Turkish Journal of Gastroenterology最新文献

{"title":"Systemic Immune-Inflammation Index and Selected Immune-Based Scores in the Diagnosis and Monitoring of Celiac Disease.","authors":"Pinar Cirit Yilmaz, Orhan Sezgin","doi":"10.5152/tjg.2026.25194","DOIUrl":"10.5152/tjg.2026.25194","url":null,"abstract":"<p><strong>Background/aims: </strong>The aim of this study was to investigate the value and effectiveness of the systemic immune-inflammation index (SII) in the diagnosis and follow-up of celiac disease (CD) is an immune-mediated enteropathy that requires reliable non-invasive markers for monitoring.</p><p><strong>Materials and methods: </strong>This retrospective analysis included patients diagnosed with CD who were followed up and treated at the Gastroenterology Department between 2018 and 2022. Healthy individuals (n=133) were included as the control group (n=121). Comparative analyses were conducted on CD patients and control group. Demographic data, hemogram, biochemical parameters, SII, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume-to-platelet ratio (MPR) values were recorded. Measurements at the initiation of treatment and at the 6th and 12th months post treatment were evaluated for the CD group.</p><p><strong>Results: </strong>The SII, PLR, NLR, and MPR values were significantly higher in the CD group at diagnosis compared to the healthy group (P < .001). Receiver operating characteristic analysis showed that SII had a significantly higher discriminatory power in differentiating CD from healthy individuals (P < .001), with a sensitivity of 86% and specificity of 90% for the diagnosis of CD. The SII values showed a significant progressive decrease in the CD group at the 6th and 12th months after initiation of diet (P < .001), parallel to improvements in laboratory findings. Similar results were detected in PLR and NLR, but their sensitivities were lower with an AUC of 0.942.</p><p><strong>Conclusion: </strong>Systemic immune-inflammation index may serve as an easily accessible, cost-effective, and promising biomarker for the diagnosis and follow-up of CD.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"573-582"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475561","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 Analysis of Body Muscle-Fat Composition Parameters and CT Severity Index with Disease Severity in Acute Pancreatitis.","authors":"WenYang Wu, YongBao Li","doi":"10.5152/tjg.2026.25489","DOIUrl":"10.5152/tjg.2026.25489","url":null,"abstract":"<p><strong>Background/aims: </strong>To investigate the correlation between body muscle-fat composition parameters (visceral adipose tissue (VAT) area, total adipose tissue (TAT) area, skeletal muscle index (SMI)) and the modified computed tomography severity index (MCTSI) with acute pancreatitis (AP) severity and their predictive value for adverse outcomes.</p><p><strong>Materials and methods: </strong>Two hundred thirty-six AP patients were enrolled. Patients were stratified by severity into 84 mild AP (MAP), 90 moderately severe AP (MSAP), and 62 severe AP (SAP), and were further grouped by 30-day survival (172 survivors, 64 non-survivors). Demographic data, laboratory parameters, and abdominal computed tomography (CT) data were collected. Intergroup differences were analyzed, predictive performance was assessed, and independent risk factors were identified.</p><p><strong>Results: </strong>The scores of VAT, TAT, VAT/TAT, VAT/SAT, and MCTSI progressively increased with the severity of AP (from MAP to MSAP and SAP). No significant difference was observed in SAT among the groups. Non-survivors had higher VAT, SAT, TAT, and MCTSI scores but lower SMI than survivors (all P < .05). Receiver-operating characteristic (ROC) analysis demonstrated prognostic value for VAT (area under the curve (AUC) = 0.823), TAT (AUC = 0.789), SMI (AUC = 0.778), and MCTSI (AUC = 0.819), with combined assessment achieving an AUC of 0.960. Multivariate analysis identified APACHE II score, HDL, VAT, TAT, SMI, and MCTSI as independent predictors (P < .05).</p><p><strong>Conclusion: </strong>Body muscle-fat composition parameters and CT severity index correlate strongly with AP severity and independently predict adverse outcomes. Combined use enhances predictive accuracy, offering valuable insights for risk stratification and individualized treatment.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"598-606"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476266","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":"Deregulated miR-487b-3p in Patients with Non-Alcoholic Fatty Liver Disease and Its Regulatory Effect on Insulin Resistance.","authors":"Mingtao Chen, Jie Tan, Min Huang, Ting Zhan, Zheng Han, Meng Liu, Yuanyuan Lu, Xia Tian","doi":"10.5152/tjg.2026.25649","DOIUrl":"10.5152/tjg.2026.25649","url":null,"abstract":"<p><strong>Background/aims: </strong>This study aims to elucidate both the diagnostic potential of miR-487b-3p for insulin resistance and its regulatory mechanisms in patients with nonalcoholic fatty liver disease (NAFLD).</p><p><strong>Materials and methods: </strong>The study group included 60 NAFLD patients and 60 healthy controls. The expression levels of miR-487b-3p and insulin receptor substrate 1 (IRS1) in serum and cells were quantified by RT-qPCR. The diagnostic utility of the microRNA was evaluated through receiver operating characteristic (ROC) analysis. Glucose uptake in HepG2 was measured using fluorescence-based assays. The interaction between miR-487b-3p and IRS1 was confirmed by dual-luciferase reporter assay.</p><p><strong>Results: </strong>Compared with controls, NAFLD patients exhibited significantly elevated serum miR-487b-3p levels (P < .05). The ROC analysis demonstrated high diagnostic accuracy of miR-487b-3p in distinguishing between healthy controls and NAFLD patients. Functional analyses demonstrated that miR-487b-3p overexpression suppressed both glucose uptake and IRS1 expression (P < .05), whereas miR487b-3p inhibition enhanced glucose uptake and IRS1 expression (P < .05). Mechanistically, miR-487b-3p negatively regulated IRS1 to modulate glucose uptake.</p><p><strong>Conclusion: </strong>miR-487b-3p may serve as a potential diagnostic biomarker for NAFLD, and miR-487b-3p negatively regulates IRS1 to modulate glucose uptake, thereby impairing insulin sensitivity in NAFLD patients.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"629-636"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476335","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":"Association of Early Heparin Use with Mortality in Cirrhotic Patients: A Retrospective Cohort Study.","authors":"Maodong Guo, Tao Ling, Jin Ding, Xin Shi","doi":"10.5152/tjg.2026.25297","DOIUrl":"10.5152/tjg.2026.25297","url":null,"abstract":"<p><strong>Background/aims: </strong>Controversy remains regarding anticoagulant use to improve the prognosis of cirrhosis. Herein, we evaluated the effect of early use of unfractionated heparin (UFH) on survival in cirrhotic patients.</p><p><strong>Materials and methods: </strong>Data were acquired from the Medical Information Mart for Intensive Care-IV database. Patients were allocated into early heparin and control groups according to the presence of UFH treatment within 48 hours following intensive care unit admissions. Effects of early UFH use on survival in cirrhotic patients were assessed using Kaplan-Meier survival curves with the log-rank test and Cox proportional hazards model. Associations between UFH use and the risk of red blood cell (RBC) transfusion were determined with the logistic regression model. The robustness of the results was assured with propensity score matching (PSM).</p><p><strong>Results: </strong>This study included 1652 cirrhotic patients (781 and 871 in the early heparin and control groups, respectively). At 30-day followup, mortality was prominently lower in the early heparin group than in the control group (P < .001). Furthermore, early heparin use was associated with diminished 30-day mortality (hazards ratio [HR]: 0.742; 95% CI: 0.599-0.919; P = .006). This result was robust even after PSM (HR: 0.729; 95% CI: 0.568-0.937; P = .014). UFH use was not strikingly associated with an augmented risk of transfusion before (odds ratio [OR]: 0.917; 95% CI: 0.693-1.215; P = .547) and after (OR: 0.857; 95% CI: 0.616-1.191; P = .357) PSM.</p><p><strong>Conclusion: </strong>Early heparin use was associated with reduced 30-day mortality among cirrhotic patients, without increasing the risk of RBC transfusion.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"607-619"},"PeriodicalIF":2.3,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476176","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":"Astragalus Polysaccharides Target the Wnt/β-catenin Pathway to Suppress Malignant Behavior in Hepatocellular Carcinoma.","authors":"Li Liu, Wenyu He, Jiaoping Liu, Haiming Zhang","doi":"10.5152/tjg.2026.25188","DOIUrl":"10.5152/tjg.2026.25188","url":null,"abstract":"<p><strong>Background/aims: </strong>Despite some improvement in patient prognosis, hepatocellular carcinoma (HCC) remains a prevalent malignant tumor with disappointingly low overall survival rates. This study aims to investigate the inhibitory effects of astragalus polysaccharides (APs) on the malignant biological behavior of HCC and its underlying mechanisms, aiming to provide new strategies and theoretical foundations for HCC treatment.</p><p><strong>Materials and methods: </strong>The inhibitory effects of APs on HCC were assessed using animal models and in vitro experiments. In animal models, different doses of APs were tested for their anti-tumor efficacy. In vitro, CCK-8 and Transwell assays assessed APs effects on HCCLM3 and HuH7 cell malignancy. Western blot analyzed Wnt/β-catenin pathway proteins and epithelial-mesenchymal transition (EMT) markers in APs-treated HCC cells. Rescue experiments confirmed APs-mediated inhibition of HCC behavior via Wnt/β-catenin signaling.</p><p><strong>Results: </strong>Animal experiments demonstrated that APs could effectively inhibit HCC development, with its inhibitory effect becoming stronger as the dose of APs increased. The in vitro data revealed that APs primarily inhibited the Wnt/β-catenin signaling pathway by downregulating β-catenin and p-GSK3β levels while increasing p-β-catenin levels, thereby inhibiting HCC malignancy. APs also regulated the expression of vimentin, N-cadherin, and E-cadherin-EMT markers. Moreover, in vitro rescue experiments indicated that APs induced apoptosis in HCC cells and inhibited their migration and invasion, which could be counteracted by a Wnt/β-catenin pathway activator.</p><p><strong>Conclusion: </strong>APs effectively curb the growth, spread, and invasiveness of HCC cells by targeting the Wnt/β-catenin pathway, thereby opening up new possibilities for HCC treatment.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"620-628"},"PeriodicalIF":2.3,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476215","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":"The First Reported Case of Hybrid Argon Plasma Coagulation Ablation for Symptomatic Cervical Inlet Patches Refractory to Proton Pump Inhibitor Therapy.","authors":"Yoen Young Chuah, Yeong Yeh Lee, Ping-Huei Tseng, Shih-Peng Hsieh, Chu-Kuang Chou, Yow-Ling Shiue","doi":"10.5152/tjg.2026.25581","DOIUrl":"10.5152/tjg.2026.25581","url":null,"abstract":"","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475631","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":"Nocturnal Melatonin Deficiency in Colorectal Cancer: Independent Predictive Value Beyond Sleep Quality.","authors":"Ibrahim Durak, Busra Durak, Tolga Duzenli, Musa Yilmaz, Muhammed Kaya, Mustafa Sadecolak, Huseyin Koseoglu, Duygu Ozol","doi":"10.5152/tjg.2026.25808","DOIUrl":"10.5152/tjg.2026.25808","url":null,"abstract":"<p><strong>Background/aim: </strong>Melatonin is a cytoprotective hormone with antioxidant activity and also mediates regulatory effects that inhibit tumor proliferation and angiogenesis. This study aimed to evaluate serum melatonin levels and sleep quality in patients with newly diagnosed colorectal cancer (CRC) compared with controls and to investigate whether melatonin could serve as a potential biomarker.</p><p><strong>Materials and methods: </strong>A total of 71 participants (36 CRC, 35 controls) were included. Blood samples were obtained between 01:00- 02:00 am and serum melatonin was measured using a high-sensitivity (ELISA) Enzyme-Linked Immunosorbent Assay kit. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and sleep apnea risk was determined by the STOP-Bang questionnaire. Group comparisons were performed, followed by multivariable logistic regression and receiver-operating characteristic analysis.</p><p><strong>Results: </strong>Colorectal cancer patients had significantly lower nocturnal serum melatonin concentrations (131.1 Å} 35.5 vs. 194.8 Å} 50.8 pg/ mL, P < .001) and higher PSQI scores (5.6 Å} 3.1 vs. 5.1 Å} 3.0, P = .028). In multivariable analysis, melatonin remained the only independent predictor of CRC (OR = 0.952, 95% CI: 0.929-0.976, P < .001). Receiver-operating characteristic analysis identified a melatonin threshold of ~150 pg/mL, discriminating CRC patients from controls with 75% sensitivity and 91.4% specificity (AUC = 0.877).</p><p><strong>Conclusion: </strong>Although cancer patients and the control group showed comparable obstructive sleep apnea risk, sleep quality was poorer, and melatonin levels were significantly lower in the cancer group. Melatonin assessment can complement traditional risk stratification and may provide new insights into the interplay between circadian biology, sleep, and colorectal carcinogenesis.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"590-597"},"PeriodicalIF":2.3,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475540","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":"Cholangioscope-Assisted Endoscopic Retrograde Appendicitis Therapy for Gangrenous Appendicitis in an HIV-Positive Patient.","authors":"Qianlong Li","doi":"10.5152/tjg.2026.25607","DOIUrl":"10.5152/tjg.2026.25607","url":null,"abstract":"","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"641-643"},"PeriodicalIF":2.3,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147476254","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":"Intragastric Balloon Therapy: Short-Term Gains and the Quest for Long-Term Success.","authors":"Yavuz Özden","doi":"10.5152/tjg.2026.25783","DOIUrl":"10.5152/tjg.2026.25783","url":null,"abstract":"","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":" ","pages":"644-645"},"PeriodicalIF":2.3,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475441","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":"De Novo Malignancies after Liver Transplantation: A Multicenter Cohort Study of Incidence, Timing, and Outcomes.","authors":"Nilay Danış, Hüseyin Döngelli, Tarkan Ünek, Aylin Bacakoğlu, İlker Turan, Abdullah Zeki Karasu, Fulya Günşar, Elvan Işık, Muhsin Murat Harputluoglu, Kutay Sağlam, Sezai Yılmaz, Bilger Çavuş, Sabahattin Kaymakoglu, Haydar Adanır, Dinç Dinçer, Derya Arı, Meral Akdogan Kayhan, Dilara Turan Gokce, Gökhan Kabacam, Sedat Karademir, Murat Kıyıcı, Selcan Cesur, Hale Gokcan, Zeynep Melekoglu Ellik, Ramazan İdilman, Murat Dayangaç, Yasemin Balaban, Ahmet Bulent Dogrul, Hilmi Anıl Dinçer, Gupse Adalı, Feyza Dilber, Murat Taner Gulsen, Orhan Sezgin, Zekiye Nur Harput, Murat Akyıldız, Kenan Moral, Tufan Egeli, Cihan Ağalar, Mücahit Özbilgin, Mesut Akarsu","doi":"10.5152/tjg.2026.25748","DOIUrl":"10.5152/tjg.2026.25748","url":null,"abstract":"<p><strong>Background/aims: </strong>De novo malignancies are an important long-term complication following liver transplantation (LT), driven by chronic immunosuppression and extended post-transplant survival. Understanding patterns by tumor type, timing, and patient characteristics is essential for optimized surveillance. This study aimed to evaluate the clinical characteristics and temporal trends of de novo neoplasms in LT recipients.</p><p><strong>Materials and methods: </strong>A total of 6943 adult LT recipients from 16 Turkish centers were evaluated between 1999 and 2023). Two hundred eight patients with 220 histologically confirmed de novo malignancies (excluding hepatocellular carcinoma) were included. Patients who died within 30 days or developed cancer within 90 days post-LT were excluded. Incidence and mortality rates were assessed across post-transplant intervals.</p><p><strong>Results: </strong>Non-skin solid (53.2%), dermatologic (28.6%), and hematologic (18.2%) cancers were predominant. Most malignancies (76.8%) occurred within 10 years post-LT. Early-onset (<10 years) malignancies were more common in living donor recipients (62.7%, P = .001) and associated with higher mortality (39.6% vs. 11.8%, P < .001). Recipients ≤60 years exhibited a higher incidence of hematologic cancers (23.9% vs. 12.6%, P = .03) and increased mortality (39.4% vs. 27.0%, P = .05). In subgroup analysis, tacrolimus use was strongly associated with cutaneous squamous cell carcinoma (P = .004). Peak incidence occurred 2-10 years post-LT (≈13-14 per 1000 recipients), with non-skin solid tumors being the most frequent.</p><p><strong>Conclusion: </strong>De novo malignancies remain a significant long-term risk after LT, with outcomes influenced by tumor type, age, immunosuppression, and timing of onset. Risk-adapted surveillance and tailored oncologic management, particularly dermatologic screening in tacrolimus-treated patients and enhanced surveillance during the 2-10 year post-transplant period are recommended to improve long-term survival.</p>","PeriodicalId":51205,"journal":{"name":"Turkish Journal of Gastroenterology","volume":"37 4","pages":"510-523"},"PeriodicalIF":2.3,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628612","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}