World Journal of Gastroenterology最新文献

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Long COVID and gut candidiasis: What is the existing relationship? 长COVID与肠道念珠菌病:现有的关系是什么?
IF 4.3 3区 医学
World Journal of Gastroenterology Pub Date : 2024-10-07 DOI: 10.3748/wjg.v30.i37.4104
Filippo Bistagnino, Davide Pizzi, Filippo Mantovani, Jacopo Rosso Antonino, Marcos Roberto Tovani-Palone
{"title":"Long COVID and gut candidiasis: What is the existing relationship?","authors":"Filippo Bistagnino, Davide Pizzi, Filippo Mantovani, Jacopo Rosso Antonino, Marcos Roberto Tovani-Palone","doi":"10.3748/wjg.v30.i37.4104","DOIUrl":"https://doi.org/10.3748/wjg.v30.i37.4104","url":null,"abstract":"<p><p>Since the beginning of the coronavirus disease (COVID) 2019 pandemic, thousands of articles on the topic have been published, and although there is a growing trend of research on another associated condition, long coronavirus disease, important points still remain to be clarified in this respect. Robust evidence has suggested a relevant link between new clinical discoveries and molecular mechanisms that could be associated with the manifestations of different signs and symptoms involving cases of long COVID. However, one of the existing gaps that requires further investigation concerns a possible relationship between gut candidiasis and long COVID. While recent studies also suggest an interplay between the occurrence of these two conditions, it is not yet fully clear how this may happen, as well as the specifics regarding the possible pathophysiological mechanisms involved. In this connection and with the advent of a potential strengthening of the body of evidence supporting the hypothesis of a link between gut candidiasis and long COVID, a better understanding of the clinical presentation, pathophysiology and clinical management of such a relationship should be essential and useful for both, additional advances towards more targeted research and appropriate case management. Knowing more about the signs, symptoms, and complications associated with cases of long COVID is essential in order to more effectively mitigate the related burden and provide a higher quality of care and life for the affected population. In light of this and the need for better outcomes, here we review and discuss the content on different aspects of long COVID, including its pathophysiology and the existing evidence of a potential relationship between such a condition and gut candidiasis, as well as suggest propositions for future related research.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"30 37","pages":"4104-4114"},"PeriodicalIF":4.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pictorial review of hepatic echinococcosis: Ultrasound imaging and differential diagnosis. 肝棘球蚴病图解综述:超声成像与鉴别诊断
IF 4.3 3区 医学
World Journal of Gastroenterology Pub Date : 2024-10-07 DOI: 10.3748/wjg.v30.i37.4115
Yi Tao, Yi-Fei Wang, Jun Wang, Shuang Long, Barnabas C Seyler, Xiao-Fei Zhong, Qiang Lu
{"title":"Pictorial review of hepatic echinococcosis: Ultrasound imaging and differential diagnosis.","authors":"Yi Tao, Yi-Fei Wang, Jun Wang, Shuang Long, Barnabas C Seyler, Xiao-Fei Zhong, Qiang Lu","doi":"10.3748/wjg.v30.i37.4115","DOIUrl":"https://doi.org/10.3748/wjg.v30.i37.4115","url":null,"abstract":"<p><p>Echinococcosis is a zoonotic disease caused by parasites belonging to the genus <i>Echinococcus</i> that primarily affect the liver. The western plateau and pastoral areas of China are high-risk regions for hepatic cystic echinococcosis and hepatic alveolar echinococcosis (HAE). The high late mortality rate associated with HAE underscores the critical need for early diagnosis to improve cure rates and mitigate the disease burden in endemic areas. Currently, the World Health Organization recommends ultrasonography as the preferred initial screening method for hepatic echinococcosis. However, distinguishing between specific types of lesions, such as those of hepatic cystic echinococcosis and HAE, and other focal liver lesions is challenging. To address this issue, contrast-enhanced ultrasound is recommended as a tool to differentiate solid and cysto-solid hepatic echinococcosis from other focal liver lesions, significantly enhancing diagnostic accuracy. In this comprehensive review, we discuss the progression of hepatic echinococcosis and detail the imaging features of various types of echinococcosis using conventional, contrast-enhanced, and intraoperative ultrasound techniques. Our objective is to provide robust imaging evidence and guidance for early diagnosis, clinical decision making, and postoperative follow-up in regions with high disease prevalence.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"30 37","pages":"4115-4131"},"PeriodicalIF":4.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of baseline body mass index on the long-term prognosis of advanced hepatocellular carcinoma treated with immunotherapy. 基线体重指数对接受免疫疗法治疗的晚期肝细胞癌长期预后的影响。
IF 4.3 3区 医学
World Journal of Gastroenterology Pub Date : 2024-10-07 DOI: 10.3748/wjg.v30.i37.4132
Yu-Qin Wang, Di Pan, Zhi-Yuan Yao, Yu-Qi Li, Peng-Fei Qu, Run-Bang Wang, Qing-Hao Gu, Jie Jiang, Zheng-Xiang Han, Hao-Nan Liu
{"title":"Impact of baseline body mass index on the long-term prognosis of advanced hepatocellular carcinoma treated with immunotherapy.","authors":"Yu-Qin Wang, Di Pan, Zhi-Yuan Yao, Yu-Qi Li, Peng-Fei Qu, Run-Bang Wang, Qing-Hao Gu, Jie Jiang, Zheng-Xiang Han, Hao-Nan Liu","doi":"10.3748/wjg.v30.i37.4132","DOIUrl":"https://doi.org/10.3748/wjg.v30.i37.4132","url":null,"abstract":"<p><strong>Background: </strong>Primary liver cancer is the sixth most common cancer worldwide, with hepatocellular carcinoma (HCC) being the most prevalent form. Despite the current availability of multiple immune or immune combination treatment options, the prognosis is still poor, so how to identify a more suitable population is extremely important.</p><p><strong>Aim: </strong>To evaluate the clinical effectiveness of combining lenvatinib with camrelizumab for patients with hepatitis B virus (HBV)-related HCC in Barcelona Clinic Liver Cancer (BCLC) stages B/C, considering various body mass index (BMI) in different categories.</p><p><strong>Methods: </strong>Retrospective data were collected from 126 HCC patients treated with lenvatinib plus camrelizumab. Patients were divided into two groups based on BMI: The non-overweight group (BMI < 25 kg/m<sup>2</sup>, <i>n</i> = 51) and the overweight/obese group (BMI ≥ 25 kg/m<sup>2</sup>, <i>n</i> = 75). Short-term prognosis was evaluated using mRECIST criteria, with subgroup analyses for non-overweight (BMI: 18.5-24.9 kg/m<sup>2</sup>), overweight (BMI: 25-30 kg/m<sup>2</sup>), and obese (BMI ≥ 30 kg/m<sup>2</sup>) patients. A Cox proportional hazards regression analysis identified independent prognostic factors for overall survival (OS), leading to the development of a column-line graph model.</p><p><strong>Results: </strong>Median progression-free survival was significantly longer in the obese/overweight group compared to the non-overweight group. Similarly, the median OS was significantly prolonged in the obese/overweight group than in the non-overweight group. The objective remission rate and disease control rate for the two groups of patients were, respectively, objective remission rate (5.88% <i>vs</i> 28.00%) and disease control rate (39.22% <i>vs</i> 62.67%). Fatigue was more prevalent in the obese/overweight group, while other adverse effects showed no statistically significant differences (<i>P</i> > 0.05). Subgroup analysis based on BMI showed that obese and overweight patients had better progression-free survival and OS than non-overweight patients, with obese patients showing the best outcomes. Multifactorial regression analysis identified BCLC grade, alpha-fetoprotein level, portal vein tumor thrombosis, and BMI as independent prognostic factors for OS. The column-line graph model highlighted the importance of BMI as a major predictor of patient prognosis, followed by alpha-fetoprotein level, BCLC classification, and portal vein tumor thrombosis.</p><p><strong>Conclusion: </strong>BMI is a long-term predictor of the efficacy of lenvatinib plus camrelizumab, and obese/overweight patients have a better prognosis.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"30 37","pages":"4132-4148"},"PeriodicalIF":4.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Current approaches to the management of jejunal variceal bleeding at the site of hepaticojejunostomy after pancreaticoduodenectomy. 目前治疗胰十二指肠切除术后肝空肠吻合术部位空肠静脉曲张出血的方法。
IF 4.3 3区 医学
World Journal of Gastroenterology Pub Date : 2024-10-07 DOI: 10.3748/wjg.v30.i37.4083
Dmitry Victorovich Garbuzenko
{"title":"Current approaches to the management of jejunal variceal bleeding at the site of hepaticojejunostomy after pancreaticoduodenectomy.","authors":"Dmitry Victorovich Garbuzenko","doi":"10.3748/wjg.v30.i37.4083","DOIUrl":"https://doi.org/10.3748/wjg.v30.i37.4083","url":null,"abstract":"<p><p>Jejunal variceal bleeding at the site of hepaticojejunostomy after pancreaticoduodenectomy due to portal hypertension caused by extrahepatic portal vein obstruction is a life-threatening complication and is very difficult to treat. Pharmacotherapy, endoscopic methods, transcatheter embolization of veins supplying the jejunal afferent loop, portal venous stenting, and surgical procedures can be used for the treatment of jejunal variceal bleeding. Nevertheless, the optimal management strategy has not yet been established, which is due to the lack of randomized controlled trials involving a large cohort of patients necessary for their development.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"30 37","pages":"4083-4086"},"PeriodicalIF":4.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects and mechanisms of Helicobacter pylori infection on the occurrence of extra-gastric tumors. 幽门螺杆菌感染对胃外肿瘤发生的影响和机制。
IF 4.3 3区 医学
World Journal of Gastroenterology Pub Date : 2024-10-07 DOI: 10.3748/wjg.v30.i37.4090
Shi-Qing Zhao, Hui-Ling Zheng, Xiao-Tian Zhong, Zi-Ye Wang, Yi Su, Yan-Yan Shi
{"title":"Effects and mechanisms of <i>Helicobacter pylori</i> infection on the occurrence of extra-gastric tumors.","authors":"Shi-Qing Zhao, Hui-Ling Zheng, Xiao-Tian Zhong, Zi-Ye Wang, Yi Su, Yan-Yan Shi","doi":"10.3748/wjg.v30.i37.4090","DOIUrl":"https://doi.org/10.3748/wjg.v30.i37.4090","url":null,"abstract":"<p><p><i>Helicobacter pylori</i> (<i>H. pylori</i>) colonizes the human stomach and many studies have discussed the mechanisms of <i>H. pylori</i> infection leading to gastric diseases, including gastric cancer. Additionally, increasing data have shown that the infection of <i>H. pylori</i> may contribute to the development of extra-gastric diseases and tumors. Inflammation, systemic immune responses, microbiome disorders, and hypergastrinemia caused by <i>H. pylori</i> infection are associated with many extra-gastric malignancies. This review highlights recent discoveries; discusses the relationship between <i>H. pylori</i> and various extra-gastric tumors, such as colorectal cancer, lung cancer, cholangiocarcinoma, and gallbladder carcinoma; and explores the mechanisms of extra-gastric carcinogenesis by <i>H. pylori</i>. Overall, these findings refine our understanding of the pathogenic processes of <i>H. pylori</i>, provide guidance for the clinical treatment and management of <i>H. pylori</i>-related extra-gastric tumors, and help improve prognosis.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"30 37","pages":"4090-4103"},"PeriodicalIF":4.3,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Construction and validation of a pancreatic cancer prognostic model based on genes related to the hypoxic tumor microenvironment. 基于缺氧肿瘤微环境相关基因的胰腺癌预后模型的构建与验证
IF 4.3 3区 医学
World Journal of Gastroenterology Pub Date : 2024-09-28 DOI: 10.3748/wjg.v30.i36.4057
Fan Yang, Na Jiang, Xiao-Yu Li, Xing-Si Qi, Zi-Bin Tian, Ying-Jie Guo
{"title":"Construction and validation of a pancreatic cancer prognostic model based on genes related to the hypoxic tumor microenvironment.","authors":"Fan Yang, Na Jiang, Xiao-Yu Li, Xing-Si Qi, Zi-Bin Tian, Ying-Jie Guo","doi":"10.3748/wjg.v30.i36.4057","DOIUrl":"10.3748/wjg.v30.i36.4057","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer is one of the most lethal malignancies, characterized by poor prognosis and low survival rates. Traditional prognostic factors for pancreatic cancer offer inadequate predictive accuracy, often failing to capture the complexity of the disease. The hypoxic tumor microenvironment has been recognized as a significant factor influencing cancer progression and resistance to treatment. This study aims to develop a prognostic model based on key hypoxia-related molecules to enhance prediction accuracy for patient outcomes and to guide more effective treatment strategies in pancreatic cancer.</p><p><strong>Aim: </strong>To develop and validate a prognostic model for predicting outcomes in patients with pancreatic cancer using key hypoxia-related molecules.</p><p><strong>Methods: </strong>This pancreatic cancer prognostic model was developed based on the expression levels of the hypoxia-associated genes <i>CAPN2</i>, <i>PLAU</i>, and <i>CCNA2</i>. The results were validated in an independent dataset. This study also examined the correlations between the model risk score and various clinical features, components of the immune microenvironment, chemotherapeutic drug sensitivity, and metabolism-related pathways. Real-time quantitative PCR verification was conducted to confirm the differential expression of the target genes in hypoxic and normal pancreatic cancer cell lines.</p><p><strong>Results: </strong>The prognostic model demonstrated significant predictive value, with the risk score showing a strong correlation with clinical features: It was significantly associated with tumor grade (G) (<sup>b</sup> <i>P</i> < 0.01), moderately associated with tumor stage (T) (<sup>a</sup> <i>P</i> < 0.05), and significantly correlated with residual tumor (R) status (<sup>b</sup> <i>P</i> < 0.01). There was also a significant negative correlation between the risk score and the half-maximal inhibitory concentration of some chemotherapeutic drugs. Furthermore, the risk score was linked to the enrichment of metabolism-related pathways in pancreatic cancer.</p><p><strong>Conclusion: </strong>The prognostic model based on hypoxia-related genes effectively predicts pancreatic cancer outcomes with improved accuracy over traditional factors and can guide treatment selection based on risk assessment.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"30 36","pages":"4057-4070"},"PeriodicalIF":4.3,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dual-targeted treatment for inflammatory bowel disease: Whether fecal microbiota transplantation can be an important part of it. 炎症性肠病的双靶向治疗:粪便微生物群移植是否可以成为其中的重要组成部分?
IF 4.3 3区 医学
World Journal of Gastroenterology Pub Date : 2024-09-28 DOI: 10.3748/wjg.v30.i36.4025
Zi-Ning Zhang, Li-Xuan Sang
{"title":"Dual-targeted treatment for inflammatory bowel disease: Whether fecal microbiota transplantation can be an important part of it.","authors":"Zi-Ning Zhang, Li-Xuan Sang","doi":"10.3748/wjg.v30.i36.4025","DOIUrl":"10.3748/wjg.v30.i36.4025","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a chronic gastrointestinal inflammatory disease. With the emergence of biologics and other therapeutic methods, two biologics or one biologic combined with a novel small-molecule drug has been proposed in recent years to treat IBD. Although treatment strategies for IBD are being optimized, their efficacy and risks still warrant further consideration. This editorial explores the current risks associated with dual-targeted treatment for IBD and the great potential that fecal microbiota transplantation (FMT) may have for use in combination therapy for IBD. We are focused on addressing refractory IBD or biologically resistant IBD based on currently available dual-targeted treatment by incorporating FMT as part of this dual-targeted treatment. In this new therapy regimen, FMT represents a promising combination therapy.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"30 36","pages":"4025-4030"},"PeriodicalIF":4.3,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Autophagy and its role in gastrointestinal diseases. 自噬及其在胃肠道疾病中的作用。
IF 4.3 3区 医学
World Journal of Gastroenterology Pub Date : 2024-09-28 DOI: 10.3748/wjg.v30.i36.4014
Bo-Zong Shao, Wen-Gang Zhang, Zhen-Yu Liu, En-Qiang Linghu
{"title":"Autophagy and its role in gastrointestinal diseases.","authors":"Bo-Zong Shao, Wen-Gang Zhang, Zhen-Yu Liu, En-Qiang Linghu","doi":"10.3748/wjg.v30.i36.4014","DOIUrl":"10.3748/wjg.v30.i36.4014","url":null,"abstract":"<p><p>Gastrointestinal disorders encompass a spectrum of conditions affecting various organs within the digestive system, such as the esophagus, stomach, colon, rectum, pancreas, liver, small intestine, and bile ducts. The role of autophagy in the etiology and progression of gastrointestinal diseases has garnered significant attention. This paper seeks to evaluate the impact and mechanisms of autophagy in gastrointestinal disorders by synthesizing recent research findings. Specifically, we delve into inflammation-related gastrointestinal conditions, including ul-cerative colitis, Crohn's disease, and pancreatitis, as well as gastrointestinal cancers such as esophageal, gastric, and colorectal cancers. Additionally, we provide commentary on a recent publication by Chang <i>et al</i> in the <i>World Journal of Gastroenterology</i>. Our objective is to offer fresh perspectives on the mechanisms and therapeutic approaches for these gastrointestinal ailments. This review aims to offer new perspectives on the mechanisms and therapeutic strategies for gastrointestinal disorders by critically analyzing relevant publications. As discussed, the role of autophagy in gastrointestinal diseases is complex and, at times, contentious. To harness the full therapeutic potential of autophagy in treating these conditions, more in-depth research is imperative.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"30 36","pages":"4014-4020"},"PeriodicalIF":4.3,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Computed tomography-based multi-organ radiomics nomogram model for predicting the risk of esophagogastric variceal bleeding in cirrhosis. 基于计算机断层扫描的多器官放射组学提名图模型,用于预测肝硬化食管胃底静脉曲张出血的风险。
IF 4.3 3区 医学
World Journal of Gastroenterology Pub Date : 2024-09-28 DOI: 10.3748/wjg.v30.i36.4044
Yu-Jie Peng, Xin Liu, Ying Liu, Xue Tang, Qi-Peng Zhao, Yong Du
{"title":"Computed tomography-based multi-organ radiomics nomogram model for predicting the risk of esophagogastric variceal bleeding in cirrhosis.","authors":"Yu-Jie Peng, Xin Liu, Ying Liu, Xue Tang, Qi-Peng Zhao, Yong Du","doi":"10.3748/wjg.v30.i36.4044","DOIUrl":"10.3748/wjg.v30.i36.4044","url":null,"abstract":"<p><strong>Background: </strong>Radiomics has been used in the diagnosis of cirrhosis and prediction of its associated complications. However, most current studies predict the risk of esophageal variceal bleeding (EVB) based on image features at a single level, which results in incomplete data. Few studies have explored the use of global multi-organ radiomics for non-invasive prediction of EVB secondary to cirrhosis.</p><p><strong>Aim: </strong>To develop a model based on clinical and multi-organ radiomic features to predict the risk of first-instance secondary EVB in patients with cirrhosis.</p><p><strong>Methods: </strong>In this study, 208 patients with cirrhosis were retrospectively evaluated and randomly split into training (<i>n</i> = 145) and validation (<i>n</i> = 63) cohorts. Three areas were chosen as regions of interest for extraction of multi-organ radiomic features: The whole liver, whole spleen, and lower esophagus-gastric fundus region. In the training cohort, radiomic score (Rad-score) was created by screening radiomic features using the inter-observer and intra-observer correlation coefficients and the least absolute shrinkage and selection operator method. Independent clinical risk factors were selected using multivariate logistic regression analyses. The radiomic features and clinical risk variables were combined to create a new radiomics-clinical model (RC model). The established models were validated using the validation cohort.</p><p><strong>Results: </strong>The RC model yielded the best predictive performance and accurately predicted the EVB risk of patients with cirrhosis. Ascites, portal vein thrombosis, and plasma prothrombin time were identified as independent clinical risk factors. The area under the receiver operating characteristic curve (AUC) values for the RC model, Rad-score (liver + spleen + esophagus), Rad-score (liver), Rad-score (spleen), Rad-score (esophagus), and clinical model in the training cohort were 0.951, 0.930, 0.801, 0.831, 0.864, and 0.727, respectively. The corresponding AUC values in the validation cohort were 0.930, 0.886, 0.763, 0.792, 0.857, and 0.692.</p><p><strong>Conclusion: </strong>In patients with cirrhosis, combined multi-organ radiomics and clinical model can be used to non-invasively predict the probability of the first secondary EVB.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"30 36","pages":"4044-4056"},"PeriodicalIF":4.3,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Glucagon-like peptide-1 receptor agonists: Exploring the mechanisms from glycemic control to treatment of multisystemic diseases. 胰高血糖素样肽-1 受体激动剂:从血糖控制到多系统疾病治疗的机制探索。
IF 4.3 3区 医学
World Journal of Gastroenterology Pub Date : 2024-09-28 DOI: 10.3748/wjg.v30.i36.4036
Mo-Wei Kong, Yang Yu, Ying Wan, Yu Gao, Chun-Xiang Zhang
{"title":"Glucagon-like peptide-1 receptor agonists: Exploring the mechanisms from glycemic control to treatment of multisystemic diseases.","authors":"Mo-Wei Kong, Yang Yu, Ying Wan, Yu Gao, Chun-Xiang Zhang","doi":"10.3748/wjg.v30.i36.4036","DOIUrl":"10.3748/wjg.v30.i36.4036","url":null,"abstract":"<p><p>This editorial takes a deeper look at the insights provided by Soresi and Giannitrapani, which examined the therapeutic potential of glucagon-like peptide-1 receptor agonists (GLP-1RAs) for metabolic dysfunction-associated fatty liver disease. We provide supplementary insights to their research, highlighting the broader systemic implications of GLP-1RAs, synthesizing the current understanding of their mechanisms and the trajectory of research in this field. GLP-1RAs are revolutionizing the treatment of type 2 diabetes mellitus and beyond. Beyond glycemic control, GLP-1RAs demonstrate cardiovascular and renal protective effects, offering potential in managing diabetic kidney disease al-ongside renin-angiotensin-aldosterone system inhibitors. Their role in bone metabolism hints at benefits for diabetic osteoporosis, while the neuroprotective properties of GLP-1RAs show promise in Alzheimer's disease treatment by modulating neuronal insulin signaling. Additionally, they improve hormonal and metabolic profiles in polycystic ovary syndrome. This editorial highlights the multifaceted mechanisms of GLP-1RAs, emphasizing the need for ongoing research to fully realize their therapeutic potential across a range of multisystemic diseases.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"30 36","pages":"4036-4043"},"PeriodicalIF":4.3,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11439120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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