BMC Gastroenterology最新文献

{"title":"The efficacy and comparison of upper gastrointestinal bleeding risk scoring systems on predicting clinical outcomes among emergency unit patients.","authors":"Sezer Arıkoğlu, Onur Tezel, Galip Büyükturan, Bilgin Bahadır Başgöz","doi":"10.1186/s12876-025-03684-7","DOIUrl":"https://doi.org/10.1186/s12876-025-03684-7","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal bleeding is a significant cause of morbidity and mortality among emergency unit patients. Several scoring systems are verified for predicting hospitalization and mortality such as Glasgow Blatchford Bleeding Score (GBS), AIMS65 score, Rockall score (RS), and International Bleeding Risk Score (INBS; ABC score). The aim of this study is to evaluate the efficacy and predictive value of these scoring systems.</p><p><strong>Methods: </strong>Adult emergency unit patients with gastrointestinal bleeding were retrospectively enrolled. The age, gender, complaints at admission, vitals and examination results, laboratory findings, outcomes, blood transfusion status, and endoscopic interventions were all reported, and GBS, AIMS65, RS, and INBS (ABC) scores were calculated individually for all enrollies.</p><p><strong>Results: </strong>A total of 311 patients were included. The median age of participants was 70 years (IQR (25-75%): 59-81), and 202 (65%) of them were male. The efficacy of all four scoring systems (GBS, AIMS65, RS, and INBS (ABC)) in predicting hospitalization, need of blood transfusion, determination of high- and low-risk patients, and mortality was found to be statistically significant (p < 0.05 for all). ROC-AUC analysis was revealed that while GBS is the most beneficial in predicting hospitalization, INBS (ABC) has the best predictive value on mortality. Besides, the only scoring model with predictive value in determining the need for endoscopic intervention was RS (p < 0.05).</p><p><strong>Conclusion: </strong>The present study showed that, among adult emergency unit patients with gastrointestinal bleeding, GBS, AIMS65, RS, and INBS (ABC) scores could successfully predict hospitalization, need of blood transfusion, determination of high- and low-risk patients, and mortality. However, the only scoring system that could be used to determine the need of endoscopic intervention is RS. Finally, we believe further studies with prospective enrollment would be beneficial for more accurate conclusions.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"93"},"PeriodicalIF":2.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective, observational study to examine the effect of early tumor necrosis factor inhibitor use on rates of surgery for Crohn's disease in Japan.","authors":"Tetsuya Ishida","doi":"10.1186/s12876-024-03578-0","DOIUrl":"https://doi.org/10.1186/s12876-024-03578-0","url":null,"abstract":"<p><strong>Background: </strong>Crohn's disease (CD) is an incurable inflammatory condition that often requires multiple surgeries, negatively impacting quality of life. As such, treatment strategies that aim to prevent damage to the bowel and reduce the burden of surgeries for patients with CD are important. This retrospective, long-term, observational study investigated whether tumor necrosis factor inhibitor (TNFi) treatment was associated with decreased rates of abdominal surgery in Japanese patients with CD.</p><p><strong>Methods: </strong>Patients were divided into two groups based on prior TNFi therapy (TNFi-treated and TNFi-untreated). Outcomes assessed included surgery rate, cumulative surgery-free survival rate, and time to surgery. For surgery rate, treatment groups were compared through estimation of an odds ratio (OR) with 95% confidence intervals (CIs). Cumulative surgery-free survival rate and time to surgery was calculated using Kaplan-Meier methodology and compared using log-rank tests. The primary analysis compared outcomes between the TNFi-treated and TNFi-untreated groups. Subgroup analyses compared outcomes between two subgroups of the TNFi-treated group (infliximab-treated vs. adalimumab-treated) and the TNFi-untreated group.</p><p><strong>Results: </strong>Overall, 124 patients with CD were included in the analysis (TNFi-treated: N = 86; TNFi-untreated: N = 38). Of those patients who received TNFi treatment, 62 received infliximab and 24 received adalimumab. The median (range) observation period in the TNFi-treated and TNFi-untreated groups was 4.62 (0.41-13.75) years and 8.13 (0.08-30.25) years, respectively. Median time to surgery was 3 years in the TNFi-untreated group and 6.58 years in the TNFi-treated group. A significantly lower proportion of patients in the TNFi-treated group required surgery (3/86) compared with those in the TNFi-untreated group (17/38; OR [CI]: 0.0446 [0.0120-0.1667]; P < 0.0001). Cumulative surgery-free survival rates were significantly higher in the TNFi-treated group versus the TNFi-untreated group (P < 0.0001). Compared with the TNFi-untreated group, the proportion of patients who required surgery was significantly lower with both infliximab (1/62; OR [CI]: 0.0203 [0.0025-0.1616]; P = 0.0002) and adalimumab (2/24; OR [CI]: 0.1123 [0.0231-0.5466]; P = 0.0068). Cumulative surgery-free survival rates were significantly higher in the infliximab-treated group versus the TNFi-untreated group (P < 0.0001).</p><p><strong>Conclusions: </strong>Introduction of TNFis for the treatment of CD may lead to a reduction in surgery rates and prolong time to surgery.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"89"},"PeriodicalIF":2.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between gastric mucosal atrophy, cystic dilatation, and histopathological characteristics.","authors":"Yang-Kun Wang, Ping Li, Hai-Ying He, Fa-Shun Zhang, Xiao-Ling Jiang, Ren-Bing Zhang, Su-Nan Wang, Si-Liang Xu","doi":"10.1186/s12876-025-03662-z","DOIUrl":"10.1186/s12876-025-03662-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to elucidate the relationship between gastric mucosal atrophy, cystic dilatation, and their associated histopathological characteristics.</p><p><strong>Methods: </strong>A comprehensive analysis was conducted on endoscopic biopsy specimens from 527 cases exhibiting gastric mucosal cystic dilatation. Detailed histological observations and immunohistochemical analysis were performed.</p><p><strong>Results: </strong>This study included 527 endoscopic biopsy and ESD samples, with a male predominance of 313 cases (59.4%) and 214 female cases (40.6%). The age distribution was as follows: 207 cases (39.3%) were ≤ 60 years, while 320 cases (60.7%) were > 60 years. Regarding cystic dilatation types, 287 cases (54.5%) were identified as simple cystic dilatation, and 240 cases (45.5%) were classified as compound cystic dilatation. Gastric mucosal atrophy was observed in all cases of cystic dilatation, with the atrophic process initially disrupting the structural integrity of the gastric glands. This led to increased interstitial tissue and widening of glandular septa, followed by compensatory hyperplasia and cystic cavity formation. Simple cystic dilatation (54.5%) and compound cystic dilatation (45.5%) were distinguished based on the extent of cellular and structural changes. Simple cystic dilatation could progress to early gastric cancer, presenting as gastric papillary cystadenocarcinoma, while compound cystic dilatation could lead to tubular papillary adenocarcinoma. The progression from simple to complex lesions involved low- and high-grade intraepithelial neoplasia, ultimately resulting in mixed cystadenocarcinoma-glandular tube papillary carcinoma, indicative of early-stage gastric cancer.</p><p><strong>Conclusion: </strong>The classification, grading, and histopathological characteristics of cystic dilatation in the gastric mucosa are crucial for guiding clinicians in precise treatment and vigilant monitoring of malignant transformation. This approach is significant for the prevention and control of gastric cancer progression.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"92"},"PeriodicalIF":2.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective, quasi-experimental study on the efficacy of a novel double-headed endoscope cleaning brush for cleaning flexible endoscopes.","authors":"Rui Shen, Yaping Wu, Jiajun Lv, Qukai Liu, Weiyan Yao, Shu Chen, Dandan Liu, Huijun Xi, Yibo Zhang","doi":"10.1186/s12876-025-03680-x","DOIUrl":"10.1186/s12876-025-03680-x","url":null,"abstract":"<p><strong>Background: </strong>The most important step in endoscope retreatment is careful manual cleaning before disinfection. Selecting the proper brushes is critical to disinfection. The study investigated the effectiveness of a novel double-headed disposable brush for cleaning flexible gastrointestinal endoscopes.</p><p><strong>Methods: </strong>This prospective, quasi-experimental study included endoscopes used in a first-class hospital between January 2020 and August 2021. The primary outcome was the change in the amount of bacteria determined using the relative light unit (RLU) value of adenosine triphosphate (ATP) fluorescence.</p><p><strong>Results: </strong>A total of 267 endoscopes (131 double-headed brushes and 136 conventional ones) were included. The changes in RLU values of the ATP detection before and after brushing in the double-headed group were significantly higher than in the conventional group (ΔRLU, 116 (55, 251) vs. 76 (26, 181), P = 0.001). Similar results were observed in the subgroup analysis of colonoscopes, especially those with a 3.8-mm channel (ΔRLU, 115 (34, 265) vs. 52 (19, 199), P = 0.007), but not for gastroscopes (P = 0.363). Positive bacterial culture rates were higher in the double-headed/nylon brush end and double-headed/non-woven fabric end than in the single-headed brush (40.5% and 70.2% vs. 33.1%, P < 0.001).</p><p><strong>Discussion: </strong>The results indicated the advantage of the novel double-headed disposable brush for flexible endoscope cleaning, and the nylon brush end may explain the advantage.</p><p><strong>Conclusion: </strong>The cleaning effect of the novel double-headed disposable brush for the flexible endoscope was better than the conventional one.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"90"},"PeriodicalIF":2.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and demographic analysis of patients with colorectal cancer screened at a reference hospital in Southern Brazil: comparative study based on age (Retrospective cohort study).","authors":"Otavio de Carvalho Modaffar Al-Alam, Rafael Jose Vargas Alves, Adele Lanziani Fae, Camile Neves Cardoso, Jamille Rizzardi Lava, Joanna Palmeira Castro, Julia Signori, Larissa Grazziotin Claudino, Tales Barros Cassal Wandscheer, Victor Viecceli Villarinho, Affoue Prisca Michelle S Yao, Claudia Giuliano Bica","doi":"10.1186/s12876-025-03607-6","DOIUrl":"10.1186/s12876-025-03607-6","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is a prevalent and lethal malignancy. This study examines differences in clinical and prognostic characteristics of CRC between patients under 50 years and those aged 50 and above, treated at a reference hospital in Southern Brazil.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted, analyzing data from the Cancer Hospital Registry in Porto Alegre, RS. Patients diagnosed with colon or rectal adenocarcinoma between January 2013 and December 2017 were included. Variables analyzed included family history, alcoholism, smoking status, clinical staging, tumor laterality, clinical presentation, CEA levels at diagnosis, adjuvant chemotherapy, and neutrophil-to-lymphocyte ratio.</p><p><strong>Results: </strong>The study cohort included 1,121 patients, with 85% aged 50 years or older, and 15% younger than 50 years. Significant differences were observed in smoking status and clinical presentation, with younger patients presenting with a higher prevalence of obstruction/subocclusion at diagnosis, which may reflect differences in clinical presentation due to delayed diagnosis.</p><p><strong>Conclusions: </strong>Age and lifestyle factors, particularly smoking, significantly influenced the clinical presentation and management of colorectal cancer. These findings underscore the importance of targeted prevention strategies and personalized treatment approaches for younger CRC patients.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"91"},"PeriodicalIF":2.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short- and long-term outcomes of neoadjuvant chemotherapy compared with neoadjuvant chemoradiotherapy for locally advanced rectal cancer: an updated meta-analysis.","authors":"Yue Guo, Zhifeng Guo, Jiaojiao Zhang, Guowu Qian, Wangquan Ji, Linlin Song, Zhe Guo, Zhuo Han","doi":"10.1186/s12876-025-03667-8","DOIUrl":"10.1186/s12876-025-03667-8","url":null,"abstract":"<p><strong>Background and purpose: </strong>Neoadjuvant chemoradiotherapy (NACRT) is the standard treatment regimen for locally advanced rectal cancer (LARC) but has unavoidable radiation toxicity. With the advent of more optimized chemotherapy regimens, neoadjuvant chemotherapy (NAC) is sometimes offered as an alternative to NACRT. The purpose of this meta-analysis was to compare the short- and long-term outcomes of NAC and NACRT for LARC patients.</p><p><strong>Materials and methods: </strong>Eligible studies through June 15, 2023, were identified in the online databases. Short-term and long-term outcomes were synthesized. A total of 10 studies involving 14,807 patients (1714 vs. 13093) were included in this meta-analysis.</p><p><strong>Results: </strong>There were no significant differences between the two groups in terms of lymphovascular invasion, perineural invasion, R0 resection, local recurrence, overall survival, disease-free survival, or grade 3-4 adverse events. The NAC group had a lower rate of pathological complete response [OR (95% CI) = 0.61 (0.45, 0.82)] and tumor regression grade [OR (95% CI) = 0.42 (0.25, 0.70)] and a greater rate of sphincter preservation [OR (95% CI) = 1.57 (1.14, 2.16)] than did the NACRT group. In the prospective studies, no differences in pathological complete response [OR (95% CI) = 0.62 (0.35, 1.11)], tumor regression grade [OR (95% CI) = 0.72 (0.52, 1.00)], and rate of sphincter preservation [OR (95% CI) = 1.40 (0.94, 2.09)] have been found between the two groups.</p><p><strong>Conclusion: </strong>NAC was able to achieve similar short- and long-term outcomes as NACRT. It is worth noting that some prospective studies excluded patients with high-risk features. For those LARC patients with high-risk features, the efficacy of NAC versus NACRT needs to be further explored.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"87"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439965","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}

{"title":"Relationship between Sarcopenia and minimal hepatic encephalopathy in patients with cirrhosis: a prospective observational study.","authors":"Wasit Wongtrakul, Wimolrak Bandidniyamanon, Phunchai Charatcharoenwitthaya","doi":"10.1186/s12876-025-03674-9","DOIUrl":"10.1186/s12876-025-03674-9","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia, characterized by loss of muscle mass and function, has gained importance in the evaluation of cirrhotic patients. Evidence suggests its role in adverse clinical outcomes, including minimal hepatic encephalopathy (MHE). This study aimed to investigate the association between sarcopenia and MHE in patients with cirrhosis.</p><p><strong>Methods: </strong>We prospectively enrolled outpatients with cirrhosis to assess sarcopenia using the 2019 criteria from the Asian Working Group for Sarcopenia. MHE was diagnosed through the Psychometric Hepatic Encephalopathy Score.</p><p><strong>Results: </strong>Of the 210 cirrhotic patients (57.1% male, mean age 62.7 ± 9.6 years), 54 (25.7%) had sarcopenia, with 26 (12.3%) classified as severe. Thirty-seven patients (17.6%) were diagnosed with MHE. Sarcopenia prevalence was significantly higher in patients with MHE compared to those without MHE (45.9% vs. 21.4%). MHE was significantly associated with age, education level, Mini-Mental State Examination score, and a history of hepatic decompensation. No significant associations were found regarding gender, body mass index, comorbidities, sleep quality, and the etiology of cirrhosis. Multivariable logistic regression showed that MHE was significantly associated with age (adjusted odds ratio [aOR] 1.08, 95% CI 1.02-1.13), sarcopenia (aOR 3.29, 95% CI 1.44-7.50), history of overt hepatic encephalopathy (aOR 7.40, 95% CI 1.20-45.56), and variceal bleeding (aOR 3.13, 95% CI 1.38-7.10). Severe sarcopenia was also independently associated with MHE (aOR 3.64, 95% CI 1.32-10.05).</p><p><strong>Conclusions: </strong>Sarcopenia is prevalent in cirrhotic patients and is associated with an increased risk of MHE. Our findings emphasize the importance of assessing sarcopenia to potentially mitigate MHE risk in managing patients with cirrhosis.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"88"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439964","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}

{"title":"Understanding the adult and adolescent patient experience with cyclic vomiting syndrome: a concept elicitation study.","authors":"Katja Karrento, Melody Wu, Danielle Rodriguez, Karin S Coyne, Muna J Tahir, Camilla A Richmond, Yaozhu J Chen, James Williams, Thangam Venkatesan","doi":"10.1186/s12876-025-03595-7","DOIUrl":"10.1186/s12876-025-03595-7","url":null,"abstract":"<p><strong>Background: </strong>Cyclic vomiting syndrome (CVS) is a phasic disorder of gut-brain interaction characterized by episodes of severe nausea and vomiting. In-depth qualitative research on phase-specific CVS symptoms and impacts is lacking. The study objectives were to explore the experience of patients with CVS in the United States and to identify CVS symptoms and impacts on adults, adolescents, and caregivers.</p><p><strong>Methods: </strong>Qualitative, cross-sectional, semi-structured concept elicitation interviews were conducted with adults and adolescents with CVS and with adolescents' caregivers. Adolescents either participated alone or in a dyad format with their caregiver. Interview data were analyzed using an open coding approach.</p><p><strong>Results: </strong>Concept elicitation interviews were conducted with 13 adults (mean age 45.3 years [standard deviation (SD) 13.1]) and 15 adolescents (mean age 14.6 years [SD 1.8]). The most frequently reported prodrome phase symptoms were nausea (n = 12, 92.3%), anxiety (n = 10, 76.9%), and abdominal pain (n = 9, 69.2%) in adults, and nausea (n = 15, 100%), abdominal pain (n = 11, 73.3%), and headache (n = 11, 73.3%) in adolescents. All adults reported nausea, tiredness, and dry heaves in the emetic phase, and 12 (92.3%) reported vomiting and retching. The remaining patient said they no longer vomited due to abortive medications. All adolescents reported nausea and vomiting in the emetic phase; other common emetic phase symptoms were abdominal pain (n = 14, 93.3%), dehydration (n = 13, 86.7%), and tiredness (n = 13, 86.7%). The leading most bothersome impact reported by adults was anxiety associated with impending vomiting (n = 5, 38.5%). Among adolescents, the leading most bothersome impact was on school (n = 7/13 asked, 53.8%), and among their caregivers, it was seeing their child suffer (n = 6/11 asked, 54.5%).</p><p><strong>Conclusions: </strong>Patients with CVS experience considerable gastrointestinal and extra-intestinal symptoms. CVS impacts the activities of daily life of patients and their caregivers, with patients reporting negative effects of CVS on their emotional status and their ability to maintain a normal school or work routine.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"85"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439967","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}

{"title":"Expression and prognostic significance of CD93 in blood vessels in colorectal cancer: an immunohistochemical analysis of 134 cases.","authors":"Shuzhe Yang, Zhongyuan Bai, Fei Zhang, Wei Cui, Peng Bu, Wenqi Bai, Yanfeng Xi","doi":"10.1186/s12876-025-03643-2","DOIUrl":"10.1186/s12876-025-03643-2","url":null,"abstract":"<p><strong>Objective: </strong>Tumor blood vessels are tortuous and dilated, contributing to the aberrant tumor microenvironment. CD93 is a newly reported transmembrane receptor, mainly expressed in tumor endothelial cells, that has demonstrated prognostic value in some cancer types. However, the role of CD93 in the vasculature of colorectal cancer (CRC) tissues and its prognostic significance remain unknown. It is therefore necessary to explore the effect of CD93 in patients with CRC.</p><p><strong>Method: </strong>We detected the expression of CD93 in human CRC tissues using immunohistochemistry. We then examined the correlation between CD93 expression and clinicopathological factors in cancer tissues from 134 patients with CRC.</p><p><strong>Result: </strong>CD93 expression levels were higher in CRC vessels than in vessels in adjacent normal tissues. Upregulation of CD93 was associated with tumor site and microsatellite instability. CD93 protein expression was positively related to macrophage infiltration in CRC. High expression of CD93 may indicate normalization of the tumor vasculature and was associated with better overall survival.</p><p><strong>Conclusion: </strong>CD93 was highly expressed in CRC vessels and correlated with infiltration of immune cells. Our findings reveal that vascular normalization and patient prognosis can be predicted by detecting CD93 expression in CRC tumor tissues.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"84"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439987","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}

{"title":"Impact of duration to endoscopy in patients with non-variceal upper gastrointestinal bleeding: propensity score matching analysis of real-world data from Thailand.","authors":"Arunchai Chang, Natthawat Sitthinamsuwan, Nuttanit Pungpipattrakul, Kittiphan Chienwichai, Keerati Akarapatima, Sorawat Sangkaew, Manus Rugivarodom, Attapon Rattanasupar, Bancha Ovartlarnporn, Varayu Prachayakul","doi":"10.1186/s12876-025-03673-w","DOIUrl":"10.1186/s12876-025-03673-w","url":null,"abstract":"<p><strong>Background: </strong>The findings on mortality, rebleeding rate, and hospital stay in patients who underwent early vs. late endoscopy are conflicting. We aimed to compare in-hospital outcomes and medical resource use in patients with acute non-variceal upper gastrointestinal bleeding.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical records of patients with acute non-variceal upper gastrointestinal bleeding who underwent early or late endoscopy between 2016 and 2019. The primary outcome was in-hospital mortality. The secondary outcomes were the need for packed red blood cells and number of transfusions, the proportion of lesions with high-risk stigmata, endoscopic and additional hemostasis, in-hospital rebleeding, duration of stay, and admission cost. Statistical analysis was performed using Pearson's chi-squared or Fisher's exact test for categorical variables, Student's t-test, and Wilcoxon rank-sum test for continuous variables.</p><p><strong>Results: </strong>Early and late endoscopies were performed on 451 and 279 patients, respectively. After 1:1 propensity score matching, 278 patients from each group were included, and patients' baseline characteristics were similar in the matched groups. Compared with the late group, the early group had a significantly increased rate of endoscopic hemostasis (22.7% vs. 13.7%, P = 0.006) and a low rate of packed red blood cell transfusion (53.6% vs. 61.9%, P = 0.048). Duration of stay and admission costs were significantly higher in the late group than in the early group (all P < 0.05). After adjusting for confounding factors, early endoscopy was positively associated with ulcers with high-risk stigmata (adjusted odds ratio = 1.83, P = 0.023) and endoscopic hemostasis (adjusted odds ratio = 1.97, P = 0.004). It was negatively associated with the need for packed red blood cell transfusion (adjusted odds ratio = 0.62, P = 0.017) and duration of stay (adjusted coefficient=-0.10, P < 0.001) with no impact on in-hospital mortality, rebleeding, or radiological interventions.</p><p><strong>Conclusions: </strong>The timing of endoscopy does not affect in-hospital mortality or rebleeding rate. This study supports using early endoscopy in patients with acute non-variceal upper gastrointestinal bleeding based on the potential benefits and feasibility of medical resource use.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"86"},"PeriodicalIF":2.5,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439988","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}