Gut and Liver最新文献

{"title":"Impact of Smoking, Alcohol Use and Exercise on Underweight after Gastrectomy: A Nationwide Cohort Study of Gastric Cancer Patients in Korea.","authors":"Yoon Ju Jung, Kyungdo Han, Sung Geun Kim","doi":"10.5009/gnl250140","DOIUrl":"10.5009/gnl250140","url":null,"abstract":"<p><strong>Background/aims: </strong>Weight loss following gastric cancer (GC) surgery is a prevalent and significant long-term complication that impacts the patient's oncologic prognosis and quality of life. The impact of lifestyle changes after surgery with regard to regular exercise, smoking, and alcohol consumption on weight loss have not been fully explored. We studied the factors associated with underweight (body mass index <18.5 kg/m²) after gastrectomy, focusing on variation across sex and age groups.</p><p><strong>Methods: </strong>We utilized a population-based cohort provided by the Korean National Health Insurance Service, which included cancer screening data. In total, 27,854 patients who underwent GC surgery between 2010 and 2016 were included.</p><p><strong>Results: </strong>Among the 27,854 patients in the study cohort, 3,064 (11.0%) were underweight. Female sex (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.55 to 1.96; p<0.001) was a significant risk factor for becoming underweight postoperatively. Engaging in regular exercise (OR, 0.73; 95% CI, 0.60 to 0.89; p=0.002) and ceasing smoking (OR, 0.31; 95% CI, 0.13 to 0.78; p<0.001) emerged as substantial preventive factors against becoming underweight, particularly in female patients. Exercise (OR, 0.76; 95% CI, 0.65 to 0.89; p=0.001) proved more beneficial for patients aged <65 years.</p><p><strong>Conclusions: </strong>Smoking cessation and regular exercise are associated with a reduced risk of postoperative underweight in GC patients following gastrectomy.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"765-775"},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fourteen-Day Amoxicillin- or Tetracycline-Containing Bismuth Quadruple Therapy versus 14-Day Metronidazole-Based Triple Therapy as the Treatment for Clarithromycin-Resistant <i>Helicobacter pylori</i> Infection: A Multicenter Randomized Controlled Trial.","authors":"Myeongseok Koh, Cheol Woong Choi, Dae Gon Ryu, Seung Jung Yu, Sung Eun Kim, Kyoungwon Jung, Bong Eun Lee, Moon Won Lee, Dong Chan Joo, Jin Lee, Ra Ri Cha, Sam Ryong Jee","doi":"10.5009/gnl250435","DOIUrl":"10.5009/gnl250435","url":null,"abstract":"<p><strong>Background/aims: </strong>Combination therapy comprising a proton pump inhibitor (PPI), amoxicillin, and metronidazole (PAM) is used to treat clarithromycin-resistant <i>Helicobacter pylori</i> in the Republic of Korea, but eradication rates are decreasing due to an increasing incidence of clarithromycin resistance. We compared PAM, bismuth compounds plus PAM (PAM-B), and the combination of PPI, bismuth compounds, metronidazole, and tetracycline (PBMT) to determine whether PAM-B can achieve an eradication rate higher than that of PAM and comparable to that of PBMT.</p><p><strong>Methods: </strong>This prospective multicenter study enrolled patients with clarithromycin-resistant <i>H. pylori</i> infections in the Busan and Gyeongsangnam-do of the Republic of Korea between December 2022 and February 2024.</p><p><strong>Results: </strong>In the intention-to-treat (ITT) analysis, the eradication rate was significantly lower in the PAM group (68.2%) than in the PAM-B group (84.8%, p=0.024), whereas the difference from the PBMT group (81.8%) was not significant (p=0.070). The rate remained lowest in the PAM group (75.4%) in the per-protocol (PP) analysis (PAM-B, 96.5%, p=0.001; PBMT, 94.6%, p=0.004). Eradication rates were comparable between the PAM-B and PBMT groups in both the ITT (p=0.640) and PP analyses (p=0.633). Nausea and vomiting were significantly less frequent in the PAM-B group than in the PBMT group (6.8% vs 25.0%; p=0.007). Severe adverse events were rare, and all symptoms resolved after treatment discontinuation.</p><p><strong>Conclusions: </strong>PAM-B yielded eradication rates higher than those of PAM and comparable to those of PBMT, with no significant increase in the incidence of adverse events, suggesting the potential of PAM-B as a first-line treatment for clarithromycin-resistant <i>H. pylori</i> infection. Further large-scale studies are needed to validate these results. Registered retrospectively with the Clinical Research Information Service (CRIS; KCT0012265).</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":"20 5","pages":"756-764"},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Heart Failure Risk with Gastric Cancer Progression: A Nationwide Population-Based Cohort Study.","authors":"Seunghan Lee, Mi Jin Oh, Bokyung Kim, Yoon Jin Choi, Kyungdo Han, Soo-Jeong Cho","doi":"10.5009/gnl250209","DOIUrl":"10.5009/gnl250209","url":null,"abstract":"<p><strong>Background/aims: </strong>Advances in gastric cancer treatment have improved survival rates, which has led to a growing interest in the risk of non-cancer-related conditions, particularly cardiovascular diseases. This study aimed to investigate the risk of heart failure in patients with gastric cancer according to their initial cancer stage.</p><p><strong>Methods: </strong>We conducted a nationwide, population-based, retrospective cohort study using the Cancer Public Library Database of Korea. Patients diagnosed with gastric cancer between 2012 and 2019 were enrolled and followed until the end of 2020. Heart failure development was defined as a new diagnosis of heart failure that required hospitalization. Based on the Surveillance, Epidemiology, and End Results Program staging for gastric cancer, patients were classified into three groups: localized, regional, and distant stages.</p><p><strong>Results: </strong>Of the 202,347 patients in the study, 16,004 (7.9%) developed heart failure during a median follow-up period of 3.6 years. The cumulative incidence of heart failure significantly increased with worsening gastric cancer stage (log-rank, p<0.001). After adjusting for age, sex, diabetes status, hypertension status, dyslipidemia status, income, residential area, and initial treatment modality, with the localized stage as the reference group, the hazard ratio for heart failure was 1.52 (95% confidence interval [CI], 1.46 to 1.58) for patients in the regional stage group and 2.87 (95% CI, 2.69 to 3.07) for those in the distant stage group.</p><p><strong>Conclusions: </strong>In patients with gastric cancer, the risk of heart failure requiring hospitalization increased with worsening cancer stage. Even in young patients and those without metabolic risk factors, close monitoring for heart failure development following cancer treatment is essential.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"776-786"},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic Dysfunction-Associated Steatotic Liver Disease and Vascular Complications: Associations with Serum Testosterone Levels in a Korean Multicenter Male Cohort.","authors":"Hyo Jung Cho, Seong Hee Kang, Hye Yeon Chon, SungA Bae, Eunju Kim, Seong Kyun Na, Su Jin Kim, Dooyeon Kim, Hye Ri Ahn, Huigyeong Kim, Soon Sun Kim, Jae Youn Cheong, Soon Koo Baik, Young Kul Jung, Hyung Joon Yim","doi":"10.5009/gnl250585","DOIUrl":"10.5009/gnl250585","url":null,"abstract":"<p><strong>Background/aims: </strong>We investigated the associations of testosterone levels with metabolic dysfunction-associated steatotic liver disease (MASLD) and vascular complications in a large Korean male cohort. Despite the high global prevalence of MASLD and significant morbidity from cardiovascular disease, the interplay among testosterone levels, MASLD, and vascular outcomes remains unclear, particularly in Asian populations.</p><p><strong>Methods: </strong>This cross-sectional study analyzed 1,167 men from the Korean Health Screening-Based MASLD Registry. MASLD was defined as imaging-confirmed steatosis with metabolic dysfunction. Log2-transformed testosterone levels were analyzed using logistic regression adjusted for metabolic risk factors to evaluate associations with MASLD, advanced fibrosis (Fibrosis-4 index [FIB-4] ≥1.3), carotid plaques, and cerebrovascular accidents (CVAs).</p><p><strong>Results: </strong>Among the 1,167 men (mean age 57.0 years), 730 (62.6%) had MASLD. These patients had lower testosterone levels than non-MASLD men did (223.5 ng/dL vs 347.5 ng/dL; p<0.001) and showed adverse metabolic features. Higher testosterone levels were independently associated with reduced risk of MASLD (odds ratio [OR], 0.89; 95% confidence interval [CI], 0.85 to 0.94; p<0.001). Among the MASLD patients, higher testosterone levels were linked to a significantly lower prevalence of carotid plaques (OR, 0.77; 95% CI, 0.73 to 0.81) and CVAs (OR, 0.75; 95% CI, 0.67 to 0.82). The associations remained robust across sensitivity analyses with adjustments for obesity, diabetes, and dyslipidemia. No significant association was observed with advanced fibrosis (FIB-4 ≥1.3).</p><p><strong>Conclusions: </strong>Low testosterone levels are independently associated with MASLD and its vascular complications but not with advanced fibrosis. Serum testosterone levels may serve as a practical biomarker for metabolic and vascular risk stratification in MASLD patients, warranting validation in prospective and interventional studies. (ClinicalTrials.gov identifier NCT06843421).</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"870-879"},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Dynamic Nature of Renal Failure in Acute-on-Chronic Liver Failure: Sequence Matters.","authors":"Hae Lim Lee","doi":"10.5009/gnl250521","DOIUrl":"10.5009/gnl250521","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"713-714"},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver Failure versus Organ Failure in Acute-on-Chronic Liver Failure: Sequence and Consequence.","authors":"Young Chang, Jae Young Jang, Soung Won Jeong, Do Seon Song, Hee Yeon Kim, Young Kul Jung, Tae Hyung Kim, Hyung Joon Yim, Eileen L Yoon, Ki Tae Suk, Jeong-Ju Yoo, Sang Gyune Kim, Moon Young Kim, Sung-Eun Kim, Jung-Hee Kim, Jung Gil Park, Won Kim, Dong Joon Kim","doi":"10.5009/gnl250299","DOIUrl":"10.5009/gnl250299","url":null,"abstract":"<p><strong>Background/aims: </strong>Acute-on-chronic liver failure (ACLF) is characterized by the acute decompensation of the liver in patients with preexisting chronic liver disease or cirrhosis, often resulting in multiorgan failure and high short-term mortality. This study aimed to investigate the sequence of organ failures, particularly liver and renal failure, and their impact on the short-term survival in ACLF patients.</p><p><strong>Methods: </strong>We analyzed data from 1,765 patients in a prospective Korean ACLF cohort, focusing on the timing of liver and renal failures. Overall survival (OS) was assessed using Kaplan-Meier survival analysis with the log-rank test, and multivariate analysis was performed using a Cox proportional hazards model.</p><p><strong>Results: </strong>Patients with initial liver failure had significantly worse OS compared to those without liver failure (adjusted hazard ratio [aHR], 3.6; p=0.008), and those who developed liver failure during the disease course had an even poorer prognosis (aHR, 5.7; p=0.002). There was no significant difference in OS between patients without renal failure and those with initial renal failure (aHR, 0.8; p=0.508). However, renal failure that developed during hospitalization was associated with a worse prognosis (aHR, 1.9; p=0.056). Patients with initial renal failure had significantly better OS than those with initial liver failure (aHR, 2.4; p=0.040).</p><p><strong>Conclusions: </strong>Organ failure developing during hospitalization is more detrimental than failure present at admission. ACLF with initial renal failure has a better prognosis than ACLF with initial liver failure. ACLF patients with initial renal failure have a 28-day survival rate exceeding 90% if renal failure is present initially; however, this rate significantly decreases if renal failure occurs during hospitalization.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"837-847"},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Traction-Assisted Endoscopic Submucosal Dissection for Prepyloric and Pyloric Neoplasms: Propensity Score Matching Analysis.","authors":"Seung Min Hong, Gwang Ha Kim, Bong Eun Lee, Moon Won Lee, Dong Chan Joo, Dong Hoon Baek, Geun Am Song","doi":"10.5009/gnl250203","DOIUrl":"10.5009/gnl250203","url":null,"abstract":"<p><strong>Background/aims: </strong>Traction-assisted endoscopic submucosal dissection (TA-ESD) using dental floss substantially reduces procedural times without increasing adverse event rates. However, few studies have described the clinical outcomes following TA-ESD for prepyloric and pyloric neoplasms. Therefore, this study aimed to investigate the clinical outcomes of patients treated with TA-ESD for prepyloric and pyloric neoplasms.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of 208 patients who underwent ESD for prepyloric and pyloric neoplasms between 2016 and 2021 at Pusan National University Hospital. The patients were categorized into the conventional ESD (C-ESD) (n=173) and TA-ESD (n=35) groups. One-to-two propensity score matching (PSM) was performed between both groups.</p><p><strong>Results: </strong>In the unmatched cohort, compared with the C-ESD group, the TA-ESD group had a significantly greater rate of resection defects exceeding half of the circumference of the pylorus (45.7% vs 27.2%, p=0.048), a lower complete resection rate (85.7% vs 97.1%, p=0.014), a higher positive vertical margin rate (5.7% vs 0.0%, p=0.028), and a longer procedural time (34.2±26.1 minutes vs 25.3±22.0 minutes, p=0.036). After PSM, the TA-ESD group required a significantly shorter procedural time than did the C-ESD group (30.1±18.1 minutes vs 40.4±23.7 minutes, p=0.031). No statistically significant differences were observed in other variables between the two groups.</p><p><strong>Conclusions: </strong>Compared to C-ESD, TA-ESD significantly shortened the procedural time for treating prepyloric and pyloric neoplasms. However, no significant differences were observed in the complete resection rate or in adverse events between the two groups.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"787-795"},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subtype-Specific Mortality and Cardiovascular Burden in HIV Patients with Steatotic Liver Disease: A Korean National Cohort Study.","authors":"Jihun Song, Seogsong Jeong, Jihwan Bang, Won Kim","doi":"10.5009/gnl250555","DOIUrl":"10.5009/gnl250555","url":null,"abstract":"<p><strong>Background/aims: </strong>Steatotic liver disease (SLD) is an emerging comorbidity among people living with human immunodeficiency virus (PLWH), but its subtype-specific burden remains unclear. We aimed to evaluate the prevalence of SLD and its associations with mortality, cardiovascular diseases, and liver cirrhosis (LC).</p><p><strong>Methods: </strong>This retrospective cohort study included 4,597 Korean PLWH using data from the National Health Insurance Service (2013-2022). SLD was defined using the fatty liver index (≥30) and categorized into metabolic dysfunction-associated SLD (MASLD), alcohol-associated liver disease (ALD), and metabolic dysfunction-associated ALD (MetALD). Outcomes were all-cause mortality, cardiovascular diseases, and LC, analyzed using multivariable Cox proportional hazards and Fine-Gray competing risk models.</p><p><strong>Results: </strong>The prevalence of SLD was 45.7%, predominantly MASLD (86.5%), followed by Met-ALD (9.7%) and ALD (3.8%). SLD prevalence in PLWH was not higher than that in matched controls. Over a median 6-year follow-up, SLD was associated with increased mortality (adjusted hazard ratio, 1.53; 95% confidence interval [CI], 1.03 to 2.29). ALD was linked to higher stroke risk (adjusted subdistribution hazard ratio [aSHR], 3.10; 95% CI, 1.04 to 9.20), and MetALD to higher LC risk (aSHR, 5.72; 95% CI, 1.48 to 22.10).</p><p><strong>Conclusions: </strong>As SLD is significantly associated with mortality in PLWH, integrated management focusing on liver health, metabolic dysfunction, and alcohol use is essential to reduce adverse outcomes.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"859-869"},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148864582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in <i>Helicobacter pylori</i> Antimicrobial Resistance among 890 Subjects over 20 Years in a Korean Tertiary Hospital.","authors":"Yonghoon Choi, Nayoung Kim, Ju Yup Lee, Jung Won Lee, Hae Dong Lee, Jongchan Lee, So Young Jo, Ryoung Hee Nam, Cheol Min Shin","doi":"10.5009/gnl260357","DOIUrl":"10.5009/gnl260357","url":null,"abstract":"<p><strong>Background/aims: </strong>Although sex-based differences in <i>Helicobacter pylori</i> eradication success rates and antibiotic resistance profiles have been suggested, which are essential for effective eradication of <i>H. pylori</i>, evidence remains limited. The aim of this study was to investigate sex-based differences in antibiotic resistance patterns of <i>H. pylori</i> to better inform eradication strategies.</p><p><strong>Methods: </strong>Subjects from whose gastric mucosal biopsy specimens <i>H. pylori</i> colonies were isolated were consecutively enrolled between 2003 and 2025. Minimum inhibitory concentration tests were performed for amoxicillin, clarithromycin, metronidazole, tetracycline, levofloxacin, and moxifloxacin using the agar dilution method.</p><p><strong>Results: </strong>A total of 890 subjects (510 males and 380 females) were included. Females demonstrated higher resistance rates to clarithromycin (50.0% vs 35.9%; p<0.001), metronidazole (45.3% vs 38.4%; p=0.041), levofloxacin (45.8% vs 33.7%; p<0.001), and moxifloxacin (45.5% vs 34.1%; p=0.001) than males did; however, no significant differences were found for amoxicillin or tetracycline. Stratified analyses revealed significant sex differences in resistance to clarithromycin and levofloxacin among secondary strains (clarithromycin, 80.9% vs 67.2%, p=0.007; levofloxacin, 61.1% vs 48.9%, p=0.034), whereas metronidazole resistance among primary strains showed only a marginal sex difference (40.8% vs 33.2%; p=0.064). Females also demonstrated significantly higher rates of multidrug resistance, and resistance rates progressively increased over time in both sexes.</p><p><strong>Conclusions: </strong>Female subjects with <i>H. pylori</i> infection showed higher resistance rates to clarithromycin, metronidazole, fluoroquinolones, and multidrug regimens than males. These findings highlight the importance of considering sex differences when interpreting antimicrobial resistance patterns and selecting eradication strategies. (ClinicalTrials.gov identifier NCT05247112).</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proteomic Analysis of Extracellular Vesicles Reveals Vitronectin and Laminin Subunit Alpha-3 as Candidate Biomarkers for Gastric Cancer.","authors":"Dong Chan Joo, Su Jin Park, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee","doi":"10.5009/gnl250470","DOIUrl":"10.5009/gnl250470","url":null,"abstract":"<p><strong>Background/aims: </strong>Clinically useful noninvasive biomarkers for gastric cancer remain limited. Extracellular vesicles (EVs) carry a molecular cargo reflective of their cells of origin and have emerged as promising candidates for blood-based cancer biomarkers. We aimed to identify EV-associated protein biomarkers for gastric cancer via a proteomic approach.</p><p><strong>Methods: </strong>Proteomic profiling of EVs was performed using one normal gastric cell line (Hs738st/int) and two gastric cancer cell lines (AGS and NCI-N87). Selected proteins were validated in blood-derived EVs isolated from plasma samples of 10 healthy controls and 36 patients with gastric cancer.</p><p><strong>Results: </strong>Proteomic analysis identified 224 differentially expressed proteins whose expression was consistently altered in gastric cancer cell line-derived EVs. Among these, vitronectin (VTN) and laminin subunit alpha-3 (LAMA3) were selected based on their consistent upregulation. EV-associated LAMA3 levels were significantly higher in patients with gastric cancer than in healthy controls (p=0.003), with significant elevations observed from stage II onward (p=0.041, p=0.017, and p=0.004 for stages II, III, and IV, respectively). EV-associated VTN levels were not significantly different overall (p=0.089); however, stage-specific analysis demonstrated significant increases in VTN levels in patients with stage III (p=0.036) and stage IV (p=0.005) gastric cancer. Both EV-associated VTN and LAMA3 levels showed significant positive correlations with the cancer stage (ρ=0.564 and ρ=0.611, respectively; both p<0.001).</p><p><strong>Conclusions: </strong>The levels of EV-associated VTN and LAMA3 appear to be more closely associated with disease progression than with early-stage detection of gastric cancer. These findings suggest that EV-based proteomic biomarkers may have clinical utility for monitoring tumor progression in patients with clinically advanced gastric cancer.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"745-755"},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13575879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}