World Journal of Gastrointestinal Oncology最新文献

{"title":"Tumor markers and multimodal magnetic resonance imaging in predicting rectal cancer stage and differentiation.","authors":"Peng Wang, Jun Han, Wen-Na Zhao, Fan Wu, Sheng-He Zhang, Yi-Juan Huang","doi":"10.4251/wjgo.v17.i8.108007","DOIUrl":"10.4251/wjgo.v17.i8.108007","url":null,"abstract":"<p><strong>Background: </strong>Rectal cancer is one of the common digestive system malignant tumors around the world. Its early diagnosis and staging are crucial for rectal cancer treatment and prognosis. In recent years, tumor markers have gradually received attention in early screening, treatment monitoring and prognostic evaluation of cancer, but their predictive role in rectal cancer staging and differentiation is still unclear.</p><p><strong>Aim: </strong>To assess the prognostic value of tumor markers alpha-fetoprotein (AFP) cancer antigen 72-4 (CA72-4), carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA), alongside multimodal magnetic resonance imaging (MRI), for staging and differentiating rectal cancer in patients.</p><p><strong>Methods: </strong>This study retrospectively analyzed 167 patients with rectal cancer who were treated at our institution from January 2020 to December 2024. Each patient underwent serological testing and multimodal MRI for diagnosis. Histopathological examination after surgical resection or imaging based on follow-up was used as the gold standard. According to the T stage and differentiation degree, patients were divided into low stage group (T1-T2) and high stage group (T3-T4). In addition, they were divided into low-differentiation groups and high-differentiation groups according to their differentiation degree. We compared the accuracy, sensitivity and specificity of tumor marker levels and MRI in rectal cancer stage and differentiation.</p><p><strong>Results: </strong>The study's findings indicate that in the context of rectal cancer T staging, there is substantial concordance between MRI and clinicopathological assessments, with a Kappa coefficient of 0.789 (<i>P</i> < 0.001). Similarly, for various degrees of tumor differentiation, MRI and clinicopathological evaluations demonstrated substantial agreement, with a Kappa coefficient of 0.651 (<i>P</i> < 0.001). Notably, the concentrations of tumor markers CA19-9, CA72-4, CEA, and AFP were significantly elevated in the T3-T4 stage compared to the T1-T2 stage. Furthermore, these markers were significantly higher in the low-differentiation group compared to the high-differentiation group (<i>P</i> < 0.05). The combined use of tumor markers and MRI for preoperative T staging of rectal cancer yielded a diagnostic sensitivity of 93.7% and a specificity of 94.6%, as evidenced by the receiver operating characteristic analysis, with an area under the curve of 0.947. For tumor differentiation, the diagnostic sensitivity and specificity were 93.6% and 97.1%, respectively, with an area under the curve of 0.978 (95% confidence interval: 0.946-1.000), surpassing the accuracy of individual detection methods.</p><p><strong>Conclusion: </strong>The CA19-9, CA72-4, CEA and AFP tumor markers combined with multimodal MRI have high sensitivity and specificity in diagnosing rectal cancer stage and differentiation. Their diagnostic efficacy is significantly bet","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"108007"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971407","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":"Correlation between baseline magnetic resonance imaging features and serum carcinoembryonic antigen levels in patients with primary rectal cancer.","authors":"Peng Wang, Wen-Na Zhao, Jun Han, Kai-Xuan Wang, Xiao-Feng Yang, Yi-Juan Huang","doi":"10.4251/wjgo.v17.i8.108016","DOIUrl":"10.4251/wjgo.v17.i8.108016","url":null,"abstract":"<p><strong>Background: </strong>Serum carcinoembryonic antigen (CEA) levels and magnetic resonance imaging (MRI) findings are widely used for the diagnosis and treatment of rectal cancer; however, research investigating their correlation remains limited.</p><p><strong>Aim: </strong>To investigate the correlation between baseline MRI features and serum CEA levels in patients diagnosed with primary rectal cancer.</p><p><strong>Methods: </strong>Eighty patients (age: 42-78 years) diagnosed with primary rectal cancer were enrolled. Baseline MRI examinations were performed to evaluate tumor size, T stage, circumferential resection margin status, extramural vascular invasion (EMVI), and lymph node metastasis. Serum CEA levels were concurrently measured. Statistical methods were used to analyze correlations.</p><p><strong>Results: </strong>Tumor size, T stage, EMVI, and lymph node metastasis were significantly correlated with serum CEA levels (<i>P</i> < 0.05). Multivariate analysis identified T stage and lymph node metastasis as independent factors influencing serum CEA levels.</p><p><strong>Conclusion: </strong>This study confirmed the correlation between baseline MRI features and serum CEA levels in patients with primary rectal cancer, highlighting their potential utility for precise diagnosis, staging, and prognostic evaluation.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"108016"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971429","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":"Correlation of pathological types and imaging features in pancreatic cancer.","authors":"Qiu-Long Wang, Xiao-Jun Yang","doi":"10.4251/wjgo.v17.i8.102757","DOIUrl":"10.4251/wjgo.v17.i8.102757","url":null,"abstract":"<p><p>The study by Luo <i>et al</i> published in the <i>World Journal of Gastrointestinal Oncology</i> presents a thorough and scientific methodology. Pancreatic cancer is the most challenging malignancy in the digestive system, exhibiting one of the highest mortality rates associated with cancer globally. The delayed onset of symptoms and diagnosis often results in metastasis or local progression of the cancer, thereby constraining treatment options and outcomes. For these patients, prompt tumour identification and treatment strategising are crucial. The present objective of pancreatic cancer research is to examine the correlation between various pathological types and imaging data to facilitate therapeutic decision-making. This study aims to clarify the correlation between diverse pathological markers and imaging in pancreatic cancer patients, with prospective longitudinal studies potentially providing novel insights into the diagnosis and treatment of pancreatic cancer.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"102757"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971352","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":"Bone marrow metastasis of gastric signet ring cell carcinoma complicated by thrombotic microangiopathy: A case report.","authors":"Wei Sun, Xiao-Ci Chen, Han Wang, Wei-Yu Chang, Yun He, Zeng-Hua Lin, Hui Jia, Xiao-Mei Zhang, Hong Liu","doi":"10.4251/wjgo.v17.i8.109424","DOIUrl":"10.4251/wjgo.v17.i8.109424","url":null,"abstract":"<p><strong>Background: </strong>Thrombotic microangiopathy (TMA) is an acute syndrome characterized by microangiopathic hemolytic anemia, thrombocytopenia, and multi-organ dysfunction due to the microcirculation of platelet thrombi. Cancer-associated TMA is a rare and fatal complication, which often occurs during cancer remission. It is frequently misdiagnosed because of limited clinical awareness.</p><p><strong>Case summary: </strong>A middle-aged female patient presented to our clinic with a 15-days history of back pain, 15 months post-gastrectomy. Cancer-associated TMA was confirmed through bone marrow aspiration, biopsy, and imaging. The patient received intermittent transfusions, fluids, nutrition, and microcirculation therapy with partial coagulation improvement. The family refused intensive care unit admission and plasma exchange, preferring palliative care. The patient died of cerebral hemorrhage and herniation due to disease progression. This case indicates that TMA may serve as an early manifestation of various malignancies, particularly gastric cancer. However, it is often misdiagnosed. Its pathogenesis is not well understood and needs to be further investigated. Currently, no standardized treatment have been developed. Plasma exchange is the only intervention available, though other therapies may also be effective.</p><p><strong>Conclusion: </strong>In this case of gastric signet-ring cell carcinoma complicated by TMA, the patient achieved transient remission with supportive care but died following treatment discontinuation. Further studies are needed to elucidate the pathological mechanisms and therapeutic strategies for cancer-associated TMA.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"109424"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971412","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":"Noninvasive prediction of microsatellite instability in stage II/III rectal cancer using dynamic contrast-enhanced magnetic resonance imaging radiomics.","authors":"Chao-Yang Zheng, Jia-Min Zhang, Qian-Sen Lin, Tao Lian, Liang-Pan Shi, Jie-Yun Chen, Ya-Li Cai","doi":"10.4251/wjgo.v17.i8.108362","DOIUrl":"10.4251/wjgo.v17.i8.108362","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer stands among the most prevalent digestive system malignancies. The microsatellite instability (MSI) profile plays a crucial role in determining patient outcomes and therapy responsiveness. Traditional MSI evaluation methods require invasive tissue sampling, are lengthy, and can be compromised by intratumoral heterogeneity.</p><p><strong>Aim: </strong>To establish a non-invasive technique utilizing dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) radiomics and machine learning algorithms to determine MSI status in patients with intermediate-stage rectal cancer.</p><p><strong>Methods: </strong>This retrospective analysis examined 120 individuals diagnosed with stage II/III rectal cancer [30 MSI-high (MSI-H) and 90 microsatellite stability (MSS)/MSI-low (MSI-L) cases]. We extracted comprehensive radiomics signatures from DCE-MRI scans, encompassing textural parameters that reflect tumor heterogeneity, shape-based metrics, and histogram-derived statistical values. Least absolute shrinkage and selection operator regression facilitated feature selection, while predictive frameworks were developed using various classification algorithms (logistic regression, support vector machine, and random forest). Performance assessment utilized separate training and validation cohorts.</p><p><strong>Results: </strong>Our investigation uncovered distinctive imaging characteristics between MSI-H and MSS/MSI-L neoplasms. MSI-H tumors exhibited significantly elevated entropy values (7.84 ± 0.92 <i>vs</i> 6.39 ± 0.83, <i>P</i> = 0.004), enhanced surface-to-volume proportions (0.72 ± 0.14 <i>vs</i> 0.58 ± 0.11, <i>P</i> = 0.008), and heightened signal intensity variation (3642 ± 782 <i>vs</i> 2815 ± 645, <i>P</i> = 0.007). The random forest model demonstrated superior classification capability with area under the curves (AUCs) of 0.891 and 0.896 across training and validation datasets, respectively. An integrated approach combining radiomics with clinical parameters further enhanced performance metrics (AUC 0.923 and 0.914), achieving 88.5% sensitivity alongside 87.2% specificity.</p><p><strong>Conclusion: </strong>DCE-MRI radiomics features interpreted through machine learning frameworks offer an effective strategy for MSI status assessment in intermediate-stage rectal cancer.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"108362"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971415","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":"Value of intravoxel incoherent motion and diffusion kurtosis imaging to differentiate hepatocellular carcinoma and intrahepatic cholangiocarcinoma.","authors":"Shan-Mei Li, Meng-Wei Feng, Guang-Hai Ji, Xiao-Peng Song, Wei Mao, Tao Zhou, Xiao-Fang Guo, Zi-Long Yuan, Yu-Lin Liu","doi":"10.4251/wjgo.v17.i8.108679","DOIUrl":"10.4251/wjgo.v17.i8.108679","url":null,"abstract":"<p><strong>Background: </strong>The differential diagnosis between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) is crucial. The individual differences of patients increase the complexity of diagnosis. Currently, imaging diagnosis mainly relies on conventional computed tomography and magnetic resonance imaging (MRI), but few studies have investigated MRI functional imaging. This study combined MRI functional imaging including intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI), facilitating differential diagnosis.</p><p><strong>Aim: </strong>To explore the differential diagnostic value of IVIM imaging and DKI in differentiating between HCC and ICC.</p><p><strong>Methods: </strong>A total of 58 patients who underwent multi-b-value diffusion weighted imaging (DWI) on a 3.0 T magnetic MRI scanner were enrolled in this study. Standard apparent diffusion coefficient (SADC), IVIM quantitative parameters, including pure diffusion coefficient (D), pseudo diffusion coefficient (Dstar), and perfusion fraction (f), as well as the DKI quantitative parameters mean diffusion coefficient (MD) and mean kurtosis coefficient (MK) were computed by multi-b DWI images. The <i>χ</i> ² test was used for classified data, and a one-way analysis of variance was performed for counted data. <i>P</i> < 0.05 indicated statistical significance. The diagnostic value of parameters in HCC and ICC was analyzed using the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>The SADC, D, and MD values were significantly lower in the HCC group compared to the ICC group, whereas MK was significantly higher in the HCC group than in the ICC group (<i>P</i> < 0.05). No significant difference in Dstar and f was observed between the HCC group and the ICC group (<i>P</i> > 0.05). The optimal cutoff levels of the total values of SADC, D, MK, MD and all associated parameters were 1.25 × 10^-3 mm²/second, 1.32 × 10^-3 mm²/second, 650.2 × 10^-3 mm²/second, 1.41 × 10^-3 mm²/second and 0.46 × 10^-3 mm²/second, respectively. The sensitivity of diagnosis was 95%, 80%, 90%, 100%, and 70%, respectively, the specificity of diagnosis was 67.39%, 69.57%, 67.39%, 43.48%, and 93.48%, respectively, and the area under the ROC curve was 0.874, 0.793, 0.733, 0.757, and 0.895, respectively.</p><p><strong>Conclusion: </strong>SADC, D, MK, and MD could be used to distinguish HCC from ICC, with the diagnostic value reaching a maximum after establishing a joint model.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"108679"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971424","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":"SOX plus sintilimab <i>vs</i> P-SOX <i>vs</i> SOX as neoadjuvant therapy in advanced gastric cancer: Efficacy and safety.","authors":"Yi-Cong Wang, Chen-Guang Zhang, Yu-Wen Wang, Can Guo, Ting Pan, Peng-Jie Yu, Bao-Jia Cai, Rui-Hua Ding, Jia-Luo Qiang, Chen-Qian Deng, Cheng-Hao Hu, Yong-Huan Xu","doi":"10.4251/wjgo.v17.i8.109646","DOIUrl":"10.4251/wjgo.v17.i8.109646","url":null,"abstract":"<p><strong>Background: </strong>Gastric cancer (GC) remains a major global health burden, particularly in East Asia, due to its high incidence, aggressive progression, and poor prognosis in advanced stages. Although surgery is the mainstay of curative treatment, outcomes for locally advanced cases remain unsatisfactory despite perioperative chemotherapy. In recent years, immune checkpoint inhibitors, especially anti-PD-1 antibodies like sintilimab, have shown promise in improving survival when combined with chemotherapy. However, the comparative efficacy and safety of SOX plus sintilimab <i>vs</i> established regimens such as P-SOX and SOX alone in the neoadjuvant setting have not been fully explored.</p><p><strong>Aim: </strong>To compare the efficacy and safety of three neoadjuvant chemotherapy regimens-SOX combined with sintilimab (SOX + PD-1), albumin-bound paclitaxel plus oxaliplatin and S-1 (P-SOX), and SOX-in patients with advanced GC.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 299 patients with advanced GC who received both neoadjuvant and adjuvant chemotherapy along with standard D2 radical gastrectomy. Among them, 81 patients received SOX plus sintilimab, 118 received the P-SOX regimen, and 100 received the SOX regimen. All patients were randomly assigned to training (70%) or validation (30%) cohorts using the R software sample function. Short-term efficacy, long-term survival outcomes, and adverse events were assessed across the three groups. Additionally, clinical factors associated with progression-free survival (PFS) were further investigated.</p><p><strong>Results: </strong>In terms of short-term efficacy, the SOX + sintilimab group had higher objective response rates [91.4% and 70.4% according to the tumor regression grade (TRG) and Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria, respectively] than did the P-SOX (88.1% and 59.3%) and SOX groups (84.0% and 55.0%), although the intergroup differences were not statistically significant (<i>P</i> = 0.167). For long-term outcomes, the SOX + sintilimab group demonstrated significantly better OS rates at 1 year (98.8%), 18 months (92.6%), 2 years (84.0%), and 3 years (48.1%) than did the P-SOX (93.2%, 86.4%, 71.2%, 30.5%) and SOX (91.0%, 84.0%, 72.0%, 29.0%) groups, with the 3-year overall survival (OS) difference being statistically significant (<i>P</i> = 0.007). Similarly, PFS rates in the SOX + sintilimab group (1 year: 92.6%; 18 months: 77.8%; 2 years: 65.4%; 3 years: 35.8%) were significantly greater than those in the P-SOX (82.2%, 68.6%, 53.4%, 26.3%) and SOX (77.0%, 66.0%, 43.0%, 27.0%) groups, with significant differences at 1 year (<i>P</i> = 0.021) and 2 years (<i>P</i> = 0.011). In terms of safety, grade 1-2 gastrointestinal reactions, peripheral neuropathy, and alopecia were the main TRAEs across groups. The P-SOX group had a significantly greater incidence of alopecia (54.2% <i>vs</i> 53.0% <i>vs</i> 23.5%, <i>P</i> = 0.009","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"109646"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971433","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":"Qige San regulates paclitaxel resistance in esophageal cancer by targeting ferroptosis.","authors":"Jie Song, Wen-Ying Guo, Le-Bo Sun","doi":"10.4251/wjgo.v17.i8.106783","DOIUrl":"10.4251/wjgo.v17.i8.106783","url":null,"abstract":"<p><strong>Background: </strong>Abnormal iron metabolism plays a critical role in paclitaxel (PTX) resistance in esophageal cancer cells. Qige San (QG) is a traditional Chinese herbal formula that is reported to improve short-term therapeutic effects of esophageal cancer.</p><p><strong>Aim: </strong>To investigate the effects and regulatory mechanisms involved in QG-targeted PTX-resistant esophageal cancer cells.</p><p><strong>Methods: </strong>Cell viability was assessed using the Cell Counting Kit-8 assay. Ferroptosis was evaluated by analyzing lipid reactive oxygen species accumulation and the Fe²⁺ concentration in PTX-resistant esophageal cancer cells. Expression of ferroptosis regulators was measured by western blot. Network pharmacology analysis was employed to identify potential targets of QG in PTX-resistant esophageal cancer cells.</p><p><strong>Results: </strong>Treatment with QG significantly suppressed the viability, proliferation, and migration of PTX-resistant esophageal cancer cells and simultaneously induced ferroptosis. The network pharmacology analysis identified the phosphoinositide 3-kinase (PI3K)/protein kinase B signaling pathway as the potential target of QG in PTX-resistant esophageal cancer cells. Activation of the PI3K pathway notably reversed the ferroptosis of PTX-resistant esophageal cancer cells that was induced by QG.</p><p><strong>Conclusion: </strong>QG could repress the resistance of esophageal cancer cells to PTX <i>via</i> targeting the PI3K signaling pathway.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"106783"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971393","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":"Interleukin-22 promotes cancer stemness and chemotherapy resistance in colorectal cancer <i>via</i> epidermal growth factor receptor/extracellular signal-regulated kinase pathway.","authors":"Hong-Xun Ruan, Yan-Le Fang, Xiao-Ning Qin, Lin Lin","doi":"10.4251/wjgo.v17.i8.108535","DOIUrl":"10.4251/wjgo.v17.i8.108535","url":null,"abstract":"<p><strong>Background: </strong>Interleukin-22 (IL-22) belongs to the IL-10 cytokine family, recognized for its ability to modulate diverse immune responses. Previous studies have indicated that IL-22 promotes cancer advancement and metastasis. However, the precise function of IL-22 in colorectal cancer (CRC) remains unclear.</p><p><strong>Aim: </strong>To investigate the role of IL-22 in promoting stem cell-like characteristics and chemotherapy resistance in CRC cells, as well as to elucidate the mechanisms underlying these effects.</p><p><strong>Methods: </strong>HCT116 cells were treated with IL-22 (50 ng/mL) and oxaliplatin (L-OHP, 5 μg/mL). A series of functional assays - including cell counting kit-8 assay, tumor sphere formation assay, and cell apoptosis assay - were conducted to assess the effects of IL-22 on cell viability and stem cell-like characteristics. The expression of stemness-related markers (SOX2, Oct4, NANOG, and Bmi-1) was examined using Western blot analysis. Additionally, the total and phosphorylated levels of epidermal growth factor receptor (EGFR), protein kinase B (AKT), and extracellular signal-regulated kinase (ERK) were evaluated by Western blot. An EGFR inhibitor, osimertinib (Osi), was used to assess the pathway's functional relevance.</p><p><strong>Results: </strong>IL-22 treatment promotes CRC cell proliferation, enhances sphere formation, and elevates the expression of stem cell markers, including SOX2, Oct4, NANOG, and Bmi-1. IL-22 treatment increases the phosphorylation of EGFR, AKT, and ERK. Additionally, IL-22 treatment mitigates the cytotoxic effects and the ability to induce apoptosis of L-OHP. Furthermore, IL-22 treatment activated the EGFR/ERK signaling pathway by increasing the phosphorylation of EGFR, AKT, and ERK. Importantly, the use of the EGFR inhibitor Osi significantly counteracted the chemoresistance induced by IL-22 in CRC cells.</p><p><strong>Conclusion: </strong>IL-22 promotes tumor growth and induces chemotherapy resistance in CRC cells by activating the EGFR/ERK signaling pathway. These findings suggest that targeting IL-22 or its downstream signaling may offer novel therapeutic strategies in CRC.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"108535"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971425","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":"Cost-effectiveness analysis of pancreatic enzyme replacement therapy in patients with pancreatic exocrine insufficiency in China.","authors":"Hansoo Kim, Joshua Byrnes, Kui-Rong Jiang, Zhuan Liao, Arun Jones, Kyoo Kim, Dafni Fragkogianni, Keith J Roberts","doi":"10.4251/wjgo.v17.i8.109544","DOIUrl":"10.4251/wjgo.v17.i8.109544","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic exocrine insufficiency (PEI) leads to fat malabsorption and maldigestion and is most commonly treated with pancreatic enzyme replacement therapy (PERT). Patients suffering from PEI in China are more likely not to receive adequate treatment as this drug is not part of the Chinese national essential medicine list.</p><p><strong>Aim: </strong>To examine the cost-effectiveness of PERT for patients suffering from PEI in China.</p><p><strong>Methods: </strong>A decision analytical Markov model was constructed to simulate the progress of patients with PEI in China. The population included in the analyses were patients suffering from PEI with advanced (non-resectable) pancreatic cancer, who have undergone surgery due to pancreatic cancer and who have undergone endoscopic treatment due to chronic pancreatitis. The cost-effectiveness analyses were undertaken from a Chinese societal perspective comparing PERT with no PERT. The incremental cost-effectiveness ratio in United States dollars <i>per</i> quality adjusted life year (QALY) gained is the main outcome. Input was informed by publicly available data supplemented with expert clinical advice.</p><p><strong>Results: </strong>The cost-effectiveness analyses estimated that PERT resulted in additional 0.45 to 2.93 QALYs at discounted costs of between 4315 dollars to 15193 dollars. This resulted in an incremental cost-effectiveness ratio of 5178 dollars to 9533 dollars <i>per</i> QALY. The one-way sensitivity analyses showed that the main drivers of the model were the cost of PERT and overall survival.</p><p><strong>Conclusion: </strong>This study demonstrates that PERT is a cost-effective treatment for patients suffering from PEI in China.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"109544"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971347","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}