World Journal of Gastrointestinal Oncology最新文献

{"title":"Clinical characteristics of programmed death-1 inhibitors for older patients with advanced pancreatic cancer.","authors":"Yun-Yun Lu, Pan Chen, Yi Lu","doi":"10.4251/wjgo.v18.i2.115562","DOIUrl":"10.4251/wjgo.v18.i2.115562","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer (PC), a highly malignant gastrointestinal cancer, is generally diagnosed at an advanced stage. However, traditional therapies for advanced PC are limited and often unsuitable for older patients.</p><p><strong>Aim: </strong>To identify clinical predictors in older patients with advanced PC to facilitate individualized treatment.</p><p><strong>Methods: </strong>This was a retrospective clinical analysis involving 99 patients aged ≥ 65 years with advanced PC who received programmed death-1 (PD-1) inhibitors at Ningbo Medical Center Lihuili Hospital from January 2019 to January 2025. Univariate and multivariate analyses were conducted to identify clinical predictors for survival outcomes, utilizing blood levels and other clinical information.</p><p><strong>Results: </strong>The median progression-free survival (PFS) was 4.6 months [95% confidence interval (CI): 3.700-5.800], and the median overall survival (OS) was 6.5 months (95%CI: 5.700-8.200). Multivariate analysis helped identify meaningful clinical differences in PFS and OS across subgroups, including factors such as Eastern Cooperative Oncology Group performance status, prognostic nutritional index, and triglyceride levels. Univariate analysis showed that factors such as the location of primary PC, carbohydrate antigen 199 levels, systemic immune-inflammation, neutrophil-to-lymphocyte ratio, and the combination therapy comprising PD-1 inhibitors and radiotherapy are of significant clinical relevance to both PFS and OS.</p><p><strong>Conclusion: </strong>The treatment of advanced PC with PD-1 inhibitors presented several potential independent clinical predictive indicators of survival outcomes in older patients. This study highlighted the importance of pre-treatment clinical characteristics and hematological variables for predicting treatment outcomes in older patients with PC.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"115562"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing expression of presenilin 1, β-catenin, and p-PTEN and its regulatory roles on cell invasion in gastric cancer.","authors":"Xi Lin, Guo-Feng Lin, Fei-Teng Gu, Yong-Liang Li","doi":"10.4251/wjgo.v18.i2.115689","DOIUrl":"10.4251/wjgo.v18.i2.115689","url":null,"abstract":"<p><strong>Background: </strong>Presenilin-1 (PS-1), a part of the gamma-secretase complex, has been implicated as a tumor promoter in various cancers. PS-1 binds to β-catenin through a large hydrophilic loop region that could lead to gastric tumorigenesis by the phosphatidylinositol 3-kinase/protein kinase B/mechanistic target of rapamycin pathway, which is known to inhibit phosphatase and tensin homolog deleted on chromosome ten (PTEN). However, little is known about the mechanisms of PS-1, β-catenin, and PTEN in gastric cancer (GC) tumorigenesis.</p><p><strong>Aim: </strong>To determine the regulatory correlation among PS-1, β-catenin, and phosphorylation of PTEN (p-PTEN) in GC tumorigenesis .</p><p><strong>Methods: </strong>Tissue samples from 116 patients with GC were analyzed by immunohistochemistry. Cell lysates from MGC-803 were used to detect protein levels by western blot. Cell invasion ability and metastatic ability were examined <i>in vitro</i> by Transwell invasion and <i>in vivo via</i> tail vein injection, respectively.</p><p><strong>Results: </strong>The high expression rates of PS-1, β-catenin, and p-PTEN in GC were 60.3% (70/116), 56.9% (66/116), and 47.4% (55/116), respectively, correlating with advanced tumor stages based on tumor invasion, lymph node metastasis, and 5-year survival. PS-1 expression was positively correlated with expression of β-catenin and p-PTEN in patients with GC. PS-1 regulated PTEN phosphorylation and cytoplasmic localization through β-catenin. PS-1 enhanced GC cell invasion <i>via</i> β-catenin.</p><p><strong>Conclusion: </strong>The expression of PS-1 was positively correlated with that of both β-catenin and p-PTEN in GC. The regulation of PTEN phosphorylation and cytoplasmic localization by PS-1 through β-catenin could be considered potential therapeutic targets to prevent GC tumorigenesis.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"115689"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography with carcinoembryonic antigen and carbohydrate antigen 19-9 in diagnosing lymph node metastasis of early gastric cancer.","authors":"Hong-Zhi Chen, Ping Zhang, Jun Ma","doi":"10.4251/wjgo.v18.i2.114066","DOIUrl":"10.4251/wjgo.v18.i2.114066","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) is the fifth most prevalent and fourth most lethal malignancy globally. China bears a disproportionately high burden, accounting for 44.0% of new cases and 48.6% of deaths worldwide. In early GC (EGC), the presence of lymph node metastasis (LNM) is a critical prognostic determinant that directly guides therapeutic strategy. While multi-detector computed tomography (CT) and serum biomarkers carcinoembryonic antigen (CEA)/carbohydrate antigen 19-9 (CA19-9) are established diagnostic tools, each demonstrates limited efficacy when used independently. This study therefore aims to verify whether a combined diagnostic approach integrating multi-detector CT (MDCT) with serum CEA/CA19-9 can significantly improve the accuracy of LNM detection in EGC patients.</p><p><strong>Aim: </strong>To investigate the diagnostic value of CT combined with CEA or CA19-9 for detecting LNM in EGC.</p><p><strong>Methods: </strong>This retrospective study included 120 patients with EGC confirmed by gastroscopic biopsy at our institution (Huai'an Hospital of Huai'an City) between February 2024 and August 2024. Based on postoperative pathological findings, participants were categorized into a LNM group (<i>n</i> = 60) and a non-metastasis group (<i>n</i> = 60). All patients underwent MDCT scanning and serum CEA and CA19-9 level measurements. The diagnostic efficacy of CT, CEA, and CA19-9 alone and in combination was evaluated using receiver operating characteristic (ROC) curve and Kappa consistency analysis.</p><p><strong>Results: </strong>Serum analysis showed significantly elevated CEA and CA19-9 levels and higher positivity rates in the metastasis group (<i>P</i> < 0.0001). ROC analysis yielded area under the curves of 0.9443 (CEA) and 0.9292 (CA19-9), with Kappa values of 0.683 and 0.650, respectively. CT revealed significantly greater short-axis diameter, CT attenuation, blood volume, and permeability in metastatic nodes (<i>P</i> < 0.05), whereas blood flow and mean transit time showed no significant differences. CT alone demonstrated 85.00% sensitivity and 95.00% specificity (Kappa = 0.800). Combined diagnosis improved sensitivity to 91.67% (CT + CEA) and 90.00% (CT + CA19-9), with specificities of 90.00% and 88.33%, respectively.</p><p><strong>Conclusion: </strong>The combination of CT with CEA or CA19-9 improves sensitivity for detecting LNM in EGC, supporting personalized treatment planning and demonstrating clinical value.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"114066"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal follicular thyroid-like carcinoma: A case report and review of literature.","authors":"Jia-Liang Li, Chao Cheng, Pei Zhang, Jun Fan, Lan Zhang, Liang-Ru Zhu, Kai-Xiong Tao, Ming Cai","doi":"10.4251/wjgo.v18.i2.115179","DOIUrl":"10.4251/wjgo.v18.i2.115179","url":null,"abstract":"<p><strong>Background: </strong>Follicular thyroid carcinoma (FTC) is the second most common subtype of thyroid malignancy, with distant metastases most often to the bones, lungs, brain, and liver, and only rarely to other sites. Rectal follicular thyroid-like carcinoma is a rare condition characterized by infiltration of FTC within the rectal wall. There are almost no literature reports.</p><p><strong>Case summary: </strong>We report a case of rectal thyroid-like follicular carcinoma in a 61-year-old woman. The patient presented with intermittent rectal bleeding, and a colonoscopy revealed a mass in the mid-rectum. She underwent laparoscopic resection of the lesion, and was diagnosed with rectal thyroid-like follicular carcinoma by postoperative pathology. After a laparoscopic partial rectal resection, she was discharged on postoperative day 7. At 6 months postoperatively, the patient was still alive.</p><p><strong>Conclusion: </strong>Rectal follicular thyroid-like carcinoma may arise from malignant struma ovarii, highlighting the need to consider ovarian origins in atypical metastases of FTC.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"115179"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12897967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum protein induced by vitamin K absence or antagonist-II predicts aggressive tumor biology in alpha-fetoprotein-normal hepatocellular carcinoma.","authors":"Zaigham Abbas, Darayus P Gazder, Zeeshan Hyder, Muhammad Ali Qadeer, Minaam Abbas","doi":"10.4251/wjgo.v18.i2.113673","DOIUrl":"10.4251/wjgo.v18.i2.113673","url":null,"abstract":"<p><strong>Background: </strong>Patients with hepatocellular carcinoma (HCC) beyond the Milan criteria or with portal vein tumor thrombosis are often excluded from the transplant list owing to aggressive biology and recurrence risk. While high alpha-fetoprotein (AFP) signals aggressiveness, the behavior of normal AFP HCC with elevated protein induced by vitamin K absence/antagonist-II (PIVKA-II) is less defined.</p><p><strong>Aim: </strong>To assess the prognostic value of PIVKA-II in normal AFP HCC.</p><p><strong>Methods: </strong>Retrospective cohort of 113 patients with normal AFP and normal or elevated PIVKA-II. \"Aggressive\" tumors were defined as beyond Milan and/or portal vein tumor thrombosis (<i>n</i> = 63); others were non-aggressive (<i>n</i> = 50). Receiver operating characteristic curve analysis identified PIVKA-II cut-offs.</p><p><strong>Results: </strong>This study included 78 men and 35 women; mean age 58.4 ± 11.1 years; 62.8% with decompensated cirrhosis. PIVKA-II was higher in aggressive tumors: Median 2785 mAU/mL (interquartile range: 222-8152) <i>vs</i> 239 mAU/mL (interquartile range: 55-727), <i>P</i> < 0.001. Area under receiver operating characteristic curve 0.756 (95% confidence interval: 0.669-0.844). The Youden-optimized cut-off for aggressive HCC was 1609.5 mAU/mL [sensitivity: 0.54, specificity: 0.94; positive predictive value (PPV): 0.919]. A sensitivity-oriented cut-off of 400 mAU/mL gave sensitivity 0.69 and specificity 0.64 (PPV: 0.71). Regression analysis showed that PIVKA-II > 400 mAU/mL was strongly associated with aggressive tumor phenotype (adjusted odds ratio = 5.16, <i>P</i> = 0.001). All the 29 patients with ≥ 4000 mAU/mL were in the aggressive group (PPV: 1.0). All thresholds were dataset-derived.</p><p><strong>Conclusion: </strong>In normal AFP HCC, PIVKA-II discriminates aggressive biology. A cut-off of 1609.5 mAU/mL balances sensitivity and specificity; 400 mAU/mL favors sensitivity; ≥ 4000 mAU/mL delineates an ultra-high-risk subgroup. Findings support the incorporation of PIVKA-II into risk stratification.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"113673"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of liver metastasis on the efficacy of immune checkpoint inhibitors for advanced colorectal cancer.","authors":"Meng-Yue Xiang, Ze-Min Tuo, Xing-Kang Sa, Peng Wang, Ji-Wen Bian, Xin-Ming Zhang","doi":"10.4251/wjgo.v18.i2.115515","DOIUrl":"10.4251/wjgo.v18.i2.115515","url":null,"abstract":"<p><strong>Background: </strong>Liver metastasis is common in advanced colorectal cancer (CRC) and may influence the response to immune checkpoint inhibitors (ICIs). However, the prognostic impact of liver metastasis on ICI efficacy remains uncertain.</p><p><strong>Aim: </strong>To evaluate the association between liver metastasis and survival outcomes in patients with metastatic CRC (mCRC) treated with ICIs in a meta-analysis.</p><p><strong>Methods: </strong>We systematically searched PubMed, EMBASE, and Web of Science up to May 14, 2025, for studies comparing survival outcomes in patients with mCRC with <i>vs</i> without liver metastasis receiving ICIs. Hazard ratios (HRs) for overall survival (OS) and/or progression-free survival (PFS) were extracted and pooled using random-effects models. Subgroup and sensitivity analyses were conducted to explore heterogeneity and result stability.</p><p><strong>Results: </strong>Sixteen studies comprising 1203 patients were included. Liver metastasis was associated with significantly worse PFS [HR = 1.94, 95% confidence interval (95%CI): 1.56-2.41, <i>P</i> < 0.001; <i>I</i> ² = 38%] and OS (HR = 2.10, 95%CI: 1.66-2.65, <i>P</i> < 0.001; <i>I</i> ² = 23%) among patients with mCRC treated with ICIs. Subgroup analyses showed consistent results across study design, microsatellite status, age, follow-up duration, and statistical adjustment (<i>P</i> for subgroup difference all > 0.05). Sensitivity analyses performed by excluding one study at a time showed consistent results, which further confirmed the robustness of the findings.</p><p><strong>Conclusion: </strong>Liver metastasis is associated with worse survival outcomes in patients with mCRC receiving ICIs. These results suggest that liver metastasis may serve as a negative prognostic factor in the context of immunotherapy for mCRC.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"115515"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiota-metabolite signatures in metastatic colorectal cancer: Promise, pitfalls, and the path forward.","authors":"Ting-Ting Zhang, Juan Yao, Han-Meng Zhang","doi":"10.4251/wjgo.v18.i2.115010","DOIUrl":"10.4251/wjgo.v18.i2.115010","url":null,"abstract":"<p><p>This letter evaluates Deng <i>et al</i> study examining the gut microbiota and metabolite changes in metastatic colorectal cancer (CRC). The research used 16S rRNA sequencing and liquid chromatography-mass spectrometry metabolomics to investigate microbial and metabolic shifts in patients with metastatic <i>vs</i> non-metastatic CRC. The study reveals that CRC patients with metastasis exhibit significant differences in their gut microbiota and metabolites compared to non-metastatic patients. However, the study's reliance on 16S rRNA sequencing presents inherent limitations, particularly with respect to species-level resolution. The sequencing depth may not have been sufficient to capture all relevant low-abundance taxa, as indicated by the rarefaction curves which did not fully plateau, potentially affecting the identification of differential species. It also identifies 91 differential metabolites, particularly those involved in nucleic acid, alkaloid, and lipid metabolism, which may contribute to metastasis progression. The findings suggest that microbiota and their metabolites play a critical role in CRC metastasis, offering potential targets for diagnosis and treatment. However, several limitations exist, including small sample size, single-center data, and a cross-sectional design that prevents causal conclusions. Additionally, the study lacks integration of key clinical factors such as dietary patterns and medication use, which could confound the results. Future research should expand these findings through multi-center studies with longer follow-up periods, incorporating more comprehensive clinical data and advanced analytical techniques to validate and refine the role of microbiota and metabolites in CRC metastasis. Despite its limitations, this study provides valuable insights into the microbiota-metabolite axis in CRC metastasis and opens potential avenues for future research. However, it is crucial to note that the metabolite identification was based on database matching rather than chemical standard validation. As such, these results should be considered putative annotations, with their accuracy requiring further confirmation through targeted analyses.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"115010"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application value of multiphase contrast-enhanced computed tomography radiomics in preoperative evaluation of peritoneal metastasis in gastric cancer.","authors":"Xiao-Dan Mu, Dong-Xu Ji, De-Qiang Kang","doi":"10.4251/wjgo.v18.i2.115404","DOIUrl":"10.4251/wjgo.v18.i2.115404","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal metastasis occurs in 10%-45% of gastric cancer patients and significantly impacts prognosis and treatment decisions. Traditional computed tomography (CT) imaging has limited sensitivity (60%-80%) for detecting early peritoneal metastases, while laparoscopic exploration is invasive. Multiphase contrast-enhanced CT radiomics offers a non-invasive approach to improve preoperative prediction, yet most existing studies rely on single-phase analysis without fully exploiting multiphase data advantages.</p><p><strong>Aim: </strong>To construct a preoperative prediction model for gastric cancer peritoneal metastasis based on multiphase contrast-enhanced CT radiomics, compare the diagnostic efficacy between multiphase combined and single-phase analysis, and evaluate its clinical application value.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 200 pathologically confirmed gastric cancer patients from January 2020 to December 2024, all of whom underwent preoperative multiphase contrast-enhanced CT examination. Patients were randomly divided into training set (<i>n</i> = 140) and validation set (<i>n</i> = 60) at a 7:3 ratio. PyRadiomics was used to extract 3920 radiomics features from arterial phase, venous phase, and delayed phase images. Synthetic minority oversampling technique was applied to handle class imbalance. Feature selection was performed through <i>Z</i>-score standardization, univariate screening, collinearity testing, and least absolute shrinkage and selection operator regression. Single-phase and multiphase combined radiomics models were constructed using logistic regression, support vector machine, and random forest algorithms. Model performance was evaluated through receiver operating characteristic curves.</p><p><strong>Results: </strong>The multiphase combined model achieved an area under the curve (AUC) of 0.876 (95% confidence interval: 0.783-0.941) in the validation set, with sensitivity of 81.0%, specificity of 84.6%, and accuracy of 83.3%, significantly superior to all single-phase models (<i>P</i> < 0.05). Among single-phase models, the venous phase model performed best (AUC = 0.834). Hosmer-Lemeshow test showed good model calibration (<i>P</i> = 0.765). Decision curve analysis demonstrated that at a threshold probability of 0.35, the multiphase combined model could avoid 33.7% of unnecessary exploratory surgeries.</p><p><strong>Conclusion: </strong>The multiphase combined model based on multiphase contrast-enhanced CT radiomics can effectively predict gastric cancer peritoneal metastasis, with diagnostic performance significantly superior to single-phase models, providing a new non-invasive technical approach for individualized preoperative assessment of gastric cancer patients.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"115404"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection rate and risk factors of colorectal adenoma in high-altitude population: A cross-sectional study.","authors":"Xiao-Lei Zhao, Wang-Yang Chen, Yi-Meng Liu, Suo-Lang Danzeng, Qu-Zhen Pingcuo, Zhen Yu, Hong-Da Chen, Yang-Jin Ciren, Dong Wu","doi":"10.4251/wjgo.v18.i2.116336","DOIUrl":"10.4251/wjgo.v18.i2.116336","url":null,"abstract":"<p><strong>Background: </strong>The epidemiology of colorectal cancer (CRC) varies significantly, with an increasing incidence in China. The Xizang Autonomous Region has the lowest CRC mortality nationally, offering a unique natural experiment to investigate carcinogenesis. As most CRCs develop <i>via</i> the adenoma-carcinoma sequence, characterizing the prevalence of its precursor lesion, colorectal adenoma (CRA), is essential for understanding this disparity.</p><p><strong>Aim: </strong>To characterize the detection rates and risk factors for colorectal lesions in the high-altitude population of Xizang Autonomous Region.</p><p><strong>Methods: </strong>In this cross-sectional study, 1154 Tibetans undergoing high-definition colonoscopy were enrolled. Univariate and multivariate logistic regression were conducted to analyze the risk factors for CRA. Data were collected <i>via</i> questionnaire, and the China Sporadic Colorectal Cancer Risk Score and Asia-Pacific Colorectal Screening (APCS) score were calculated. A control group from low altitude was established using a 1:2 case-control matching protocol based on age, sex, body mass index (BMI), and first-degree family history of CRC, and detection rates were compared.</p><p><strong>Results: </strong>The detection rates in the Xizang Autonomous Region cohort were 7.7% for CRA (<i>n</i> = 89) and 1.6% for CRC (<i>n</i> = 18). Univariate analysis showed that CRA was associated with advanced age, male sex, higher BMI, and higher risk tiers on both the China and APCS scores. However, multivariate logistic regression confirmed only advanced age (OR = 1.035, 95%CI: 1.019-1.052, <i>P</i> < 0.001) and male sex (OR = 2.161, 95%CI: 1.337-3.492, <i>P</i> = 0.002) as independent risk factors. In the comparative analysis, the Xizang CRA detection rate was significantly lower than that in the matched Beijing cohort (7.7% <i>vs</i> 22.8%, <i>P</i> < 0.001). No significant difference was found in CRC detection rates (1.6% <i>vs</i> 1.3%, <i>P</i> = 0.626).</p><p><strong>Conclusion: </strong>The prevalence of CRA in the high-altitude population was significantly lower. Advanced age and male sex remain independent risk factors for CRA in Xizang Autonomous Region.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"116336"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12897897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metallic elements and their molecular roles in gastric cancer: Pathogenic mechanisms and therapeutic implications.","authors":"Li-Baihe Jing, Jie Liu, Zi-Hai Yang, Fei-Fei Yang, De-Gui Wang, Yu-Min Li","doi":"10.4251/wjgo.v18.i2.114351","DOIUrl":"10.4251/wjgo.v18.i2.114351","url":null,"abstract":"<p><p>Gastric cancer (GC) remains among the leading causes of cancer-related mortality globally. Increasing evidence indicates that metallic elements such as iron, copper (Cu²⁺), zinc, and calcium (Ca²⁺) play crucial roles in GC pathogenesis, diagnosis, and treatment through diverse molecular mechanisms. This review systematically summarizes recent advances in the application of metallomics in GC. Relevant studies published up to 2024 were retrieved from PubMed, Web of Science, and Scopus using keywords including \"gastric cancer\", \"metal ions\", \"metallomics\", and \"metal-based therapy\". After screening and evaluation, representative studies elucidating the roles of metallic elements in GC were analyzed and synthesized. The findings revealed that iron overload induces oxidative stress and immune suppression <i>via</i> the Fenton reaction. Further analysis indicated that Cu²⁺ imbalance triggers mitochondrial dysfunction and cuproptosis, zinc deficiency disrupts transcriptional regulation through zinc finger proteins and metalloproteinases, and Ca²⁺ dysregulation activates Ca²⁺/calmodulin-dependent protein kinase kinase- AMP-activated protein kinase signaling to promote proliferation and chemoresistance. Advances in analytical techniques such as laser ablation inductively coupled plasma mass spectrometry have enabled spatial mapping of metal distributions in tumors, providing novel diagnostic and prognostic insights. Moreover, metal-based anti-cancer drugs and combination regimens involving traditional Chinese medicines exhibit promising therapeutic potential. Understanding the molecular crosstalk of metal metabolism offers new perspectives for precision diagnosis and targeted treatment in GC.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"18 2","pages":"114351"},"PeriodicalIF":2.5,"publicationDate":"2026-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}