World Journal of Gastrointestinal Oncology最新文献

{"title":"Unmasking immune checkpoint resistance in esophageal squamous cell carcinoma: Insights into the tumor microenvironment and biomarker landscape.","authors":"Zhe Wang, Rui-Ying Zhang, Yi-Fan Xu, Bing-Tong Yue, Jia-Yi Zhang, Feng Wang","doi":"10.4251/wjgo.v17.i8.109489","DOIUrl":"10.4251/wjgo.v17.i8.109489","url":null,"abstract":"<p><p>Esophageal squamous cell carcinoma (ESCC) remains a daunting global health concern. It is marked by aggressive progression and poor survival. While immunotherapy has emerged as a promising treatment modality, both primary and acquired resistance continue to limit its clinical impact, leaving many patients without durable benefits (<i>e.g.,</i> CheckMate-648, ESCORT-1^st). This review explains resistance mechanisms and suggests new strategies to improve outcomes. These mechanisms include immunosuppressive cells (Treg cells, myeloid-derived suppressor cells), inhibitory cytokines, molecular alterations involving programmed death 1/programmed death-ligand 1 signaling, and impaired antigen presentation. We also highlight key clinical trials-for example, CheckMate-648 and ESCORT-1^st-that reveal both the potential and pitfalls of current immune checkpoint blockade strategies, underscoring the need for robust predictive biomarkers. Moreover, we examine cutting-edge tactics to overcome resistance, including combination regimens, tumor microenvironment remodeling, and tailored treatment approaches rooted in the patient's unique genomic and immunologic landscape.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"109489"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971379","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":"Contrast-enhanced ultrasound in evaluating the curative effect of interventional therapy in patients with liver cancer.","authors":"Li-Ping Chen, Yan Dong, Jing-Guang He, Qing-Qing Yang, Zhi-Wen Hu","doi":"10.4251/wjgo.v17.i8.105818","DOIUrl":"10.4251/wjgo.v17.i8.105818","url":null,"abstract":"<p><strong>Background: </strong>Contrast-enhanced ultrasonography (CEUS) is utilized to assess the therapeutic efficacy of interventional therapy in liver cancer patients, offering insights into tumor blood flow changes, angiogenesis, and tumor markers.</p><p><strong>Aim: </strong>To evaluate the use of CEUS in examining the effectiveness of interventional therapy for liver cancer, we aim to investigate its diagnostic utility for tumor perfusion patterns, microvessel density, perfusion recovery, blood flow enhancement response, and alterations in tumor markers among patients receiving interventional therapy for liver cancer.</p><p><strong>Methods: </strong>The study involved 124 patients who underwent interventional therapy for liver cancer at Guangzhou First People's Hospital from January 2022 to February 2024. All patients were examined using CEUS before treatment and at 1 month, 3 months, and 6 months, and the concentrations of tumor markers were collected and statistically analyzed using Statistical Package for the Social Sciences 25.0. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of CEUS and analyze its sensitivity, specificity, and correlation with clinical indicators.</p><p><strong>Results: </strong>Before treatment, tumor blood flow was primarily enhanced. After treatment, enhanced perfusion declined, while uniform and non-uniform perfusion increased, indicating reduced tumor activity. Enhanced perfusion decreased from 68.25% before treatment to 53.75% at 6 months post-treatment (<i>F</i> = 6.123, <i>P</i> = 0.016), indicating reduced tumor activity. The microvessel density of the tumors decreased significantly after treatment (<i>P</i> < 0.05), and the proportion of low microvessel density increased. After treatment, perfusion recovery in the tumor area improved, the proportion of complete and partial responses gradually increased, and the proportion of stable lesions decreased (<i>P</i> < 0.05). The levels of alpha-fetoprotein, carcinoembryonic antigen, and carbohydrate antigen 19-9 decreased by 68.7%, 30.4%, and 41.6%, respectively, at 6 months post-treatment (<i>P</i> < 0.05). CEUS showed a sensitivity of 85.72%, specificity of 92.31%, and area under the curve of 0.911 (95%CI: 0.883-0.939) for evaluating treatment response. ROC curve analysis showed that CEUS had high sensitivity and specificity and could effectively evaluate the efficacy of interventional therapy for liver cancer.</p><p><strong>Conclusion: </strong>CEUS has high diagnostic value in evaluating therapeutic effects in patients with liver cancer following interventional therapy. It can reflect changes in tumor blood flow, angiogenesis, and tumor marker levels, providing an effective basis for real-time monitoring of treatment outcomes.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"105818"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971445","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":"Postoperative adjuvant PD-1 immunotherapy survival and body-mass-index dynamics in esophageal cancer: A real-world retrospective study.","authors":"Liu-Yu Li, Mei-Qing Zhang, Wen-Min Ying, Wen-Zhen Zhang, Wei-Jing Jiang, Ting-Jie Xiong, Feng-Mei Wang, Zhi-Chao Fu","doi":"10.4251/wjgo.v17.i8.108484","DOIUrl":"10.4251/wjgo.v17.i8.108484","url":null,"abstract":"<p><strong>Background: </strong>Esophageal cancer (EC), primarily esophageal squamous cell carcinoma in China, has a poor prognosis with a 5-year survival rate of approximately 25% after surgery alone. Neoadjuvant chemoradiotherapy combined with surgery is the standard treatment for locally advanced EC, with a 47% 5-year survival rate, although adverse events are common. Immunotherapy, particularly PD-1 inhibitors, has shown promise in treating advanced EC, and neoadjuvant chemotherapy with immunotherapy is effective. However, the efficacy of postoperative immunotherapy remains unclear, with studies like Checkmate577 showing promising results but limited applicability to surgery-only patients, highlighting the need for further research.</p><p><strong>Aim: </strong>To evaluate the efficacy, prognostic factors, and safety of adjuvant immunotherapy with anti-PD-1 inhibitors following radical surgery for EC.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on EC patients who received adjuvant immunotherapy after radical treatment at the 900^th Hospital of the China Joint Logistics Force between January 2018 and October 2024. Demographic, treatment and laboratory data were collected. Progression-free survival (PFS) was assessed using the Kaplan-Meier method, and independent prognostic factors were identified using Cox regression. Optimal cutoff values for continuous variables, including body mass index (BMI) difference and neutrophil-to-lymphocyte ratio (NLR), were determined using the maxstat package in R.</p><p><strong>Results: </strong>A total of 44 patients were included, with a 2-year PFS rate of 68.6% [95% confidence interval (CI): 53%-88.7%]. Univariate analysis identified several factors significantly associated with prognosis, including the interval between surgery and immunotherapy, BMI difference between before surgery and first immunotherapy, presurgical lymphocyte count, and presurgical NLR. Multivariable Cox regression revealed that a BMI difference < 3.86 was an independent protective factor for PFS (hazard ratio: 0.42, 95%CI: 0.21-0.85, <i>P</i> < 0.05). At the last follow-up, the median PFS for patients with BMI < 3.86 had not been reached, compared to 8.83 months for those with BMI > 3.86. The 1-year PFS for patients receiving postoperative chemotherapy combined with immunotherapy was 88.5%, suggesting superior efficacy over chemotherapy alone.</p><p><strong>Conclusion: </strong>Adjuvant immunotherapy for EC shows good efficacy and safety. A BMI difference < 3.86 is a protective factor for PFS, highlighting the importance of monitoring nutrition and inflammation for personalized treatment.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"108484"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971349","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":"Diet and physical activity in colorectal cancer patients: A research protocol of a randomized controlled study.","authors":"Ali Mohamed Aboturkia, Wala Ben Kridis, Mukhtar Omer Aqoup, Munir Omer Abdoalmola, Suhil Ben Ali, Afef Khanfir","doi":"10.4251/wjgo.v17.i8.109579","DOIUrl":"10.4251/wjgo.v17.i8.109579","url":null,"abstract":"<p><strong>Background: </strong>As the population of colorectal cancer (CRC) survivors continues to grow, the demand for effective, evidence-based post-treatment strategies becomes increasingly urgent. Despite robust evidence linking lifestyle factors to cancer outcomes, there remains no established consensus on the optimal nutritional and physical activity (PA) guidelines for disease-free CRC survivors.</p><p><strong>Aim: </strong>To demonstrate that structured lifestyle interventions, specifically tailored dietary and PA programs, can significantly improve behavioral targets as well as disease-free and overall survival (OS).</p><p><strong>Methods: </strong>We designed a 2 × 2 factorial phase II randomized controlled trial to compare the effects of dietary and PA interventions with standard care.</p><p><strong>Results: </strong>A total of 300 CRC survivors in complete remission will be recruited from oncology centers in Misurata and Zliten (Libya) and the Habib Bourguiba University Hospital (Tunisia). Participants will be randomized into four groups: Combined intervention, diet-only, PA-only, or usual care. They will be followed for 24 months, with outcomes including disease-free survival, OS, and quality of life. Ethical approval has been obtained (Sfax ID: 61/24; Misurata ID: 04/2023), and the trial is registered at ClinicalTrials.gov (NCT06194786).</p><p><strong>Conclusion: </strong>This study will provide crucial region-specific evidence on the feasibility and effectiveness of lifestyle interventions in CRC survivorship care. By evaluating the role of a high-fiber, low-red meat diet and structured PA, we aim to demonstrate the potential of these behaviors to improve survival outcomes and support their integration into future clinical practice guidelines.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"109579"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971358","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":"Effect of enhanced recovery after surgery-based anesthesia resuscitation on awakening quality in da Vinci robotic rectal cancer surgery.","authors":"Ling-Yan Gou, Chun-Yan Zhou, Qian Yong, Yu-Long Zhang","doi":"10.4251/wjgo.v17.i8.107899","DOIUrl":"10.4251/wjgo.v17.i8.107899","url":null,"abstract":"<p><strong>Background: </strong>Rectal cancer is a common digestive tract malignancy influenced by genetic, dietary, and environmental factors. While traditional open surgery is effective, it often leads to significant recovery challenges and complications. The da Vinci robotic system provides a minimally invasive option, enhancing precision and reducing recovery time. However, the anesthesia recovery phase is critical for effective patient outcomes, particularly in older individuals. This study explores the impact of enhanced recovery after surgery (ERAS)-based anesthesia resuscitation on awakening quality in patients undergoing da Vinci robotic rectal cancer surgery, aiming to improve recovery protocols.</p><p><strong>Aim: </strong>To analyze the impact of anesthesia resuscitation interventions grounded in the principles of ERAS on the awakening quality of patients undergoing da Vinci robotic rectal cancer surgery.</p><p><strong>Methods: </strong>A total of 84 rectal cancer patients admitted from February 2021 to December 2022 were selected and randomized into two groups: The control group (<i>n</i> = 42) received conventional anesthesia recovery nursing care, while the study group (<i>n</i> = 42) underwent anesthesia resuscitation interventions based on the ERAS framework. The quality of awakening, pain levels, vital signs, and complications were compared between the two groups.</p><p><strong>Results: </strong>The study group showed significantly shorter times for eye opening, extubation, orientation recovery, spontaneous respiration, and anesthesia recovery room stay than the control group (<i>P</i> < 0.05). Visual analog scale scores at 1 hours, 2 hours, 4 hours, and 6 hours post-nursing were lower in the study group (<i>P</i> < 0.05). In the control group, systolic blood pressure, diastolic blood pressure, heart rate, and respiratory rate at 10 minutes post-anesthesia were higher than preoperative values (<i>P</i> < 0.05), while no significant differences were found in the study group. These parameters were also lower in the study group at 10 minutes (<i>P</i> < 0.05). The complication rate was significantly lower in the study group (4.76%) than in the control group (28.56%) (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The implementation of ERAS-based anesthesia resuscitation interventions in patients undergoing da Vinci robotic rectal cancer surgery enhances awakening quality, reduces complication rates, and helps stabilize vital signs.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"107899"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971427","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":"<i>GEN1</i> regulates cell proliferation, migration, apoptosis and ferroptosis in gastric cancer.","authors":"Qi Zhang, Zu-Guo Yuan, Kai-Feng Zheng, Ke Chen","doi":"10.4251/wjgo.v17.i8.106781","DOIUrl":"10.4251/wjgo.v17.i8.106781","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Gastric cancer (GC) has a high prevalence and mortality overall. &lt;i&gt;GEN1&lt;/i&gt; is associated with abnormal centrosome amplification, DNA damage and increased apoptosis. To date, little is known about the function and mechanism of &lt;i&gt;GEN1&lt;/i&gt; in GC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To explore the cellular processes associated with GC will help to elucidate the mechanism of the occurrence and development of GC and discover potential therapeutic targets.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The detection of &lt;i&gt;GEN1&lt;/i&gt; expression at mRNA and protein levels was done by real-time quantitative polymerase chain reaction and western blotting. The function of &lt;i&gt;GEN1&lt;/i&gt; was verified by loss-of-function experiments in AGS cells. The genes co-expressed with &lt;i&gt;GEN1&lt;/i&gt; were searched from the stomach adenocarcinomas (STAD) data in The Cancer Genome Atlas database. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the genes co-expressed with &lt;i&gt;GEN1&lt;/i&gt; to further identify the pathways involved in &lt;i&gt;GEN1&lt;/i&gt;. Rescue experiments using ferroptosis inhibitor ferrostatin-1 and chemotherapeutic sensitivity assays with cisplatin were also performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Significant up-regulation of &lt;i&gt;GEN1&lt;/i&gt; was observed in GC cell lines AGS and MGC-803. Inhibition of &lt;i&gt;GEN1&lt;/i&gt; induced cell apoptosis and decreased cell proliferation, cycle progression, migration in AGS cells. There were 264 genes co-expressed with &lt;i&gt;GEN1&lt;/i&gt; in STAD cohort (&lt;i&gt;r&lt;/i&gt; &gt; 0.4, &lt;i&gt;P&lt;/i&gt; &lt; 0.001). KEGG enrichment analysis showed that &lt;i&gt;GEN1&lt;/i&gt; might be associated with the cell cycle, Fanconi anemia pathway, homologous recombination, oocyte meiosis and cellular senescence in GC. Furthermore, &lt;i&gt;CCNA2&lt;/i&gt;, &lt;i&gt;CCNB1&lt;/i&gt;, &lt;i&gt;CCNB2&lt;/i&gt;, cyclin-dependent kinase (CDK) 1, CDK2 and polo-like kinase 1 protein levels were lower in &lt;i&gt;GEN1&lt;/i&gt;-knockdown AGS cells, manifesting that &lt;i&gt;GEN1&lt;/i&gt; was associated with the cell cycle pathway in AGS cells. Downregulation of &lt;i&gt;GEN1&lt;/i&gt; decreased adenosine triphosphate content and elevated reactive oxygen species in AGS cells, suggesting that &lt;i&gt;GEN1&lt;/i&gt; silencing led to mitochondrial dysfunction in AGS cells. In addition, &lt;i&gt;GEN1&lt;/i&gt; silencing caused an overt decrease in &lt;i&gt;FTH1&lt;/i&gt; and &lt;i&gt;GPX4&lt;/i&gt; protein levels and a significant elevation in &lt;i&gt;ACSL4&lt;/i&gt; protein levels, implying that &lt;i&gt;GEN1&lt;/i&gt; silencing promoted AGS cell ferroptosis. Treatment with ferrostatin-1 rescued cell viability loss induced by &lt;i&gt;GEN1&lt;/i&gt; knockdown, confirming ferroptosis as a key death mechanism. Additionally, &lt;i&gt;GEN1&lt;/i&gt;-deficient AGS cells showed enhanced sensitivity to cisplatin, with a significantly reduced half-maximal inhibitory concentration compared to control cells.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;&lt;i&gt;GEN1&lt;/i&gt; promotes GC cell proliferation and migration while suppressing apoptosis and ferroptosis. Targeting &lt;i&gt;GEN1&lt;/i&gt; not only disrupts mitochondrial function and cell cycle progression but also sensitizes GC","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"106781"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971357","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":"Clinical characteristics and diagnostic factors of tumor-associated acute pancreatitis: A comparative analysis of early <i>vs</i> delayed diagnosis.","authors":"Chuan-Chao Xia, Long-Gui Ning, Yue Xu, Guo-Qiang Xu","doi":"10.4251/wjgo.v17.i8.109743","DOIUrl":"10.4251/wjgo.v17.i8.109743","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP) is a leading gastrointestinal cause of hospitalization worldwide. While gallstones, alcohol use, and hypertriglyceridemia account for most cases, pancreatic malignancy remains an underdiagnosed but critical etiology requiring prompt identification due to its significant prognostic implications.</p><p><strong>Aim: </strong>To systematically evaluate the clinical characteristics of tumor-associated AP and identify risk factors influencing early diagnosis.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 167 patients with pancreatic cancer-associated AP (2014-2023), stratified by diagnostic timing: Early-diagnosis (<i>n</i> = 75, identified during initial AP admission) <i>vs</i> delayed-diagnosis (<i>n</i> = 92, requiring ≥ 2 admissions). Multivariable logistic regression was performed to determine independent predictors of early cancer detection.</p><p><strong>Results: </strong>The early-diagnosis group demonstrated distinct clinical and biochemical signatures, with independent predictors including: Diabetes history [odds ratio (OR) = 2.69, 95% confidence interval (CI): 1.08-3.34], concurrent AP etiologies (OR = 4.77, 95%CI: 1.84-7.81), elevated carbohydrate antigen 19-9 (OR = 1.38, 95%CI: 1.03-1.84), hyperbilirubinemia (direct: OR = 2.36, 95%CI: 1.35-3.48; indirect: OR = 2.67, 95%CI: 1.38-4.62), and serum glucose (OR = 1.42, 95%CI: 1.08-2.55).</p><p><strong>Conclusion: </strong>Key high-risk indicators for occult pancreatic malignancy in tumor- associated AP patients include: Advanced age, pre-existing diabetes mellitus, hyperbilirubinemia, and concurrent with conventional AP etiologies. These findings advocate for enhanced surveillance protocols incorporating serial tumor markers and multimodal imaging to earlier cancer detection.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"109743"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971398","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":"Associations between serum biomarkers and gut microbial imbalance in predicting chemotherapy response in colorectal cancer: A retrospective analysis.","authors":"Ming-Zhi Ling, Zhen Wan, Biao Hu, Ming-Jing Zhao, Hao-Sheng Gong, Gang Li","doi":"10.4251/wjgo.v17.i8.108870","DOIUrl":"10.4251/wjgo.v17.i8.108870","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) remains one of the leading causes of cancer-related morbidity and mortality worldwide. Growing evidence suggests that gut microbial dysbiosis plays a crucial role in tumorigenesis and can influence therapeutic responses.</p><p><strong>Aim: </strong>To explore the associations between serum S100A12 and soluble CD14 (sCD14) levels and gut microbiota alterations in patients with CRC, and to assess the predictive utility of these biomarkers in forecasting chemotherapy response.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 104 patients diagnosed with advanced CRC (CRC group) and 104 age-matched and sex-matched healthy controls. Serum concentrations of S100A12 and sCD14 were measured using enzyme-linked immunosorbent assay. Fecal samples collected before chemotherapy were subjected to 16S rRNA sequencing to profile gut microbial composition. Pearson correlation analysis was used to evaluate the relationship between biomarker levels and microbial abundance. Receiver operating characteristic (ROC) curves were used to assess the predictive performance of S100A12 and sCD14 for chemotherapy response.</p><p><strong>Results: </strong>CRC patients exhibited significantly higher serum levels of S100A12 and sCD14 compared to healthy individuals (<i>P</i> < 0.05). Patients with moderate to severe gut dysbiosis showed the highest elevations of these biomarkers (<i>P</i> < 0.05). Elevated levels of S100A12 and sCD14 were positively correlated with <i>Fusobacterium nucleatum</i> and <i>Prevotella abundance</i>, and negatively correlated with <i>Faecalibacterium prausnitzii</i> and <i>Akkermansia muciniphila</i> (<i>P</i> < 0.05). Both biomarkers significantly decreased following chemotherapy (<i>P</i> < 0.05). Non-responders to chemotherapy had higher pre-treatment levels of S100A12 and sCD14 compared to responders (<i>P</i> < 0.05). Combined ROC analysis showed improved diagnostic accuracy compared to either marker alone.</p><p><strong>Conclusion: </strong>Serum S100A12 and sCD14 levels are closely associated with gut microbiota imbalance and chemotherapy response in CRC patients. These markers may serve as promising predictive indicators for treatment efficacy and offer potential value in individualized treatment strategies.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"108870"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971426","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":"Treatment options in patients with pancreatic cancer: A 10-year multicenter epidemiological investigation in China.","authors":"Wan-Yi Sun, Shui-Sheng Zhang, Shao-Kai Zhang, Ren-Yi Qin, Bin Zhou, Jun Liu, Sheng-Ping Li, Ru-Fu Chen, Cheng-Feng Wang, Jin-Hu Fan","doi":"10.4251/wjgo.v17.i8.106447","DOIUrl":"10.4251/wjgo.v17.i8.106447","url":null,"abstract":"<p><strong>Background: </strong>The survival rate of pancreatic cancer is low, and there is a lack of effective treatment.</p><p><strong>Aim: </strong>To explore the epidemiological characteristics of patients with pancreatic cancer in China and compare multiple chemotherapy regimens at different stages.</p><p><strong>Methods: </strong>This was a retrospective study conducted from 2005 to 2014, involving six cancer hospitals and eight general hospitals across seven geographical regions of China (East, South, North, Central, Southwest, Northwest, and Northeast). Stratified sampling was used based on the population distribution of each region. Efficacy assessments were conducted by Cox proportional hazards regression models. When assessing the effectiveness of various chemotherapy regimens, traditional drugs such as gemcitabine used as monotherapy served as the reference.</p><p><strong>Results: </strong>A total of 3256 patients were included. The median follow-up time was 407 days, and the median overall survival was 183 days. At diagnosis, 56% of patients were already in stage IV. Chemotherapy was administered to 39.73% of patients. In the adjuvant therapy phase, gemcitabine + fluorouracil was superior to gemcitabine monotherapy [hazard ratio (HR) = 0.35, 95% confidence interval (CI): 0.14-0.89]. In fluorouracil-based regimens, other combination regimens did not show effectiveness relative to monotherapy. For first-line treatment in patients with advanced disease, tegafur alone (HR = 0.20, 95%CI: 0.06-0.66), gemcitabine plus cisplatin (HR = 0.16, 95%CI: 0.04-0.70), and tegafur, gemcitabine plus platinum-based agents (HR = 0.32, 95%CI: 0.11-0.91) were associated with a lower risk of death compared to gemcitabine alone. In second-line treatment, there were no significant differences in efficacy among various drugs, but FOLFIRINOX (irinotecan + oxaliplatin + leucovorin + 5-fluorouracil) had an outstanding point estimate (HR = 0.10, 95%CI: 0.01-1.27).</p><p><strong>Conclusion: </strong>In China, pancreatic cancer is often diagnosed at advanced stages, emphasizing the need for early diagnosis and treatment. Combined therapies in adjuvant and first-line settings may reduce the risk of death compared with monotherapy, and FOLFIRINOX might offer more significant benefits in second-line treatment.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"106447"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971431","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":"Risk prediction of acute variceal bleeding in hepatocellular carcinoma patients undergoing systemic therapy based on immune checkpoint inhibitors.","authors":"Xu Zhang, Li-Meng Song, Yu-Piao Zheng, Bao-Xin Qian, Jing Liang, Feng-Mei Wang","doi":"10.4251/wjgo.v17.i8.108887","DOIUrl":"10.4251/wjgo.v17.i8.108887","url":null,"abstract":"<p><strong>Background: </strong>Acute variceal bleeding (AVB) represents a life-threatening complication in hepatocellular carcinoma (HCC) patients undergoing systemic therapy, mainly including immune checkpoint inhibitors (ICIs) and antivascular drugs used alone or in combination. The pathogenesis of AVB in this population may involve tumor-related factors, treatment-induced effects, or progression of underlying portal hypertension. Identifying high-risk factors for AVB is crucial for the management of this patient population.</p><p><strong>Aim: </strong>To develop and validate a risk prediction model for AVB occurrence in cirrhotic HCC patients receiving ICI-based systemic therapy.</p><p><strong>Methods: </strong>This retrospective study analyzed 286 HCC patients (2021-2022) receiving ICIs (mono-/combination therapy), randomly split into training (<i>n</i> = 184) and validation (<i>n</i> = 102) cohorts. In the training cohort, bleeding <i>vs</i> non-bleeding groups were compared for general information, etiological data, laboratory indicators, tumor staging, systemic treatment drugs, variceal bleeding history, and endoscopic treatment history. Risk factors for AVB were identified and used to establish a logistic regression model for predicting bleeding, which was further validated in the validation cohort.</p><p><strong>Results: </strong>The bleeding group had significantly higher proportions of patients with platelet count ≥ 100 × 10⁹/L, alpha-fetoprotein ≥ 400 ng/mL, tumor diameter ≥ 5 cm, portal vein tumor thrombosis, ascites, bleeding history, prior endoscopic treatment, albumin-bilirubin grade level 2-3, fibrosis-4 index (FIB-4) ≥ 4.57, and prognostic nutritional index < 45 compared to the non-bleeding group. Multivariate analysis identified tumor diameter ≥ 5 cm, portal vein thrombosis, bleeding history, and elevated FIB-4 as independent risk factors for bleeding (<i>P</i> < 0.05). A predictive model based on these factors showed good discrimination, with area under the receiver operating characteristic curve values of 0.861 (training) and 0.816 (validation).</p><p><strong>Conclusion: </strong>A history of pre-ICI bleeding significantly increases recurrent bleeding risk, necessitating close monitoring. The FIB-4 fibrosis model, combined with tumor features, can also serve as a predictive factor for bleeding.</p>","PeriodicalId":23762,"journal":{"name":"World Journal of Gastrointestinal Oncology","volume":"17 8","pages":"108887"},"PeriodicalIF":2.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971435","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}