gonad and germ cell development.The distribution of molecules in Hedgehog signaling in testis indicated that Hedgehog signaling executes important functions during testis development.The patients with Dhh signaling deficiency develop dysgenesis of gonads and hormone production which demands further exploration of gonad HH signaling.Some results proved the indispensable roles of HH signaling in gonad and germ cell development and the interaction with hormones.This review evaluates HH functions in the testis and how HH affects and is affected by hormones and provides novel insights about HH signaling to the readers.展开更多
Numerous research conducted in recent years has revealed that gut microbial dysbiosis,such as modifications in composition and activity,might influence lung tissue homeostasis through specific pathways,thereby promoti...Numerous research conducted in recent years has revealed that gut microbial dysbiosis,such as modifications in composition and activity,might influence lung tissue homeostasis through specific pathways,thereby promoting susceptibility to lung diseases.The development and progression of lung cancer,as well as the effectiveness of immunotherapy are closely associated with gut flora and metabolites,which influence immunological and inflammatory responses.During abnormal proliferation,non-small cell lung cancer cells acquire more substances and energy by altering their own metabolic pathways.Glucose and amino acid metabolism reprogramming provide tumor cells with abundant ATP,carbon,and nitrogen sources,respectively,providing optimal conditions for tumor cell proliferation,invasion,and immune escape.This article reviews the relationship of immune response with gut flora and metabolic reprogramming in non-small cell lung cancer,and discusses the potential mechanisms by which gut flora and metabolic reprogramming affect the occurrence,development,and immunotherapy of non-small cell lung cancer,in order to provide new ideas for precision treatment of lung cancer patients.展开更多
The sine oculis homeobox homolog(SIX)family,a group of transcription factors characterized by a conserved DNA-binding homology domain,plays a critical role in orchestrating embryonic development and organogenesis acro...The sine oculis homeobox homolog(SIX)family,a group of transcription factors characterized by a conserved DNA-binding homology domain,plays a critical role in orchestrating embryonic development and organogenesis across various organisms,including humans.Comprising six distinct members,from SIX1 to SIX6,each member contributes uniquely to the development and differentiation of diverse tissues and organs,underscoring the versatility of the SIX family.Dysregulation or mutations in SIX genes have been implicated in a spectrum of developmental disorders,as well as in tumor initiation and progression,highlighting their pivotal role in maintaining normal developmental trajectories and cellular functions.Efforts to target the transcriptional complex of the SIX gene family have emerged as a promising strategy to inhibit tumor development.While the development of inhibitors targeting this gene family is still in its early stages,the significant potential of such interventions holds promise for future therapeutic advances.Therefore,this review aimed to comprehensively explore the advancements in understanding the SIX family within gastrointestinal cancers,focusing on its critical role in normal organ development and its implications in gastrointestinal cancers,including gastric,pancreatic,colorectal cancer,and hepatocellular carcinomas.In conclusion,this review deepened the understanding of the functional roles of the SIX family and explored the potential of utilizing this gene family for the diagnosis,prognosis,and treatment of gastrointestinal cancers.展开更多
BACKGROUND Gastrointestinal cancers are among the most commonly diagnosed cancers globally.Traditional Chinese medicine(TCM)offers distinct advantages in preventing and treating these cancers.AIM To investigate the me...BACKGROUND Gastrointestinal cancers are among the most commonly diagnosed cancers globally.Traditional Chinese medicine(TCM)offers distinct advantages in preventing and treating these cancers.AIM To investigate the metabolic basis of a common TCM syndrome in gastrointestinal cancers,exploring underlying metabolic mechanisms and identifying potential METHODS Thirty healthy controls(normal group),30 patients with gastric cancer(GC),and 30 patients with colorectal cancer(CRC)were enrolled in 2023.Plasma metabolic profiles were detected using gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry,and pathway enrichment analysis was conducted using the Kyoto Encyclopedia of Genes and Genomes.RESULTS Metabolic profiling revealed distinct alterations in gastrointestinal cancers.CRC samples exhibited 455 differentially expressed metabolites(234 upregulated and 221 downregulated).Similarly,GC samples exhibited 459 differentially expressed metabolites(251 upregulated and 208 downregulated).Additionally,352 shared metabolites were identified among gastrointestinal cancers.Enrichment analysis highlighted the involvement of these shared metabolites in 10 metabolic pathways.CONCLUSION To some extent,this study revealed the metabolomic characteristics of spleen deficiency and blood stasis toxin(PXYD)syndrome in gastrointestinal cancers.It provides the rationale for the"same treatment for different diseases"approach in PXYD syndrome of gastrointestinal cancers,and for identifying potential metabolomicsbased biomarkers.展开更多
The aim of this investigation was to determine the optimal storage medium for testicular hypothermic transportation and identify the ideal concentration for the application of the protective agent 5-aminolevulinic aci...The aim of this investigation was to determine the optimal storage medium for testicular hypothermic transportation and identify the ideal concentration for the application of the protective agent 5-aminolevulinic acid(5-ALA).Furthermore,this study aimed to explore the underlying mechanism of the protective effects of 5-ALA.First,we collected and stored mouse testicular fragments in different media,including Hank’s balanced salt solution(HBSS;n=5),Dulbecco’s Modified Eagle Medium/Nutrient Mixture F-12(DMEM/F12;n=5),and alpha-minimum essential medium(αMEM;n=5).Storage of testicular tissue in HBSS preserved the integrity of testicular morphology better than that in the DMEM/F12 group(P<0.05)and theαMEM group(P<0.01).Testicular fragments were subsequently placed in HBSS with various concentrations of 5-ALA(0[control],1 mmol l−1,2 mmol l−1,and 5 mmol l−1)to determine the most effective concentration of 5-ALA.The 2 mmol l−15-ALA group(n=3)presented the highest positive rate of spermatogonial stem cells compared with those in the control,1 mmol l−1,and 5 mmol l−15-ALA groups.Finally,the tissue fragments were preserved in HBSS with control(n=3)and 2 mmol l−15-ALA(n=3)under low-temperature conditions.A comparative analysis was performed against fresh testes(n=3)to elucidate the underlying mechanism of 5-ALA.Gene set enrichment analysis(GSEA)for WikiPathways revealed that the p38 mitogen-activated protein kinase(MAPK)signaling pathway was downregulated in the 2 mmol l−15-ALA group compared with that in the control group(normalized enrichment score[NES]=−1.57,false discovery rate[FDR]=0.229,and P=0.019).In conclusion,these data suggest that using 2 mmol l−15-ALA in HBSS effectively protected the viability of spermatogonial stem cells upon hypothermic transportation.展开更多
Dear Editor,We are much obliged that Hadziselimovic1 has used our data2 to highlight the substantial proportion of boys with cryptorchidism where gonadotropin insufficiency is an important factor related to the pathog...Dear Editor,We are much obliged that Hadziselimovic1 has used our data2 to highlight the substantial proportion of boys with cryptorchidism where gonadotropin insufficiency is an important factor related to the pathogenesis.We have recently presented a study on a series of 453 consecutive boys with bilateral nonsyndromic cryptorchidism,in which we conducted hormonal evaluations and assessed germ cell numbers in testicular biopsies.3 In this series,45%of the boys were classified as having gonadotropin insufficiency.3 Identifying these patients at the time of surgery is important.A recent follow-up study of 208 boys with nonsyndromic bilateral cryptorchidism from our department showed that the boys with gonadotropin insufficiency had an impaired fertility potential after surgery compared to boys with an intact hypothalamus–pituitary–gonadal feedback mechanism.4 In a review from 2022,Hadziselimovic5 suggested that infertility in patients diagnosed with cryptorchid testes is a consequence of a hormonal deficiency rather than temperature-induced cellular damage.展开更多
Background:Nuclear receptor-binding SET domain 2(NSD2)is a histone methyltrans-ferase,that catalyzes dimethylation of lysine 36 of histone 3(H3K36me2)and is asso-ciated with active transcription of a series of genes.N...Background:Nuclear receptor-binding SET domain 2(NSD2)is a histone methyltrans-ferase,that catalyzes dimethylation of lysine 36 of histone 3(H3K36me2)and is asso-ciated with active transcription of a series of genes.NSD2 is overexpressed in multiple types of solid human tumors and has been proven to be related to unfavorable prog-nosis in several types of tumors.Methods:We established a mouse model in which the NSD2 gene was conditionally knocked out in intestinal epithelial cells.We used azoxymethane and dextran sodium sulfate to chemically induce murine colorectal cancer.The development of colorectal tumors were investigated using post-necropsy quantification,immunohistochemistry,and enzyme-linked immunosorbent assay(ELISA).Results:Compared with wild-type(WT)control mice,NSD2^(fl/fl)-Vil1-Cre mice exhib-ited significantly decreased tumor numbers,histopathological changes,and cytokine expression in colorectal tumors.Conclusions:Conditional knockout of NSD2 in intestinal epithelial cells significantly inhibits colorectal cancer progression.展开更多
Dear Editor,I would like to congratulate Mamsen et al.i on their extensive and scientifically valuable work.I analyzed their raw data presented in Table 1 of the original article from a different perspective and disco...Dear Editor,I would like to congratulate Mamsen et al.i on their extensive and scientifically valuable work.I analyzed their raw data presented in Table 1 of the original article from a different perspective and discovered an effect not mentioned in the article.My analysis showed that luteinizing hormone(LH)levels are significantly lower in patients at high infertility risk(HIR),whose testes lack A dark(Ad)spermatogonia and display an abnormal ratio of germ cells per crosssectional tubule(G/T).展开更多
It is increasingly recognized that young,chow-fed inbred mice poorly model the com-plexity of human carcinogenesis.In humans,age and adiposity are major risk factors for malignancies,but most genetically engineered mo...It is increasingly recognized that young,chow-fed inbred mice poorly model the com-plexity of human carcinogenesis.In humans,age and adiposity are major risk factors for malignancies,but most genetically engineered mouse models(GEMM)induce car-cinogenesis too rapidly to study these influences.Standard strains,such as C57BL/6,commonly used in GEMMs,further limit the exploration of aging and metabolic health effects.A similar challenge arises in modeling periodontitis,a disease influenced by aging,diabesity,and genetic architecture.We propose using diverse mouse popula-tions with hybrid vigor,such as the Collaborative Cross(CC)×Apc ^(Min) hybrid,to slow disease progression and better model human colorectal cancer(CRC)and comorbidi-ties.This perspective highlights the advantages of this model,where delayed car-cinogenesis reveals interactions with aging and adiposity.Unlike Apc ^(Min) mice,which develop cancer rapidly,CC×Apc ^(Min) hybrids recapitulate human-like progression.This facilitates the identification of modifier loci affecting inflammation,diet susceptibility,organ size,and polyposis distribution.The CC×Apc ^(Min) model offers a transformative platform for studying CRC as a disease of adulthood,reflecting its complex inter-play with aging and comorbidities.The insights gained from this approach will en-hance early detection,management,and treatment strategies for CRC and related conditions.展开更多
In this article,we evaluate the findings of the study by Qian et al,which explores the efficacy of combining hyperthermia with opioid therapy for enhanced cancer pain management in patients with middle and late-stage ...In this article,we evaluate the findings of the study by Qian et al,which explores the efficacy of combining hyperthermia with opioid therapy for enhanced cancer pain management in patients with middle and late-stage gastrointestinal tumors.The study undertakes a retrospective analysis comparing traditional opioid therapy to an integrated approach of hyperthermia and opioids across 70 patients,highlighting significant benefits in pain control,reduction of opioid dosage,and minimization of adverse reactions.In our article,we not only discuss these fin-dings but also emphasize the broader implications for clinical practice,parti-cularly in enhancing patient outcomes through innovative pain management strategies.We advocate for further research to establish more robust data su-pporting this approach and to explore the mechanistic insights that enable these benefits.This discussion reflects on the potential paradigm shift in managing debilitating cancer-related pain,urging a reevaluation of current practices to incorporate these findings effectively.展开更多
BACKGROUND The global incidence of cirrhosis and luminal gastrointestinal cancers are increasing.It is unknown if cirrhosis itself is a predisposing factor for luminal gastrointestinal cancer.Such an association would...BACKGROUND The global incidence of cirrhosis and luminal gastrointestinal cancers are increasing.It is unknown if cirrhosis itself is a predisposing factor for luminal gastrointestinal cancer.Such an association would have significant clinical implications,particularly for cancer screening prior to liver transplantation.AIM To investigate the incidence of luminal gastrointestinal cancers in patients with underlying cirrhosis.METHODS An electronic search was conducted to study the incidence of luminal gastrointestinal cancers in patients with cirrhosis.Study-specific standardized incidence ratios(SIR)along with corresponding 95%CI for both overall cancer incidence and luminal cancer incidence were analyzed using a random-effects model.Subgroup analysis was performed based on cirrhosis etiology and location of luminal malignancy.RESULTS We identified 5054 articles;4 studies were selected for data extraction.The overall incidence of all cancers was significantly higher in patients with cirrhosis,with an SIR of 2.79(95%CI:2.18–3.57).When stratified by cirrhosis etiology,the incidence of luminal cancers remained significantly elevated for alcohol(SIR=3.13,95%CI:2.24–4.39),Primary Biliary Cholangitis(SIR=1.40,95%CI:1.10–1.79),and unspecified cirrhosis(SIR=3.52,95%CI:1.87–6.65).CONCLUSION The incidence of luminal gastrointestinal cancer is increased amongst patients with cirrhosis.Oral cavity,pharyngeal and esophageal cancer had increased incidence across all cirrhosis etiologies compared to gastric and colorectal cancer.Therefore,increased screening of luminal cancers,and in particular these upper luminal tract subtypes,should be considered in this population.展开更多
Colorectal cancer(CRC),ranking as the third most common malignant tumor globally,continues to have high incidence and mortality rates.In China,the incidence of CRC has been increasing in recent years,imposing a heavy ...Colorectal cancer(CRC),ranking as the third most common malignant tumor globally,continues to have high incidence and mortality rates.In China,the incidence of CRC has been increasing in recent years,imposing a heavy economic burden on society[1].Low prevalence of early screening leads to the majority of patients being diagnosed at an advanced stage.Current main treatment methods,such as surgery,chemotherapy,targeted therapy,and immunotherapy,have limited effectiveness for these patients and are prone to recurrence and metastasis.Moreover,the interplay of various pathogenic factors including genetic,environmental,and lifestyle factors increases the difficulty of CRC prevention and treatment[1].展开更多
Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely int...Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely integrated into routine clinical diagnostics of gastric cancer to guide personalized treatment.Human epidermal growth factor receptor 2(HER2)was the first molecular biomarker to be used in gastric cancer with trastuzumab being the first approved targeted therapy for HER2-positive gastric cancer.Programmed death-ligand 1 positivity and microsatellite instability can guide the use of immunotherapies,such as pembrolizumab and nivolumab.More recently,zolbetuximab has been approved for patients with claudin 18.2-positive diseases in some countries.More targeted therapies,including savolitinib for MET-positive patients,are currently under clinical investigation.However,the clinical application of these diagnostic approaches could be hampered by many existing challenges,including invasive and costly sampling methods,variability in immunohistochemistry interpretation,high costs and long turnaround times for next-generation sequencing,the absence of standardized and clinically validated diagnostic cut-off values for some biomarkers,and tumor heterogeneity.Novel testing and analysis techniques,such as artificial intelligence-assisted image analysis and multiplex immunohistochemistry,and emerging therapeutic strategies,including combination therapies that integrate immune checkpoint inhibitors with targeted therapies,offer potential solutions to some of these challenges.This article reviews recent progress in gastric cancer testing,outlines current challenges,and explores future directions for biomarker testing and targeted therapy for gastric cancer.展开更多
Objective To evaluate the efficacy and safety of electroacupuncture(EA)for postoperative recovery in patients with gastrointestinal(GI)cancers.Methods We retrieved articles from PubMed,Embase,OVID,Cochrane Library,Web...Objective To evaluate the efficacy and safety of electroacupuncture(EA)for postoperative recovery in patients with gastrointestinal(GI)cancers.Methods We retrieved articles from PubMed,Embase,OVID,Cochrane Library,Web of Science,CINAHL,SinoMed,China National Knowledge Infrastructure(CNKI),Wanfang,and Technology Journal Database(VIP)from database inception to November 1,2024.Randomized controlled trials(RCTs)that examine the use of EA to improve GI function,reduce pain,and promote ability ofself-care after GI cancer surgery were included.Based on the type of control interventions,separate meta-analyses were conducted for EA vs postoperative nursing(PN)and EA vs sham acupuncture(SA).The primary outcomes were the time to first flatus(TFF)and the time to first defecation(TFD).The secondary outcomes included the time to recovery of bowel sounds(TRBS),the time to tolerance of liquid diet(TTLD),the time to tolerance of semiliquid diet(TTSD),the time to independent walking(TIW),the length of hospitalization(LH),and visual analog scale(VAS)immediate resting pain scores measured on the first,second and third postoperative days(POD 1–3).Results are reported as mean differences(MDs)with 95%confidence intervals(CIs).RevMan 5.3 was used for meta-analysis,StataSE 15.1 was used for sensitivity analyses and Egger’s tests.This study was registered on PROSPERO(CRD42022314754).Results A total of 19 RCTs involving 1902 participants were included,all of which were conducted in China between 2004 and 2023.When EA compared with PN,the meta-analysis showed EA significantly reduce TFF(n=673,MD=-13.14,95%CI=[-18.97 to-7.31],P<0.00001),TFD(n=598,MD=-19.86,95%CI=[-27.83 to-11.89],P<0.00001),TRBS(n=216,MD=-12.44,95%CI=[-15.00 to-9.87],P<0.00001),TTLD(n=268,MD=-18.14,95%CI=[-24.98 to-11.29],P<0.00001),TTSD(n=141,MD=-20.44,95%CI=[-33.84 to-7.04],P=0.003),VAS on POD 1(n=299,MD=-0.52,95%CI=[-0.92 to-0.11],P=0.01),VAS on POD 2(n=256,MD=-0.91,95%CI=[-1.23 to-0.60],P<0.00001),VAS on POD 3(n=203,MD=-0.57,95%CI=[-0.80 to-0.34],P<0.00001),while no significantly decreasing in the LH(n=322,MD=-1.16,95%CI=[-2.56 to 0.24],P=0.10).As EA compared with SA,EA could significantly reduce TFF(n=782,MD=-15.78,95%CI=[-24.96 to-6.60],P=0.0008),TFD(n=782,MD=-20.42,95%CI=[-36.14 to-4.70],P=0.01),LH(n=782,MD=-1.37,95%CI=[-2.69 to-0.05],P=0.04),TIW(n=743,MD=-0.33,95%CI=[-0.62 to-0.04],P=0.03).13 studies reported that EA reduced the incidence of postoperative complications,and 7 studies reported safety assessments of acupuncture-related adverse events,including hematoma,residual needling,sharp pain,pain,soreness or swelling after needle removal,with no serious adverse events.Conclusion EA can significantly promote the recovery of GI function,reduce postoperative pain,enhance ability of self-care in patients undergoing surgery for GI cancers.展开更多
BACKGROUND There is a lack of integrated Chinese and Western medicine treatment regimens supported by high-level evidence-based medicine in the maintenance therapy phase of metastatic colorectal cancer(mCRC).Based on ...BACKGROUND There is a lack of integrated Chinese and Western medicine treatment regimens supported by high-level evidence-based medicine in the maintenance therapy phase of metastatic colorectal cancer(mCRC).Based on the traditional Chinese medicine theory of“Yin tumor”,we believe that“Yang does not transform Yin,and it is blocked in the intestines”is the core pathogenesis of mCRC.Based on the basic treatment principle of“warming Yang and dredging intestines”,we developed the Quxie Capsule.Previous randomized controlled clinical trials demonstrated that the Quxie Capsule can significantly prolong the overall survival of patients with mCRC,but it remains to be verified whether the combination of the“warming Yang and dredging intestines method”prescription with Western medicine standard regimen can prolong the efficacy and safety of the mCRC during the period of maintenance therapy.AIM To confirm and clinically validate that the combination of“warming Yang and dredging intestines method”prescription with Western medicine standard regimen can prolong progression-free survival(PFS)during maintenance treatment of mCRC.The safety of“warming Yang and dredging intestines method”prescription is also assessed.METHODS The study has a prospective,open-label,randomized,controlled study design.Patients have been recruited beginning November 2023 from Xiyuan Hospital of China Academy of Chinese Medical Sciences,Guang’anmen Hospital of China Academy of Chinese Medical Sciences,Dongfang Hospital of Beijing University of Chinese Medicine,and Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine.The study period is from March 2024 to March 2026.After screening in outpatient clinics or wards,subjects who met the inclusion criteria are randomized into the treatment or control group in a 2:1 ratio.The treatment group receives the“warming Yang and dredging intestines method”formula combined with Western standard maintenance therapy.The control group receives Western standard maintenance therapy formulated by the investigators based on the Chinese Society of Clinical Oncology guidelines for colorectal cancer.All participants receive treatment until the occurrence of disease progression,death,or unmanageable adverse effects,with post-treatment monitoring continued until mortality.An independent panel of chief physicians with extensive clinical experience evaluates the progression of the disease.RESULTS This study aims to clarify whether the combination of warming Yang and dredging intestines method formula with standard Western medicine regimens can prolong PFS during maintenance therapy for mCRC and whether the treatment has a favorable safety profile.The goal is to provide a combined Chinese and Western medicine treatment option for clinical physicians and mCRC patients.Notably,with the actual sample size,this study has an 80%probability of detecting a significant difference if a true difference exists.Small sample sizes may lead to increased instability of the results of subgroup analyses,and may also result in findings that are only applicable to patients with characteristics highly similar to those of the present study population(e.g.,specific genotypes,therapeutic backgrounds,etc.),making it difficult to generalize to the broader mCRC population.In the future,it may be possible to expand the sample size based on this study to further validate the efficacy and safety of combining Chinese and Western medicine in the treatment of mCRC.Basic research on the therapeutic combination of warming Yang and dredging intestines method formula and standard Western regimen will be performed in parallel.CONCLUSION This study aims to clarify whether the combination of warming Yang and dredging intestines method formula with standard Western medicine regimens can prolong PFS during maintenance therapy for mCRC and whether the treatment has a favorable safety profile.展开更多
基金Supported by Grant-in-Aid for research by the Kitasato University Medical Center,No.H26-008the JSPS KAKENHI,No.17K16578+3 种基金the JSPS KAKENHI,No.26670609Takeda Science FoundationKitasato University Research Grant for Young ResearchersGrant-in-Aid for research from the Kitasato University Medical Center,No.H25-0006
文摘BACKGROUND The ABCD stratification[combination of serum pepsinogen(PG)levels and titers of antibody(immunoglobulin G,IgG)against Helicobacter pylori(H.pylori)]is effective for the classification of individuals at risk of developing gastric cancer(GC).The Kita–Kyushu lung cancer antigen-1(KK-LC-1)is a Cancer/Testis antigen frequently expressed in GC.AIM To evaluate the effectiveness of KK-LC-1 and ABCD stratification in the diagnosis of GC.METHODS We analyzed the gene expression of KK-LC-1 in surgical specimens obtained from GC tumors.The levels of serum PG I/PG II and IgG against H.pylori were measured.According to their serological status,the patients were classified into the four groups of the ABCD stratification.RESULTS Of the 77 examined patients,63(81.8%)expressed KK-LC-1.The IgG titers of H.pylori and PG II were significantly higher in patients expressing KK-LC-1 than those measured in patients not expressing KK-LC-1(P=0.0289 and P=0.0041,respectively).The expression of KK-LC-1 in group C[PG method(+)/H.pylori infection(+)]was as high as 93.9%high.KK-LC-1 was also detected in group A[-/-].CONCLUSION The KK-LC-1 expression in GC was associated with H.pylori infection and atrophic status,so that,KK-LC-1 may be a useful marker for the diagnosis of GC.
文摘Prostate-associated gene 4 （PAGE4） is a remarkably prostate-specific Cancer/Testis Antigen that is highly upregulated in the human fetal prostate and its diseased states but not in the adult normal gland. PAGE4 is an intrinsically disordered protein （IDP） that functions as a stress-response protein to suppress reactive oxygen species as well as prevent DNA damage. In addition, PAGE4 is also a transcriptional regulator that potentiates transactivation by the oncogene c-Jun, c-Jun forms the AP-1 complex by heterodimerizing with members of the Fos family and plays an important role in the development and pathology of the prostate gland, underscoring the importance of the PAGE4/c-Jun interaction. HIPK1, also a component of the stress-response pathway, phosphorylates PAGE4 at T51 which is critical for its transcriptional activity. Phosphorylation induces conformational and dynamic switching in the PAGE4 ensemble leading to a new cellular function. Finally, bioinformatics evidence suggests that the PAGE4 mRNA could be alternatively spliced resulting in four potential isoforms of the polypeptide alluding to the possibility of a range of conformational ensembles with latent functions. Considered together, the data suggest that PAGE4 may represent the first molecular link between stress and prostate cancer （PCa）. Thus, pharmacologically targeting PAGE4 may be a novel opportunity for treating and managing patients with PCa, especially patients with low-risk disease.
文摘The introduction of serum prostate-specific antigen （PSA） in the 1980s has dramatically altered and benefited the initial diagnosis of prostate cancer. However, the widespread use of PSA testing has resulted in overdetection and overtreatment of potentially indolent disease. Thus, a clinical dilemma today in the management of prostate cancer is to discern men with aggressive disease who need definitive treatment from men whose disease are not lethal. Although several serum and tissue biomarkers have been evaluated during the past decade, improved markers are still needed to enhance the accuracy, with which patients at risk can be discerned and treated more aggressively. The cancer/testis antigens （CTAs） are a group of proteins that are restricted to the testis in the normal adult, but are aberrantly expressed in several types of cancers. Because of their restricted expression pattern, the CTAs represent attractive biomarker candidates for cancer diagnosis/prognosis. Furthermore, several studies to date have reported the differential expression of CTAs in prostate cancer. Here, we review recent developments that demonstrate the potential of the CTAs as biomarkers to discern the a^ressive Dhenotvoe of orostate cancer.
基金supported by the National Key R&D Program of China(grant number:2023YFC2415200)National Natural Science Foundation of China(grant numbers:82361168664,U24A20759,82441018,82372053,92259302,62027901,82302296)+6 种基金Science and Technology Development Fund of Macao Special Administrative Region(grant number:0006/2023/AFJ)Strategic Priority Research Program of the Chinese Academy of Sciences(grant number:XDB38040200)Beijing Natural Science Foundation(grant numbers:Z20J00105,JQ24048)Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences(grant number:CI2023C008YG)Key-Area Re-search and Development Program of Guangdong Province(grant number:2021B0101420005)the Youth Innovation Promotion Association CAS(grant number:Y2021049)China Postdoctoral Science Foun-dation under Grant(grant number:2022M720357)。
文摘Upper gastrointestinal cancers,mainly comprising esophageal and gastric cancers,are among the most prevalent cancers worldwide.There are many new cases of upper gastrointestinal cancers annually,and the survival rate tends to be low.Therefore,timely screening,precise diagnosis,appropriate treatment strategies,and effective prognosis are crucial for patients with upper gastrointestinal cancers.In recent years,an increasing number of studies suggest that artificial intelligence(AI)technology can effectively address clinical tasks related to upper gastrointestinal cancers.These studies mainly focus on four aspects:screening,diagnosis,treatment,and progno-sis.In this review,we focus on the application of AI technology in clinical tasks related to upper gastrointestinal cancers.Firstly,the basic application pipelines of radiomics and deep learning in medical image analysis were introduced.Furthermore,we separately reviewed the application of AI technology in the aforementioned aspects for both esophageal and gastric cancers.Finally,the current limitations and challenges faced in the field of upper gastrointestinal cancers were summarized,and explorations were conducted on the selection of AI algorithms in various scenarios,the popularization of early screening,the clinical applications of AI,and large multimodal models.
基金Supported by Gansu Provincial Natural Science Foundation,No.21JR1RA010In-Hospital Research Fund of Gansu Provincial Hospital,No.23GSSYD-5.
文摘BACKGROUND The incidence of malignant gastrointestinal(GI)tumors is increasing,and advancements in medical care have significantly improved patient survival rates.As a result,the number of cases involving multiple primary cancers(MPC)has also increased.The rarity of MPC and the absence of sensitive and specific dia-gnostic markers often lead to missed or incorrect diagnoses.It is,therefore,of vital importance to improve the vigilance of clinicians and the accurate diagnosis of this disease.Patients with GI malignancies face a higher relative risk of deve-loping additional primary malignant tumors compared to those with other systemic tumors.Vigilant monitoring and follow-up are crucial,especially for high-risk groups,which include older adults,men,those with addictions to alcohol and tobacco,those with a family history of tumors,and those who have undergone radiotherapy.CASE SUMMARY In this article,we report three cases of MPC,each involving malignant tumors of the GI tract as the initial primary carcinoma,offering insights that may aid in effectively managing similar cases.CONCLUSION Patients with GI malignancies face a higher MPC risk.Developing screening and follow-up protocols may enhance detection and treatment outcomes.
基金supported in part by the National Natural Science Foundation of China(Nos.32270555 and 32072954).
文摘Hedgehog(HH)signaling has been researched for decades and Hedgehog has 3 homologs:Sonic Hedgehog(Shh),Indian Hedgehog(Ihh),and Desert Hedgehog(Dhh).Dhh is the one involved in male gonad and germ cell development.The distribution of molecules in Hedgehog signaling in testis indicated that Hedgehog signaling executes important functions during testis development.The patients with Dhh signaling deficiency develop dysgenesis of gonads and hormone production which demands further exploration of gonad HH signaling.Some results proved the indispensable roles of HH signaling in gonad and germ cell development and the interaction with hormones.This review evaluates HH functions in the testis and how HH affects and is affected by hormones and provides novel insights about HH signaling to the readers.
基金supported by the Scientific Research Fund Project of Education Department of Yunnan Province,China(No.2024Y386).
文摘Numerous research conducted in recent years has revealed that gut microbial dysbiosis,such as modifications in composition and activity,might influence lung tissue homeostasis through specific pathways,thereby promoting susceptibility to lung diseases.The development and progression of lung cancer,as well as the effectiveness of immunotherapy are closely associated with gut flora and metabolites,which influence immunological and inflammatory responses.During abnormal proliferation,non-small cell lung cancer cells acquire more substances and energy by altering their own metabolic pathways.Glucose and amino acid metabolism reprogramming provide tumor cells with abundant ATP,carbon,and nitrogen sources,respectively,providing optimal conditions for tumor cell proliferation,invasion,and immune escape.This article reviews the relationship of immune response with gut flora and metabolic reprogramming in non-small cell lung cancer,and discusses the potential mechanisms by which gut flora and metabolic reprogramming affect the occurrence,development,and immunotherapy of non-small cell lung cancer,in order to provide new ideas for precision treatment of lung cancer patients.
基金Supported by the National Natural Science Foundation of China,No.82273457the Natural Science Foundation of Guangdong Province,No.2023A1515012762 and No.2021A1515010846+1 种基金Special Grant for Key Area Programs of Guangdong Department of Education,No.2021ZDZX2040Science and Technology Special Project of Guangdong Province,No.210715216902829.
文摘The sine oculis homeobox homolog(SIX)family,a group of transcription factors characterized by a conserved DNA-binding homology domain,plays a critical role in orchestrating embryonic development and organogenesis across various organisms,including humans.Comprising six distinct members,from SIX1 to SIX6,each member contributes uniquely to the development and differentiation of diverse tissues and organs,underscoring the versatility of the SIX family.Dysregulation or mutations in SIX genes have been implicated in a spectrum of developmental disorders,as well as in tumor initiation and progression,highlighting their pivotal role in maintaining normal developmental trajectories and cellular functions.Efforts to target the transcriptional complex of the SIX gene family have emerged as a promising strategy to inhibit tumor development.While the development of inhibitors targeting this gene family is still in its early stages,the significant potential of such interventions holds promise for future therapeutic advances.Therefore,this review aimed to comprehensively explore the advancements in understanding the SIX family within gastrointestinal cancers,focusing on its critical role in normal organ development and its implications in gastrointestinal cancers,including gastric,pancreatic,colorectal cancer,and hepatocellular carcinomas.In conclusion,this review deepened the understanding of the functional roles of the SIX family and explored the potential of utilizing this gene family for the diagnosis,prognosis,and treatment of gastrointestinal cancers.
基金Supported by the National Key R and D Program of China,No.2022YFC3500200,No.2022YFC3500202 and No.2022YFC3500204Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine,No.ZYYCXTD-C-202208+4 种基金NATCM’s Project of High-Level Construction of Key TCM Disciplines,No.[2023]85Qing Lan Project of Jiangsu Higher Education Institutions,No.[2023]27Postgraduate Research&Practice Innovation Program of Jiangsu Province,No.SJCX22_0706General Project of Universities’Philosophy and Social Science in Jiangsu Province,No.2024SJYB0564Jiangsu Provincial Leading Talents Program in Traditional Chinese Medicine,No.SLJ0314.
文摘BACKGROUND Gastrointestinal cancers are among the most commonly diagnosed cancers globally.Traditional Chinese medicine(TCM)offers distinct advantages in preventing and treating these cancers.AIM To investigate the metabolic basis of a common TCM syndrome in gastrointestinal cancers,exploring underlying metabolic mechanisms and identifying potential METHODS Thirty healthy controls(normal group),30 patients with gastric cancer(GC),and 30 patients with colorectal cancer(CRC)were enrolled in 2023.Plasma metabolic profiles were detected using gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry,and pathway enrichment analysis was conducted using the Kyoto Encyclopedia of Genes and Genomes.RESULTS Metabolic profiling revealed distinct alterations in gastrointestinal cancers.CRC samples exhibited 455 differentially expressed metabolites(234 upregulated and 221 downregulated).Similarly,GC samples exhibited 459 differentially expressed metabolites(251 upregulated and 208 downregulated).Additionally,352 shared metabolites were identified among gastrointestinal cancers.Enrichment analysis highlighted the involvement of these shared metabolites in 10 metabolic pathways.CONCLUSION To some extent,this study revealed the metabolomic characteristics of spleen deficiency and blood stasis toxin(PXYD)syndrome in gastrointestinal cancers.It provides the rationale for the"same treatment for different diseases"approach in PXYD syndrome of gastrointestinal cancers,and for identifying potential metabolomicsbased biomarkers.
基金funded by the National Natural Science Foundation of China(No.81971759 and No.82171604)the Guangdong Basic and Applied Basic Research Foundation(2023B1515020108)+3 种基金the Science and Technology Program of Guangzhou(202206010089)the Excellent Talents Training Project of The Sixth Affiliated Hospital of Sun Yat-sen University(R20210217202601970)the Postdoctoral Fellowship Program of CPSF(GZC20233216)the Basic and Applied Basic Research Foundation of Guangdong Province(2021A1515111195).
文摘The aim of this investigation was to determine the optimal storage medium for testicular hypothermic transportation and identify the ideal concentration for the application of the protective agent 5-aminolevulinic acid(5-ALA).Furthermore,this study aimed to explore the underlying mechanism of the protective effects of 5-ALA.First,we collected and stored mouse testicular fragments in different media,including Hank’s balanced salt solution(HBSS;n=5),Dulbecco’s Modified Eagle Medium/Nutrient Mixture F-12(DMEM/F12;n=5),and alpha-minimum essential medium(αMEM;n=5).Storage of testicular tissue in HBSS preserved the integrity of testicular morphology better than that in the DMEM/F12 group(P<0.05)and theαMEM group(P<0.01).Testicular fragments were subsequently placed in HBSS with various concentrations of 5-ALA(0[control],1 mmol l−1,2 mmol l−1,and 5 mmol l−1)to determine the most effective concentration of 5-ALA.The 2 mmol l−15-ALA group(n=3)presented the highest positive rate of spermatogonial stem cells compared with those in the control,1 mmol l−1,and 5 mmol l−15-ALA groups.Finally,the tissue fragments were preserved in HBSS with control(n=3)and 2 mmol l−15-ALA(n=3)under low-temperature conditions.A comparative analysis was performed against fresh testes(n=3)to elucidate the underlying mechanism of 5-ALA.Gene set enrichment analysis(GSEA)for WikiPathways revealed that the p38 mitogen-activated protein kinase(MAPK)signaling pathway was downregulated in the 2 mmol l−15-ALA group compared with that in the control group(normalized enrichment score[NES]=−1.57,false discovery rate[FDR]=0.229,and P=0.019).In conclusion,these data suggest that using 2 mmol l−15-ALA in HBSS effectively protected the viability of spermatogonial stem cells upon hypothermic transportation.
文摘Dear Editor,We are much obliged that Hadziselimovic1 has used our data2 to highlight the substantial proportion of boys with cryptorchidism where gonadotropin insufficiency is an important factor related to the pathogenesis.We have recently presented a study on a series of 453 consecutive boys with bilateral nonsyndromic cryptorchidism,in which we conducted hormonal evaluations and assessed germ cell numbers in testicular biopsies.3 In this series,45%of the boys were classified as having gonadotropin insufficiency.3 Identifying these patients at the time of surgery is important.A recent follow-up study of 208 boys with nonsyndromic bilateral cryptorchidism from our department showed that the boys with gonadotropin insufficiency had an impaired fertility potential after surgery compared to boys with an intact hypothalamus–pituitary–gonadal feedback mechanism.4 In a review from 2022,Hadziselimovic5 suggested that infertility in patients diagnosed with cryptorchid testes is a consequence of a hormonal deficiency rather than temperature-induced cellular damage.
基金supported by the National Key Research and Development Program of China (2022YFF0710705)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2021-I2M-1-0 13)+2 种基金funding support from the Special Research Fund for Central UniversitiesPeking Union Medical College (3332022182)the 111 Project (B20095)
文摘Background:Nuclear receptor-binding SET domain 2(NSD2)is a histone methyltrans-ferase,that catalyzes dimethylation of lysine 36 of histone 3(H3K36me2)and is asso-ciated with active transcription of a series of genes.NSD2 is overexpressed in multiple types of solid human tumors and has been proven to be related to unfavorable prog-nosis in several types of tumors.Methods:We established a mouse model in which the NSD2 gene was conditionally knocked out in intestinal epithelial cells.We used azoxymethane and dextran sodium sulfate to chemically induce murine colorectal cancer.The development of colorectal tumors were investigated using post-necropsy quantification,immunohistochemistry,and enzyme-linked immunosorbent assay(ELISA).Results:Compared with wild-type(WT)control mice,NSD2^(fl/fl)-Vil1-Cre mice exhib-ited significantly decreased tumor numbers,histopathological changes,and cytokine expression in colorectal tumors.Conclusions:Conditional knockout of NSD2 in intestinal epithelial cells significantly inhibits colorectal cancer progression.
文摘Dear Editor,I would like to congratulate Mamsen et al.i on their extensive and scientifically valuable work.I analyzed their raw data presented in Table 1 of the original article from a different perspective and discovered an effect not mentioned in the article.My analysis showed that luteinizing hormone(LH)levels are significantly lower in patients at high infertility risk(HIR),whose testes lack A dark(Ad)spermatogonia and display an abnormal ratio of germ cells per crosssectional tubule(G/T).
基金Israel Cancer Research FoundationSamuel Waxman Cancer Research FoundationCore funding from Tel Aviv University。
文摘It is increasingly recognized that young,chow-fed inbred mice poorly model the com-plexity of human carcinogenesis.In humans,age and adiposity are major risk factors for malignancies,but most genetically engineered mouse models(GEMM)induce car-cinogenesis too rapidly to study these influences.Standard strains,such as C57BL/6,commonly used in GEMMs,further limit the exploration of aging and metabolic health effects.A similar challenge arises in modeling periodontitis,a disease influenced by aging,diabesity,and genetic architecture.We propose using diverse mouse popula-tions with hybrid vigor,such as the Collaborative Cross(CC)×Apc ^(Min) hybrid,to slow disease progression and better model human colorectal cancer(CRC)and comorbidi-ties.This perspective highlights the advantages of this model,where delayed car-cinogenesis reveals interactions with aging and adiposity.Unlike Apc ^(Min) mice,which develop cancer rapidly,CC×Apc ^(Min) hybrids recapitulate human-like progression.This facilitates the identification of modifier loci affecting inflammation,diet susceptibility,organ size,and polyposis distribution.The CC×Apc ^(Min) model offers a transformative platform for studying CRC as a disease of adulthood,reflecting its complex inter-play with aging and comorbidities.The insights gained from this approach will en-hance early detection,management,and treatment strategies for CRC and related conditions.
基金Supported by the Shandong Province Medical and Health Science and Technology Development Plan Project,No.202203030713Science and Technology Program of Yantai Affiliated Hospital of Binzhou Medical University,No.YTFY2022KYQD06.
文摘In this article,we evaluate the findings of the study by Qian et al,which explores the efficacy of combining hyperthermia with opioid therapy for enhanced cancer pain management in patients with middle and late-stage gastrointestinal tumors.The study undertakes a retrospective analysis comparing traditional opioid therapy to an integrated approach of hyperthermia and opioids across 70 patients,highlighting significant benefits in pain control,reduction of opioid dosage,and minimization of adverse reactions.In our article,we not only discuss these fin-dings but also emphasize the broader implications for clinical practice,parti-cularly in enhancing patient outcomes through innovative pain management strategies.We advocate for further research to establish more robust data su-pporting this approach and to explore the mechanistic insights that enable these benefits.This discussion reflects on the potential paradigm shift in managing debilitating cancer-related pain,urging a reevaluation of current practices to incorporate these findings effectively.
文摘BACKGROUND The global incidence of cirrhosis and luminal gastrointestinal cancers are increasing.It is unknown if cirrhosis itself is a predisposing factor for luminal gastrointestinal cancer.Such an association would have significant clinical implications,particularly for cancer screening prior to liver transplantation.AIM To investigate the incidence of luminal gastrointestinal cancers in patients with underlying cirrhosis.METHODS An electronic search was conducted to study the incidence of luminal gastrointestinal cancers in patients with cirrhosis.Study-specific standardized incidence ratios(SIR)along with corresponding 95%CI for both overall cancer incidence and luminal cancer incidence were analyzed using a random-effects model.Subgroup analysis was performed based on cirrhosis etiology and location of luminal malignancy.RESULTS We identified 5054 articles;4 studies were selected for data extraction.The overall incidence of all cancers was significantly higher in patients with cirrhosis,with an SIR of 2.79(95%CI:2.18–3.57).When stratified by cirrhosis etiology,the incidence of luminal cancers remained significantly elevated for alcohol(SIR=3.13,95%CI:2.24–4.39),Primary Biliary Cholangitis(SIR=1.40,95%CI:1.10–1.79),and unspecified cirrhosis(SIR=3.52,95%CI:1.87–6.65).CONCLUSION The incidence of luminal gastrointestinal cancer is increased amongst patients with cirrhosis.Oral cavity,pharyngeal and esophageal cancer had increased incidence across all cirrhosis etiologies compared to gastric and colorectal cancer.Therefore,increased screening of luminal cancers,and in particular these upper luminal tract subtypes,should be considered in this population.
文摘Colorectal cancer(CRC),ranking as the third most common malignant tumor globally,continues to have high incidence and mortality rates.In China,the incidence of CRC has been increasing in recent years,imposing a heavy economic burden on society[1].Low prevalence of early screening leads to the majority of patients being diagnosed at an advanced stage.Current main treatment methods,such as surgery,chemotherapy,targeted therapy,and immunotherapy,have limited effectiveness for these patients and are prone to recurrence and metastasis.Moreover,the interplay of various pathogenic factors including genetic,environmental,and lifestyle factors increases the difficulty of CRC prevention and treatment[1].
基金support by grants from Capital’s Funds for Health Improvement and Research(Grant No.2024-2-1024)Beijing Natural Science Foundation(Grant No.7232018).
文摘Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely integrated into routine clinical diagnostics of gastric cancer to guide personalized treatment.Human epidermal growth factor receptor 2(HER2)was the first molecular biomarker to be used in gastric cancer with trastuzumab being the first approved targeted therapy for HER2-positive gastric cancer.Programmed death-ligand 1 positivity and microsatellite instability can guide the use of immunotherapies,such as pembrolizumab and nivolumab.More recently,zolbetuximab has been approved for patients with claudin 18.2-positive diseases in some countries.More targeted therapies,including savolitinib for MET-positive patients,are currently under clinical investigation.However,the clinical application of these diagnostic approaches could be hampered by many existing challenges,including invasive and costly sampling methods,variability in immunohistochemistry interpretation,high costs and long turnaround times for next-generation sequencing,the absence of standardized and clinically validated diagnostic cut-off values for some biomarkers,and tumor heterogeneity.Novel testing and analysis techniques,such as artificial intelligence-assisted image analysis and multiplex immunohistochemistry,and emerging therapeutic strategies,including combination therapies that integrate immune checkpoint inhibitors with targeted therapies,offer potential solutions to some of these challenges.This article reviews recent progress in gastric cancer testing,outlines current challenges,and explores future directions for biomarker testing and targeted therapy for gastric cancer.
基金Supported by the Capital Health Development Research Special Program:2022-4-7016。
文摘Objective To evaluate the efficacy and safety of electroacupuncture(EA)for postoperative recovery in patients with gastrointestinal(GI)cancers.Methods We retrieved articles from PubMed,Embase,OVID,Cochrane Library,Web of Science,CINAHL,SinoMed,China National Knowledge Infrastructure(CNKI),Wanfang,and Technology Journal Database(VIP)from database inception to November 1,2024.Randomized controlled trials(RCTs)that examine the use of EA to improve GI function,reduce pain,and promote ability ofself-care after GI cancer surgery were included.Based on the type of control interventions,separate meta-analyses were conducted for EA vs postoperative nursing(PN)and EA vs sham acupuncture(SA).The primary outcomes were the time to first flatus(TFF)and the time to first defecation(TFD).The secondary outcomes included the time to recovery of bowel sounds(TRBS),the time to tolerance of liquid diet(TTLD),the time to tolerance of semiliquid diet(TTSD),the time to independent walking(TIW),the length of hospitalization(LH),and visual analog scale(VAS)immediate resting pain scores measured on the first,second and third postoperative days(POD 1–3).Results are reported as mean differences(MDs)with 95%confidence intervals(CIs).RevMan 5.3 was used for meta-analysis,StataSE 15.1 was used for sensitivity analyses and Egger’s tests.This study was registered on PROSPERO(CRD42022314754).Results A total of 19 RCTs involving 1902 participants were included,all of which were conducted in China between 2004 and 2023.When EA compared with PN,the meta-analysis showed EA significantly reduce TFF(n=673,MD=-13.14,95%CI=[-18.97 to-7.31],P<0.00001),TFD(n=598,MD=-19.86,95%CI=[-27.83 to-11.89],P<0.00001),TRBS(n=216,MD=-12.44,95%CI=[-15.00 to-9.87],P<0.00001),TTLD(n=268,MD=-18.14,95%CI=[-24.98 to-11.29],P<0.00001),TTSD(n=141,MD=-20.44,95%CI=[-33.84 to-7.04],P=0.003),VAS on POD 1(n=299,MD=-0.52,95%CI=[-0.92 to-0.11],P=0.01),VAS on POD 2(n=256,MD=-0.91,95%CI=[-1.23 to-0.60],P<0.00001),VAS on POD 3(n=203,MD=-0.57,95%CI=[-0.80 to-0.34],P<0.00001),while no significantly decreasing in the LH(n=322,MD=-1.16,95%CI=[-2.56 to 0.24],P=0.10).As EA compared with SA,EA could significantly reduce TFF(n=782,MD=-15.78,95%CI=[-24.96 to-6.60],P=0.0008),TFD(n=782,MD=-20.42,95%CI=[-36.14 to-4.70],P=0.01),LH(n=782,MD=-1.37,95%CI=[-2.69 to-0.05],P=0.04),TIW(n=743,MD=-0.33,95%CI=[-0.62 to-0.04],P=0.03).13 studies reported that EA reduced the incidence of postoperative complications,and 7 studies reported safety assessments of acupuncture-related adverse events,including hematoma,residual needling,sharp pain,pain,soreness or swelling after needle removal,with no serious adverse events.Conclusion EA can significantly promote the recovery of GI function,reduce postoperative pain,enhance ability of self-care in patients undergoing surgery for GI cancers.
基金Supported by the National Natural Science Foundation of China,No.82174461Capacity Enhancement Program of Xiyuan Hospital,China Academy of Traditional Chinese Medicine,No.XYZX0201-22Science and Technology Innovation Project of China Academy of Traditional Chinese Medicine,No.CI2021A01811.
文摘BACKGROUND There is a lack of integrated Chinese and Western medicine treatment regimens supported by high-level evidence-based medicine in the maintenance therapy phase of metastatic colorectal cancer(mCRC).Based on the traditional Chinese medicine theory of“Yin tumor”,we believe that“Yang does not transform Yin,and it is blocked in the intestines”is the core pathogenesis of mCRC.Based on the basic treatment principle of“warming Yang and dredging intestines”,we developed the Quxie Capsule.Previous randomized controlled clinical trials demonstrated that the Quxie Capsule can significantly prolong the overall survival of patients with mCRC,but it remains to be verified whether the combination of the“warming Yang and dredging intestines method”prescription with Western medicine standard regimen can prolong the efficacy and safety of the mCRC during the period of maintenance therapy.AIM To confirm and clinically validate that the combination of“warming Yang and dredging intestines method”prescription with Western medicine standard regimen can prolong progression-free survival(PFS)during maintenance treatment of mCRC.The safety of“warming Yang and dredging intestines method”prescription is also assessed.METHODS The study has a prospective,open-label,randomized,controlled study design.Patients have been recruited beginning November 2023 from Xiyuan Hospital of China Academy of Chinese Medical Sciences,Guang’anmen Hospital of China Academy of Chinese Medical Sciences,Dongfang Hospital of Beijing University of Chinese Medicine,and Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine.The study period is from March 2024 to March 2026.After screening in outpatient clinics or wards,subjects who met the inclusion criteria are randomized into the treatment or control group in a 2:1 ratio.The treatment group receives the“warming Yang and dredging intestines method”formula combined with Western standard maintenance therapy.The control group receives Western standard maintenance therapy formulated by the investigators based on the Chinese Society of Clinical Oncology guidelines for colorectal cancer.All participants receive treatment until the occurrence of disease progression,death,or unmanageable adverse effects,with post-treatment monitoring continued until mortality.An independent panel of chief physicians with extensive clinical experience evaluates the progression of the disease.RESULTS This study aims to clarify whether the combination of warming Yang and dredging intestines method formula with standard Western medicine regimens can prolong PFS during maintenance therapy for mCRC and whether the treatment has a favorable safety profile.The goal is to provide a combined Chinese and Western medicine treatment option for clinical physicians and mCRC patients.Notably,with the actual sample size,this study has an 80%probability of detecting a significant difference if a true difference exists.Small sample sizes may lead to increased instability of the results of subgroup analyses,and may also result in findings that are only applicable to patients with characteristics highly similar to those of the present study population(e.g.,specific genotypes,therapeutic backgrounds,etc.),making it difficult to generalize to the broader mCRC population.In the future,it may be possible to expand the sample size based on this study to further validate the efficacy and safety of combining Chinese and Western medicine in the treatment of mCRC.Basic research on the therapeutic combination of warming Yang and dredging intestines method formula and standard Western regimen will be performed in parallel.CONCLUSION This study aims to clarify whether the combination of warming Yang and dredging intestines method formula with standard Western medicine regimens can prolong PFS during maintenance therapy for mCRC and whether the treatment has a favorable safety profile.
