Moderated Poster Presentation

Abstract

MP-01-01

Bloody stool: diagnosis from colonoscopy findings in Dr. Cipto Mangunkusumo General National Hospital

Saskia Nursyirwan¹ and Izzati Diyanah²

¹Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Dr. Cipto Mangunkusumo Hospital/Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; ²Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

Moderated Poster 1, November 22, 2024, 12:20 PM - 12:50 PM.

Objectives: A colonoscopy is a diagnostic and therapeutic tool widely used to confirm the diagnosis of digestive tract diseases, including GI bleeding. It is beneficial in determining the etiology of a complaint. Bloody stool is one of the complaints frequently encountered in health facilities. This study examines the various colonoscopy findings in patients with bloody stool who underwent gastrointestinal colonoscopy. It is essential to determine the enforcement of the diagnosis and provide appropriate management.

Materials and methods: Data were retrospectively collected and analyzed from the medical records of patients who underwent colonoscopy procedures between 2021–2023 at Digestive Endoscopy Center, Dr. Cipto Mangunkusumo General National Hospital.

Results: Between 2021 and 2023, data from 1,120 colonoscopy patients at Dr. Cipto Mangunkusumo General National Hospital revealed that 656 (58.6%) were female and 464 (41.4%) were male. Among the 372 patients reporting bloody stool. The most common findings were internal or external hemorrhoids (38.98%), followed by proctitis (18.28%), and other findings that were dominated by tumors or masses (17.5%). Other diagnoses included polyps (12.36%), ileitis (9.7%), colorectal cancer (7.26%), ulcerative colitis (5.64%), and Crohn's disease (5.1%). Diverticulosis and rectal ulcers were each identified in 11 patients (2.96%). On the other hand, 12 patients (3.22%) were identified as normal in their colonoscopy results.

Conclusion: This study found that most colonoscopy findings in patients with bloody stool are internal or external hemorrhoids, followed by proctitis and other findings that were dominated by tumors or masses.

MP-01-02

Effect and safety of sofosbuvir/velpatasvir/voxilaprevir for patients with CHC previously treated with DAAs

Sangdeok Shin¹, Sung Hwan Yoo^2,3, Tae Seop Lim^2,4, Chang Won Ha¹, Byeong Geun Song¹, Myung Ji Goh¹, Dong Hyun Shin¹, Geum-Youn Gwak¹, Young Han Paik^1,6, Moon Seok Choi¹, Hye Won Lee^2,5 and Wonseok Kang^1,6

¹Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine; ²Department of Internal Medicine, Yonsei University College of Medicine; ³Gangnam Everance Hospital; ⁴Yongin Severance Hospital, Yongin-si, North Korea; ⁵Yonsei Liver Center, Severance Hospital, Seodaemun-gu; ⁶Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Gangnam-gu

Moderated Poster 1, November 22, 2024, 12:20 PM - 12:50 PM

Background and Aims: Sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) has recently been introduced to Korea for the treatment of patients with chronic hepatitis C virus (HCV) infection who have failed previous treatments with DAAs, based on genotype and the degree of cirrhosis. We aimed to evaluate the effectiveness and safety of SOF/VEL/VOX in a real-life clinical practice in Korea.

Methods: In this multicenter study, a total of 30 patients with chronic HCV infection who have failed previous treatments with direct acting antivirals (DAAs) were treated with SOF/VEL/VOX between November 2022 and February 2024. Sustained virologic response at 12 weeks after the end of treatment (SVR12) rate, change in noninvasive fibrosis markers (i.e. FIB-4), and treatment-related adverse events of SOF/VEL/VOX treatment wereanalyzed.

Results: The mean age was 61.3 years, and 66.7% were female. Nine patients (30%) had cirrhosis. HCV genotype distribution was as follows: 19 patients (63.3%) with genotype 1b, 7 (23.3%) with genotype 2, 3 (10%) with genotype 3, and 1 (3.3%) with genotype 6. Among the patients with cirrhosis, the FIB-4 index decreased from 5.68 (range, 2.61 – 11.12) to 4.13 (range, 1.83 – 9.38) after treatment. The end-of-treatment response rate was 100% (26/26) and SVR12 rate was 100% (27/27), with no treatment-related adverse effects observed.

Conclusion: The use of SOF/VEL/VOX in patients with chronic hepatitis C who have failed previous DAA treatments demonstrated excellent effectiveness and safety profiles, highlighting SOF/VEL/VOX as a highly effective and safe treatment option for this patient population in a real-world clinical setting in Korea.

MP-01-03

Predicting gastrointestinal stromal tumor: risk stratification via patient characteristics and endoscopic ultrasound with machine learning

Jeffrey Sun¹ and Cheuk Kay Sun²

¹West Middlesex Hospital/Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; ²Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

Moderated Poster 1, November 22, 2024, 12:20 PM - 12:50 PM.

Objectives: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumor in the gastrointestinal tract. Due to their malignant potential, international guidelines advocate for resection regardless of size once tissue proven for GIST; however, the subepithelial nature of these lesions often causes tissue sampling difficulties.

The objective of this study was to analyze different presentations, risk factors and Endoscopic ultrasound (EUS) findings using machine learning (ML) algorithms to identify significant predictors which denote positive finding of GIST.

Materials and Methods: This retrospective study uses data collected from 92 patients who had undergone EUS and subsequent endoscopic resection. A total of 118 independent variables were analyzed, including risk factors, symptomatology and EUS findings, comparing four different integrated ML schemes; namely XGB, CART, LGR LASSO and RF.

Results: LGR LASSO demonstrated the greatest efficacy compared to other ML schemes. Thirteen variables showed predictive value. The top five significant predictors for positive results on tissue biopsy for GIST were lesion localization to the gastric fundus, homogeneity on EUS, echogenicity on EUS, a history of peptic ulcer disease, and lesion growth patterns.

Conclusion: The conclusions drawn from this study would be able to identify patients with strong positive predictors for GIST who would benefit from early resection and more rigorous follow-up. The results from our study are promising and further studies could lead to the formulation of a risk stratification score to assess the likelihood of GIST, which would help determine the need for endoscopic biopsy and additional clinical intervention.

MP-01-04

Diagnosis of autoimmune gastritis: focus on typical endoscopic images

Ms Anastasiia Kasikhina, Sergei Kashin, Kuvaev Roman and Chamorovskaya Alevtina

Yaroslavl State Cancer Hospital, Yaroslavl, Russian Federation

Moderated Poster 1, November 22, 2024, 12:20 PM - 12:50 PM.

Objectives: The prevalence of autoimmune gastritis (AIG) in the population is estimated low, to range from 0.5 to 4.5% globally. The number of missed cases of AIG is unknow. The key to improving the detection of this disease is the identification of typical endoscopic features.

Materials: A total of 90 patients with AIG from 2 institutions in Russia from January 2022 to June 2024 were included, and their clinical and endoscopic findings were evaluated. Gastroscopy using imaging techniques (narrow-spectral examination with magnification function, Dual Focus) with evaluation of typical endoscopic features of AIG was performed in 100% (90/90) of cases.

Results: Mean age was 60,8 years, and 85,6% of the participants were women. The approach to diagnose AIG was endoscopic examination. Refractory iron-deficiency anemia, previously diagnosed neuroendocrine tumor, ranked the basis for diagnosis of AIG. Typical endoscopic features of AIG have been founded: “reverse atrophy” - 93,3%, normal antrum - 28,8%, remnant oxyntic mucosa was found in 48,8% of the patients and new signs of AIG: white globe appearance - 55,5%, glomus-like lesions - 52,2%, NETs 1 type - 36,6%, size smaller than 5 mm- 60,6%, gastric adenocarcinoma - 5,5%, adenoma - 6,6%.

MP-01-05

The effectiveness of written vs verbal screening advice for relatives of colorectal cancer patients

Taya Kitiyakara

Ramathibodi hospital, Bangkok, Thailand

Moderated Poster 1, November 22, 2024, 12:20 PM - 12:50 PM.

Background: Colorectal cancer (CRC) is a major cause of cancer death worldwide. First-degree relatives (FDR) of CRC patients are at increased risk but is often screened less than guidelines recommendation.

Objective: To compare the effectiveness of written advice vs. standard verbal advice in transferring knowledge about CRC risk & and screening advice to FDRs.

Method: This prospective randomized controlled study included FDRs of patients diagnosed with CRC after January 1, 2022 from the gastrointestinal, surgical, and oncological outpatients of Ramathibodi Hospital. The CRC patients and their respective FDRs were randomized into written (WA) and verbal advice (VA) groups. CRC patients were asked to relay the advice in verbal or written form to their FDR in 2 weeks. The FDRs were then contacted and asked to answer a questionnaire. The answers to the questionnaire were analyzed.

Results: Very few FDRs (6.7% WA vs 2.2% VA groups) had had a prior screening colonoscopy. The main reason was that they were unaware of their risk and need for colonoscopy. However, the primary outcome showed that FDRs in the VA group were more aware of their CRC risk than the WA group (21.1% & 35.6%, P-value 0.03).

Screening advice was conveyed to FDRs slightly more in the VA groups (57.8% & 46.7%, p-value 0.1) but this did not reach statistical significance, with the biggest problem reported being living distantly in both groups.

Conclusions: Written advice did not improve the awareness of the need for colorectal cancer screening in FDRs compared with verbal advice.

MP-01-06

Role of C-reactive protein/albumin ratio in Japanese patients with unresectable pancreatic cancer receiving gemcitabine-based chemotherapy

Yusuke Sasaki, Arata Onuma, Jojo Hirota and Jun Konno

Hakodate Central General Hospital, Hakodateshi, 日本

Moderated Poster 1, November 22, 2024, 12:20 PM - 12:50 PM.

Objectives: Gemcitabine-based chemotherapy is one of the standard treatment for pancreatic cancer. In previous studies, a high C-reactive protein (CRP)/albumin ratio (CAR) was found to have worse outcomes in patients with advanced pancreatic cancer. However, data on the significance of pre-treatment CAR for unresectable pancreatic cancer treated with gemcitabine-based chemotherapy are not available.

Materials and Methods: Data were retrospectively collected from 97 Japanese patients belonging to our institution from 2013 to 2022. All patients had unresectable pancreatic cancer and blood samples were taken before starting first-line gemcitabine or gemcitabine plus nab-paclitaxel chemotherapy. The cut-off value for the CAR was calculated and patients were divided into groups. Progression-free survival (PFS) and overall survival (OS) were compared between the groups, and multivariate analysis was performed, taking into consideration the CAR as a prognostic factor.

Results: The median CAR was 0.11, and 0.10 was set as the cut-off value for grouping patients into high CAR (≥0.10) and low CAR (<0.10) groups. The median PFS was significantly shorter in the high CAR group than in the low CAR group (4.1 vs. 8.0 months; hazard ratio (HR) = 0.55; P = 0.01). Also, there was a similar trend in the median OS (5.9 vs. 14.8 months; HR = 0.61; P = 0.03). Both univariate and multivariate analysis showed that a high CAR was the only independent prognostic factor (adjusted HR = 0.58; P = 0.03) for OS.

Conclusion: Pre-treatment CAR was a prognostic factor in Japanese patients with unresectable pancreatic cancer treated with gemcitabine-based chemotherapy.

MP-01-07

Comparison of therapeutic outcomes between concomitant and tailored therapy for Helicobacter pylori: a multicenter study

Seung Woo Lee¹, Young Sin Cho², Sun Moon Kim³, Sun Hyung Kang⁴, Ki Bae Bang⁵, Sung Hyeok Ryou⁶, Ki Bae Kim⁷, Hee Seok Moon⁴ and Jae Kyu Sung⁴

¹The Catholic University Of Korea, Daejeon, South Korea; ²Soonchunhyang University, Cheonan, South Korea; ³Konyang University, Daejeon, South Korea; ⁴Chungnam National University, Daejeon, South Korea; ⁵H + Yangji Hospital, Seoul, South Korea; ⁶Dankook University College of Medicine, Cheonan, South Korea; ⁷Chungbuk National University School of Medicine, Cheongju, South Korea

Moderated Poster 1, November 22, 2024, 12:20 PM - 12:50 PM.

Objectives: The increasing trend of clarithromycin resistance in H. pylori is a primary cause of failure in standard triple therapy. In areas with high clarithromycin resistance, concomitant therapy is recommended as an alternative. Recently, tailored therapy has become available. This study compared the eradication rates and adverse effects of concomitant therapy with those of tailored therapy.

Materials and Methods: We enrolled 319 patients diagnosed with H. pylori, for whom the DPO-PCR test was performed in 6 hospitals in Daejeon Chung Cheong area in Korea. Patients were randomly assigned to either the concomitant therapy group (non-bismuth quadruple therapy) or the tailored therapy group (therapy according to DPO-PCR results, either standard triple therapy for clarithromycin-sensitive cases or bismuth quadruple therapy for clarithromycin-resistant cases). After eradication therapy, we performed a urea breath test to confirm eradication one month later. We assessed demographics, eradication success rates, adverse effects, and compliance. Data between the two groups were compared using intention-to-treat (ITT), modified ITT, and per-protocol analyses.

Results: The eradication success rate was significantly higher in the tailored therapy group compared to the concomitant therapy group in per protocol analysis(92.62% vs 85.21%, P = 0.044). The severity grade of adverse effects were significantly greater in the concomitant therapy group than in the tailored therapy group. (P = 0.025).

Conclusion: Considering the high eradication success rate and lower severity of adverse effects, tailored therapy based on DPO PCR test results is preferable to concomitant therapy without resistant testing for the treatment of H. pylori infection.

MP-01-08

Gut microbiome alterations in Central Kazakhstan IBD patients

Yelena Laryushina¹, Доктор Nadezhda Samoilova-Bedych¹, Lyudmila Turgunova² and Samat Kozhakhmetov²

¹NCJSC “Karaganda Medical University”, Karaganda, Kazakhstan; ²Microbiome Laboratory, National Laboratory Astana, Nazarbayev University, Astana Akmola region, Kazakhstan, Astana, Kazakhstan

Moderated Poster 1, November 22, 2024, 12:20 PM - 12:50 PM.

Objectives: to compare and identify changes in the gut microbiome composition in patients with ulcerative colitis (UC) and Crohn's disease (CD).

Materials and Methods: 31 patients with ulcerative colitis and 29 with Crohn's disease were collected fecal samples with followed metagenomic sequencing of 16 s ribosomal RNA. Data analysis was performed using the LotuS2 bioinformatics pipeline, determining beta diversity between sample groups using the Bray-Curtis index. For the most significant differences taxa, linear discriminant analysis (LDA) of effect size was performed.

Results: assessment of species diversity showed no differences in richness and relative abundance in groups between UC and CD (Shanon diversity P = 0.785, Simpson diversity P = 0.406). Beta diversity also showed no statistically significant differences (Bray-Curtis index P = 0.640). LDA plotting shows that in both groups, Clostrdia is the most abundant genus, followed by Lachnospiracea and Bacteroides. Further, differences between groups are observed: in UC, Bacteroides, Bifidobacterium, Blautia, Escherichia-Shigella predominate, whereas in CD, Faecalibacterium and Prevotella g increase and Bacteroides decrease. At the same time, the number of Klebsiella and Roseburia is similar in both groups.

Conclusion: As a result, we obtained data on the features of the gut microbiome composition in patients with IBD in the Central Kazakhstani region of Kazakhstan. The findings highlight differences in microbial community composition between these two IBD, potentially aiding in diagnosis, understanding disease mechanisms, developing targeted treatments, and predicting therapy outcomes.

MP-01-09

The use of MRI for locoregional staging of rectal cancers in Sri Lanka

Dulanja Senanayake¹, Githma Wimalasena¹, Harry Prashath⁴, Modini Jayawickrame², Roshana Constantine², Priyani Amarathunga³, Harshima Wijesinghe³ and Sivasuriya Sivaganesh^1,4

¹Department of Surgery, Faculty of Medicine, University of Colombo, Sri Lanka; ²Department of Pathology, National Hospital, Sri Lanka, Colombo; ³Department of Pathology, Faculty of Medicine, University of Colombo, Sri Lanka; ⁴University Surgical Unit, National Hospital, Sri Lanka, Colombo

Moderated Poster 1, November 22, 2024, 12:20 PM - 12:50 PM.

Objectives: Rectal MRI is superior to CT in locoregional staging of rectal cancers. This guides decisions on the suitability of neoadjuvant chemo-radio therapy (CRT/RT) before surgery in mid or lower rectal cancers. The utility of MRI in this process is dependent on factors including the use of rectum specific protocols, reporting standards and the stage distribution of rectal cancer in the population concerned. This study aims to evaluate the spectrum of locoregional disease in a cohort of Sri Lankan patients and the utility of routine MRI.

Materials and Methods: All histopathology reports of anterior resections (AR) and abdomino-perineal resections (APR) done at in a tertiary hospital were retrospectively analyzed from 2018 to 2022. Tumor location, T and N stage were tabulated.

Results: Of 184 resections, 57.1% (n = 105) were upper rectal/rectosigmoid, 4.9%(n = 9) middle and 25.5%(n = 47) lower rectal cancers. (In 23 samples(12.5%) exact location in the rectum was not specified). 66.7% (n = 70) of upper rectal cancers were pT3 or above and 21% (n = 22) received neoadjuvant CRT/RT. 66.7% (n = 6) of mid-rectal cancers were pT3 or above and received neoadjuvant CRT/RT. 51% (n = 24) low-rectal cancers were pT3 or above and 57.4% (n = 27) received neoadjuvant CRT/RT.

Conclusion: More than 50% of mid and lower-rectal cancers were pT3 or above. This may be an underestimate due to T-stage downstaging after neoadjuvant CRT/RT. This study cannot comment on the utility of routine MRI to stage rectal cancer in Sri Lanka. Further studies using larger numbers, and comparative prospective CT/MRI staging may help clarify this question.

MP-01-10

A model of cuprotosis-associated lncRNAs for predicting the prognostic status of esophageal cancer

Ying Li, Luping Zhang, Nan Zhang and Hong Xu

The First Hospital of Jilin University, Changchun, China

Moderated Poster 1, November 22, 2024, 12:20 PM - 12:50 PM.

Objectives: The aim of this study was to investigate the relationships between cuprotosis-related genes and long non-coding RNAs (lncRNAs) and esophageal cancer, and to develop a prognostic risk model for cuprotosis gene-associated lncRNAs in esophageal cancer.

Materials and Methods: In this study, we downloaded RNA-seq transcriptomic data, clinical data and tumor mutation data related to esophageal cancer from the CGA database. A prognostic model for lncRNAs was subsequently constructed based on one-way Cox regression, Lasso regression and multifactorial Cox regression analyses, and its performance in assessing prognoses was validated.

Results: The prognostic model constructed in this study contained 4 cuprotosis gene-associated lncRNAs, namely, UGDH-AS1, TMEM161B-AS1, ALMS1-IT1 and AC011773.1, and subsequent analyses revealed that the model could accurately predict overall patient survival and was an independent prognostic factor for esophageal cancer. The line graphs constructed in combination with other clinical traits and prognostic models also showed good performance in assessing survival. Esophageal cancer patients in the high-risk cohort had a higher tumor mutation load than those in the low-risk cohort. With respect to immune cell infiltration, we detected significant differences in Type II IFN Response, APC co-inhibition, APC co-stimulation, CCR, and T cell co-stimulation in the high- and low-risk cohorts and identified NSC-207895 as a potential therapeutic agent for the treatment of esophageal cancer.

MP-02-01

Comparison of stool multiplex PCR vs stool culture to detect pathogen in chronic diarrhea patients

Rabbinu Rangga Pribadi¹, Ro Shinta Christina Solin², Saskia Aziza Nursyirwan¹, Virly Nanda Muzellina¹ and Marcellus Simadibrata¹

¹Division of Gastroenterology, Pancreatobiliary, and Digestive Endoscopy, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Central Jakarta, Indonesia; ²Department of Clinical Pathology, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo National General Hospital, Central Jakarta, Indonesia

Moderated Poster 2, November 23, 2024, 12:00 PM - 12:30 PM.

Objectives: Stool multiplex PCR has been validated as a diagnostic tool for acute diarrhea. However, the benefit of stool multiplex PCR compared to stool culture in patients with chronic diarrhea remains unclear. This study aims to evaluate detection rate of stool multiplex PCR and stool culture in chronic diarrhea.

Materials and Methods: This cross sectional study was conducted at Cipto Mangunkusumo National General Hospital from June 2022 to July 2024. A total of 123 patients were recruited. Stool multiplex PCR and stool culture analyses were performed on all subjects. Colonoscopy and histopathology were also conducted.

Results: Analysis showed the etiologies of chronic diarrhea patients were infection (53.66%), Crohn's disease (17,89%), mass (17.07%), ulcerative colitis (13.82%), radiation (4.88%), microscopic colitis (6.50%), functional diarrhea (4.07%), drugs (4.07%), eosinophilic colitis (0.81%), amyloidosis (0.81%), hyperthyroidism (0.81%), diabetes mellitus (0.81%). The detection rate of stool PCR multiplex vs. stool culture was 46.34% vs 2.44%.

Conclusion: Stool multiplex PCR demonstrates a higher detection rate of pathogens compared to stool culture in the evaluation of patients with chronic diarrhea.

MP-02-02

Investigation of metabolic heterogeneity in colorectal cancer based on multi-omics analysis of signaling pathways

Dingfan Guo and Kun-He Zhang

Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China

Moderated Poster 2, November 23, 2024, 12:00 PM - 12:30 PM.

Objectives: Colorectal cancer (CRC) exhibits metabolic reprogramming, crucial for diagnosis, treatment, and prognosis. This study aimed to investigate the metabolic heterogeneity of CRC and its clinical and biological significance using multi-omics analysis of metabolic signaling pathways.

Materials and Methods: Fresh frozen cancer tissues from 106 CRC patients treated at the First Affiliated Hospital of Nanchang University (2022–2023) underwent transcriptome and whole-exome sequencing. Serum metabolome sequencing was performed on 80 patients. Additionally, multi-omics data from 14 external cohorts were analyzed. Cox regression identified key metabolic signaling pathways related to CRC prognosis. Unsupervised clustering analyzed and classified metabolic heterogeneity in patient cohorts and cell lines. Drug screening and cell biology experiments validated the association between metabolic heterogeneity and drug response. The random forest algorithm analyzed the serum metabolome's value in classifying CRC metabolic heterogeneity.

Results: CRC samples were divided into two subtypes: subtype A, with poor prognosis and higher glycosaminoglycan activity, and subtype B, with better prognosis and higher glycolysis, tricarboxylic acid cycle, and pentose phosphate pathway activity. Subtype A had frequent TP53 mutations and an immune-escape tumor microenvironment, while subtype B had frequent PI3K and RTK-RAS pathway mutations. Subtype-specific drug responses were identified: subtype A responded to YM-155, while subtype B responded to oxaliplatin and 5-fluorouracil. Serum metabolome data could distinguish between the two subtypes, suggesting clinical classification through liquid biopsy.

MP-02-03

Role of human Wharton-jelly stem cells exosomes as innovative molecular inhibitors of hepatocellular carcinoma growth

Nisha Vats and Ayush Sharma and Renu Raina sehgal

Artemis Education and Research Foundation, Artemis Hospitals, Gurugram, India

Moderated Poster 2, November 23, 2024, 12:00 PM - 12:30 PM.

Background: Hepatocellular carcinoma (HCC) is a critical malignancy requiring innovative therapeutic approaches. This study investigates the effects of Wharton Jelly Mesenchymal Stem Cell (WJ-MSC) derived exosomes/secretome on the HepG2 cell line to uncover the underlying mechanisms regulating HCC proliferation and evaluate the potential of exosomes as a molecular therapeutic target.

Materials and Methods: Mesenchyme Stem cell were isolated from Wharton jelly and also characterized. HepG2 cells were cultured. MSCs were cultured in a complete medium, and exosomes were isolated from the conditioned medium using ultracentrifugation. The exosomes were characterized by western blot. HepG2 cells were treated with or without WJ-MSC-derived exosomes for 48 hours. Cell proliferation, apoptosis, and angiogenesis assays were performed to assess the biological effects of the treatment.

Results: HepG2 cells were treated with or without WJ-MSC-derived exosomes for 48 hours. Proliferation, apoptosis, and angiogenesis were assessed. Quantitative real-time PCR was used to measure gene expression levels of TNF-α, VEGF, and CXCR-4. The treatment with WJ-MSC-derived exosomes significantly reduced cell survival at 48 hours compared to the control group. VEGF and CXCR-4 expression levels were significantly lower, while TNF-α expression levels were significantly higher in exosomes/secretome-treated HepG2 cells than in controls.

Conclusion: This study demonstrates that WJ-MSC-derived exosomes/secretome significantly reduce the proliferation of HepG2 cells by modulating the expression of CXCR-4, VEGF, and TNF-α. The findings highlight the potential of WJ-MSC-derived exosomes as a novel therapeutic approach for HCC. Further large-scale studies are recommended to confirm these promising results and fully elucidate the therapeutic mechanisms involved.

MP-02-04

Exosomal miRNA as a biomarker for predicting response of atezolizumab and bevacizumab in hepatocellular carcinoma

Yang Jae Yoo, Jong Eun Yeon, Ji Hoon Kim, Young-Sun Lee, Eunho Choi and Youngwoo Lee

Korea University Guro Hospital, Seoul, South Korea

Moderated Poster 2, November 23, 2024, 12:00 PM - 12:30 PM.

Objectives: Atezolizumab and bevacizumab combination therapy is currently used for patients with advanced hepatocellular carcinoma, but biomarkers for response to systemic therapy is unknown. This study aimed to find exosomal miRNA biomarkers to predict response to combination therapy.

Materials and Methods: Sera were collected from patients with advanced hepatocellular carcinoma before the first cycle treatment of atezolizumab and bevacizumab. The patients were divided into two groups; the response group comprised patients showing stable disease, partial or complete response, while the non-response group consisted of patients showing progressive disease. The serum was concentrated with qEV concentration and isolation kit. Exosomal RNA was extracted from isolates and small RNA sequencing using next-generation sequencing (NGS) was performed. We selected miRNAs that effectively distinguished between response or non-response using decision tree analysis among the top 100 in the order of most expressed. T-test was used to verify decision tree results.

Results: Eight patients each were included in the response and non-response group. A total of 1,076 miRNA were obtained from NGS. Among 1,076 miRNAs, 12 miRNAs showed significant difference in expression between response group and non-response group. Three miRNAs significantly increased and 9 miRNAs significantly decreased in response group. Significantly increased miRNAs in response group were let7c-5p, miR-30a-5p, and miR192-5p. Out of top 100 most read miRNAs, 30 miRNAs were selected by decision tree analysis. miR-30a-5p levels were significantly higher in good response group (P = 0.0047).

Conclusion: Exosomal miRNAs could be used as a biomarker for predicting response to atezolizumab-bevacizumab therapy.

MP-02-05

Accelerated biological aging, inflammatory bowel disease, genetic susceptibility and life expectancy: a large cohort study

Lingyi Li¹, Han Zhang¹, Lijun Zhang¹, Yu Long¹, Yuying Ma¹, Dongling Luo¹, Ruijie Zeng¹, Felix W Leung², Chongyang Duan³, Weihong Sha¹ and Hao Chen¹

¹Southern Medical University, Guangzhou, Guangdong Province, China; ²University of California, Los Angeles, USA; ³Southern Medical University, Guangzhou, Guangdong Province, China

Moderated Poster 2, November 23, 2024, 12:00 PM - 12:30 PM.

Objectives: Inflammatory bowel disease (IBD), a chronic condition affecting all ages, has unclear associations with biological aging.

Materials and Methods: Using UK Biobank data (n = 501,070), we employed Cox proportional hazard models to study biological aging's role in IBD and its subtypes. Biological age was assessed using the Klemera-Doubal method (KDMAge) and PhenoAge based on 9 aging-related variables. Accelerated biological aging was defined as the difference between chronological age and biological age. Polygenic risk scores (PRS) assessed genetic susceptibility. Life expectancy impacts and multi-state models evaluated aging's influence on IBD development and mortality transitions.

Results: Accelerated biological aging increased IBD risk (KDMAge: hazard ratio [HR] 1.22 [95% confidence intervals [CI] 1.13–1.32]; PhenoAge: HR 1.57 [95% CI 1.46–1.69]; both P < 0.001). Subgroup analysis by PRS highlighted greater risk synergies (KDMAge HR 1.36 [95% CI 1.20–1.53]; PhenoAge HR 1.59 [95% CI 1.41–1.79]; both P < 0.001). At age 45, accelerated aging correlated with a life expectancy loss of approximately 1.36 (KDMAge) or 1.95 (PhenoAge) years. Multi-state models confirmed increased IBD risk (KDMAge HR 1.24 [95% CI 1.15–1.34]; PhenoAge HR 1.61 [95% CI 1.49–1.73]; both P < 0.001) and IBD onset to death risk (PhenoAge HR 1.44 [95% CI 1.17–1.77]; P < 0.001).

MP-02-06

SHR-1701 combined with famitinib for advanced biliary tract or pancreatic cancer: a phase Ib/II study

Lixia Yi¹, Longfei Peng², Ying Wang³, Jing Xie¹ and Zhiqiang Meng¹

¹Fudan University Shanghai Cancer Center, Shanghai, China; ²Chinese Academy of Sciences, Suzhou, China; ³Jiangsu Hengrui Pharmaceuticals Co., Ltd., Suzhou, China

Moderated Poster 2, November 23, 2024, 12:00 PM - 12:30 PM.

Objectives: Advanced biliary tract cancer (BTC) and pancreatic ductal adenocarcinoma (PDAC) have poor prognoses and limited treatment options. This study aimed to evaluate the efficacy and safety of SHR-1701, a bifunctional fusion protein targeting PD-L1 and TGF-β, combined with famitinib, a multi-target receptor tyrosine kinase inhibitor, in patients with advanced BTC or PDAC.

Materials and Methods: In this open-label, single-arm phase Ib/II trial, patients with advanced BTC or PDAC who had failed prior therapy were enrolled. Participants received SHR-1701 (30 mg/kg, IV, Q3W) plus famitinib (20 mg, PO, daily). The primary endpoint was objective response rate (ORR); secondary endpoints included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety.

Results: As of May 1, 2024, in the BTC cohort (n = 25), the ORR was 28.0%, and DCR was 80.0%. The mPFS and mOS were 5.1 and 16.0 months, respectively. In the PDAC cohort (n = 20), the ORR was 15.0%, and DCR was 60.0%. The mPFS and mOS were 2.1 and 5.3 months, respectively. Grade 3/4 treatment-related adverse events (TRAEs) occurred in 29.4% of patients. Exploratory analyses revealed that surgical resection history, peripheral blood immunophenotype changes, and distinct immune-metabolic profiles were associated with treatment benefits, with the TGF-β trap function of SHR-1701 potentially sequestering TGFB1 that was elevated in responders. An immune/metabolism (I/M) score was developed as a robust predictive biomarker for immunotherapy response in multiple cohorts.

MP-02-07

Development of an explainable machine learning model for predicting 30-day mortality in patients with ANVUGIB

Fang Yang

Tianjin Medical University General Hospital, Tianjin, 中国; Baodi Hospital of Tianjin Medical University, Tianjin, 中国

Moderated Poster 2, November 23, 2024, 12:00 PM - 12:30 PM.

Objectives: Acute Nonvariceal Upper Gastrointestinal Bleeding (ANVUGIB) remains a prevalent cause of hospitalization and a common clinical emergency. This study aimed to develop and validate a machine learning (ML) model to predict 30-day mortality in ANVUGIB patients using demographic and clinical data and to construct explainable ML models with SHapley Additive exPlanations (SHAP).

Materials and Methods: We included 534 patients admitted to Baodi Hospital of Tianjin Medical University for ANVUGIB. The dataset was divided into training and test sets. Five ML models were evaluated: logistic regression, nearest neighbor algorithm (KNN), support vector machine (SVM), extreme gradient boosting (XGBoost), and random forest (RF). Model performance was assessed using the area under the receiver operating characteristic curve (AUC). SHAP was employed to interpret the results.

Results: The median age of patients was 64 years. The 30-day mortality rates were 11.3% and 11.8% in the training and test sets, respectively. XGBoost had the highest AUC (0.981, 95% CI: 0.961–0.995). SHAP analysis identified low protein levels, high Glasgow-Blatchford scores, endoscopic procedures, elevated prothrombin time (PT), tachycardia, and older age as significant predictors of 30-day mortality. SHAP maps and decision graphs provided meaningful insights into the XGBoost model's predictions.

MP-02-08

Neutrophil-to-lymphocyte ratio predict metachronous cancer after curative resection of early gastric cancer by endoscopic resection

Jong-Jae Park¹, Moon Kyung Joo¹, Beom Jae Lee¹, Seung Han Kim¹, Won Shik Kim¹ and Hoon Jai Chun²

¹Korea University College of Medicine, Korea University Guro Hospital, Seoul, South Korea; ²Korea University College of Medicine, Korea University Anam Hospital, Seoul, South Korea

Moderated Poster 2, November 23, 2024, 12:00 PM - 12:30 PM.

Background: We investigate the predictive value of inflammatory markers for occurrence of metachronous cancers among patients who underwent endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) and are judged as curative resection (CR).

Methods: We enrolled patients who were diagnosed as EGC and underwent ESD during 2006 and 2020. We retrospective collected data of inflammatory indexes such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and erythrocyte sediment ratio (ESR).

Results: A total of 1,011 patients underwent ESD for EGC, achieved CR and were followed up more than 12 months. Among them, 86 patients had metachronous cancers (85/1011, 8.4%) during 53.4 months of follow-up. Compared with patients without metachronous cancers, those with metachronous cancers were significantly older (66.9 vs. 63.8 years, P = 0.004) and had higher NLR (2.1 vs. 1.8, P = 0.002), however, other inflammatory indexes such as PLR and ESR were not significantly different between two groups. Kaplan–Meier analysis showed that patients with NLR ≥ 2.0 had significantly higher possibility of metachronous cancer compared with patients with NLR < 2.0 (P = 0.049 by log rank test). After adjusting age, atrophy and Helicobacter pylori status, NLR was the only significant risk factor for metachronous cancer (odds ratio: 1.33, 95% confidence interval: 1.007–1.665, P = 0.011).

Conclusion: NLR may have a predictive value for occurrence of metachronous cancer after CR of EGC by ESD. Further thorough investigation is necessary to validate this outcome.

MP-02-09

The PM2.5 exposure and hepatocellular carcinoma incidence and mortality: a global meta-analysis study

Tinpawee Thongkongthun¹, Suchaya Damrongwattanasuk¹, Somkiat Phutinart⁴, Ratha Korn Vilaichone³ and Arti Wongcha Um²

¹Faculty of Medicine, Chulabhorn International College of Medicine (CICM), Thammasat University, Prathum Thani, Thailand; ²Department of Medicine, Chulabhorn International College of Medicine (CICM), Thammasat University, Prathum Thani, Thailand; ³Department of Medicine, Gastroenterology Unit, Faculty of Medicine, Thammasat University Hospital, Thailand; ⁴Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Moderated Poster 2, November 23, 2024, 12:00 PM - 12:30 PM.

Objectives: This meta-analysis investigates the alarming link between long-term PM2.5 exposure and hepatocellular carcinoma (HCC) prevalence by synthesizing data from global studies. The aim is to critically assess and inform public health policies and cancer prevention strategies addressing the dire impact of air pollution on liver cancer.

Materials and Methods: A comprehensive search was conducted in databases including PubMed, Google Scholar, EMBASE, and Web of Science up to April 18, 2024. Studies included PM2.5 exposure and HCC in human subjects, providing relative risk (RR) or hazard ratio (HR) with 95% confidence intervals (CIs). From an initial 1,245 articles, 9 cohort studies met the inclusion criteria after rigorous screening.

Results: The analysis incorporated 9 cohort studies from North America, Europe, and Asia, with sample sizes from 900 to 330,000 participants and follow-up periods of 5 to 20 years. Due to high heterogeneity, a common effect model was used, revealing significant associations between PM2.5 exposure and increased risks of mortality and HCC incidence. The pooled hazard ratio (HR) for mortality was 2.28 (95% CI: 2.01–2.59), and the pooled odds ratio (OR) for HCC incidence was 1.44 (95% CI: 1.20–1.74).

MP-02-10

Prognostic implications of left vs right-sided primary tumors in stage III/IV colorectal cancer

Suyata Suyata, Febry Rahmayani and Eddy Yuristo

Mohammad Hoesin General Hospital Palembang, Palembang, Indonesia

Moderated Poster 2, November 23, 2024, 12:00 PM - 12:30 PM.

Objectives: This study aims to evaluate the prognostic significance of primary tumor location (left vs right-sided) in patients with Stage III/IV colorectal cancer treated at Mohammad Hoesin General Hospital, top referral hospital in Southern Sumatera.

Materials and Methods: We conducted a retrospective cohort study involving patients diagnosed with Stage III/IV colorectal cancer between January 2022 and December 2023 at Mohammad Hoesin General Hospital. Patient demographics, tumor characteristics, treatment details, and survival outcomes were collected. Primary tumor location was categorized as left-sided (distal to the splenic flexure) or right-sided (proximal to the splenic flexure). Multivariate Cox proportional hazards models were used to assess the impact of tumor sidedness on overall survival, adjusting for stage, race, and adjuvant chemotherapy.

Results: A total of 527 patients were included in the study, with 426 (54.3%) having left-sided and 111 (45.7%) having right-sided primary tumors. Left-sided primary tumor location was associated with a significantly reduced risk of death (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.75–0.94; P < .001). This association remained significant after adjusting for stage, race, and adjuvant chemotherapy, indicating an independent prognostic benefit of left-sided tumor location. These findings underscore the importance of tumor sidedness as a prognostic factor and may influence therapeutic strategies in advanced colorectal cancer.

Conclusion: In this cohort of patients with Stage III/IV colorectal cancer, left-sided primary tumors were associated with better overall survival compared to right-sided tumors.