BMC Gastroenterology最新文献

{"title":"Cardiometabolic index as a predictor of gallstone risk: evidence from NHANES 2017-2020.","authors":"Huachao Zheng, Bo Wu, Caixiang Zhuang, Jiesheng Mao, Min Li, Yuncheng Luo, Lidong Huang, Sisi Lin, Feiyang Zhao, Yiren Hu","doi":"10.1186/s12876-025-03777-3","DOIUrl":"https://doi.org/10.1186/s12876-025-03777-3","url":null,"abstract":"<p><strong>Background: </strong>The Cardiometabolic Index (CMI), a composite marker integrating lipid profiles (triglycerides-to-HDL-C ratio) and abdominal obesity (waist-to-height ratio), we aimed to assess its association with gallstone prevalence.</p><p><strong>Methods: </strong>We analyzed data from 2,692 participants in the NHANES 2017-2020 dataset. Gallstones were identified through self-reported data, which may introduce bias in the diagnosis. This limitation should be considered when interpreting the results. Logistic regression modelling, smoothed curve fitting and threshold effect analysis assessed the association between CMI and gallstones.</p><p><strong>Result: </strong>Higher CMI was significantly associated with an increased risk of gallstones (OR = 1.90, 95% CI: 1.37-2.62, P < 0.0001). A threshold effect was observed at CMI = 0.85, below which risk increased significantly (OR = 2.62, 95% CI:1.34-5.12, P = 0.0049), but became non-significant above this value. The association was stronger in women.</p><p><strong>Conclusion: </strong>Our findings support the use of CMI as a potential predictive marker for gallstone risk, suggesting its integration into clinical assessments for early detection and prevention.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"218"},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779152","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 randomized open label pilot study evaluating the efficacy of two dosing regimens of rifamycin SV MMX in the treatment of small intestinal bacterial overgrowth.","authors":"Bradley A Connor, Marina Rogova, Jefferson Garcia, Morgan Gardner, Charandeep Waraich, Victoria Averill","doi":"10.1186/s12876-025-03804-3","DOIUrl":"https://doi.org/10.1186/s12876-025-03804-3","url":null,"abstract":"<p><p>Antibiotics have demonstrated efficacy in the eradication of the underlying overgrowth bacteria and improvement of symptoms of small intestinal bacterial overgrowth (SIBO). The use of standard antibiotics may cause intolerable side effects such as development of multidrug-resistant enteric bacteria, Clostridioides difficile infections and dysbiosis. Nonabsorbable antibiotics have the advantage of minimized side effects. Rifaximin, an antibiotic of the ansamycin class has been shown to be effective in the treatment of SIBO. We evaluated the use of another ansamycin antibiotic, rifamycin SV MMX (AEMCOLO) in the treatment of SIBO. One difference from rifaximin is the site of delivery of AEMCOLO which appears to be the distal small intestine and colon. Hence by maintaining the microbial milieu of the proximal small intestine, the clearance of the overgrowth bacteria might be enhanced. The side effect profile of Rifamycin SV MMX has been described elsewhere in the pivotal trials; there were no safety signals noted in this study. This randomized open label pilot study evaluated the efficacy of two dosing regimens of AEMCOLO in treating SIBO. We used a simple randomization method to assign participants into study groups. The participants included 31 patients, split between two treatment arms: one receiving the medication twice daily and the other - three times daily. The outcomes were assessed based on symptom improvement and breath test normalization. The results indicated a beneficial response with both dosing regimens leading to symptom improvement and breath test normalization. Further evaluation revealed that in the three-time daily regimen, greater symptomatic improvement was observed. For clinicians treating SIBO, this study suggests that AEMCOLO is a viable treatment option. A double-blind, placebo-controlled design will probably be necessary to ascertain the true efficacy of different dosing regimens of AEMCOLO in treating SIBO.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"219"},"PeriodicalIF":2.5,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779151","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":"The prevalence of Barrett 's esophagus in Iranian patients with gastrointestinal symptoms: a systematic review and meta-analysis.","authors":"Maryam Rashidian, Fatemeh Bastan, Hedieh Soltani, Reza Ghosheni, Kiyarash Bakhshande, Mahdi Mohammaditabar, Yasin Tabatabaei Mehr, Khaled Rahmani, Mahmood Bakhtiyari, Mostafa Qorbani, Mojgan Forootan, Mahsa Mohammadi, Mohsen Rajabnia","doi":"10.1186/s12876-025-03822-1","DOIUrl":"10.1186/s12876-025-03822-1","url":null,"abstract":"<p><strong>Background: </strong>Barrett's esophagus (BE) is a premalignant columnar metaplasia of the esophagus that predisposes victims to esophageal adenocarcinoma (EAC). Depending on differences in the study population and risk factors, the prevalence of BE may vary, from 0.4 to 20% globally. The current study aimed to systematically review and analyse the prevalence of BE in in patients with gastrointestinal symptoms in Iran. Furthermore, gastrointestinal malignancies are among the most common tumours in Iran, making this study even more significant.</p><p><strong>Methods: </strong>A systematic search was carried out in PubMed, Web of Science, Scopus, and EMBASE as well as some domestic databases including SID, Magiran, IranDoc, IranMedex from inception to the end of 2023. We included all cross-sectional studies which reported the prevalence of BE and calculated pooled prevalence.</p><p><strong>Results: </strong>The results of the analysis, including 9 studies in a total of 4978 cases (213 Barret diagnoses), revealed that by the results of these studies, the prevalence of Barret's esophagus is 4.4% [I2 = 94.9% [92.2%; 96.6%]/p-value < 0.0001]. Subgroup analysis, divided by region and year, revealed significant differences between groups.</p><p><strong>Conclusions: </strong>The epidemiology of BE in Iran is not completely identified. This is the first systematic review and meta-analysis evaluating the prevalence and of BE in Iran. Due to the importance of BE in progressing to esophageal adenocarcinoma, much importance should be given to its timely diagnosis. It is strongly recommended to conduct more comprehensive studies including more patients in this field.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"217"},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771323","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":"Association between wet-bulb globe temperature with peptic ulcer disease in different geographic regions in a large Taiwanese population study.","authors":"Yuh-Ching Gau, Chia-Yu Kuo, Wei-Yu Su, Wan-Ling Tsai, Ying-Jhen Wu, Ping-Hsun Wu, Ming-Yen Lin, Chih-Da Wu, Chao-Hung Kuo, Szu-Chia Chen","doi":"10.1186/s12876-025-03803-4","DOIUrl":"10.1186/s12876-025-03803-4","url":null,"abstract":"<p><strong>Background: </strong>Peptic ulcer disease (PUD) is a common and important cause of morbidity worldwide, with a large impact on healthcare costs. Little research has been conducted on the association between wet-bulb globe temperature (WBGT) and PUD. The aim of this study was to explore this association among different geographical regions of Taiwan in a large sample of participants.</p><p><strong>Methods: </strong>This is a cross-sectional study. The study participants (n = 120,424) were enrolled from the Taiwan Biobank (TWB) and resided across northern, central, southern and eastern Taiwan. Self-reported questionnaires were used to ascertain the occurrence of PUD. Average WBGT values were recorded during working hours (8:00 AM to 5:00 PM) and the noon period (11:00 AM to 2:00 PM) for each participant at 1, 3, and 5 years before the TWB survey year. The association between WBGT and PUD was examined with logistic regression analysis.</p><p><strong>Results: </strong>The 1-year and 5-year noon WBGT values per 1℃ increase were significantly associated with a low prevalence of PUD in northern Taiwan (odds ratio [OR], 0.960, 95% confidence interval [CI], 0.925-0.955; OR, 0.962, 95% CI, 0.929-0.997; respectively). In contrast, there were no significant associations between WBGT and PUD in central Taiwan. In southern Taiwan, the 1-, 3-, and 5-year WBGT values per 1℃ increase during the noon period (OR, 0.875, 95% CI, 0.873-0.909; OR, 0.860, 95% CI, 0.825-0.896; OR, 0.848, 95% CI, 0.812-0.885; respectively) and working period (OR, 0.852, 95% CI, 0.825-0.880; OR, 0.845, 95% CI, 0.816-0.876; OR, 0.832, 95% CI, 0.0.801-0.863; respectively) were significantly associated with a low prevalence of PUD. However, in eastern Taiwan, the 1-, 3-, and 5-year WBGT values per 1℃ increase during the noon period (OR, 1.074, 95% CI, 1.022-1.127; OR, 1.058, 95% CI, 1.013-1.104; OR, 1.058, 95% CI, 1.013-1.105; respectively), and the 3- and 5-year WBGT values per 1℃ increase during the working period were significantly associated with a high prevalence of PUD (OR, 1.049, 95% CI, 1.003-1.097; OR, 1.047, 95% CI, 1.001-1.095; respectively). Based on nonlinear trend analysis, WBGT was categorized into three groups for the noon period or work period, and the results were similar to and generally consistent with those in linear models.</p><p><strong>Conclusion: </strong>The associations between WBGT and PUD differed across the geographical regions of Taiwan. In northern and southern Taiwan, increases in average WBGT values were significantly associated with a low prevalence of PUD. In addition, this relationship was much stronger in southern Taiwan than in northern Taiwan. Of note, there was a reverse relationship between WBGT and PUD during the noon and working periods in eastern Taiwan. Further studies are needed to elucidate the effects of WBGT on PUD.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"216"},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771311","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":"Construction and validation of a novel nomogram based on the log odds of positive lymph nodes to predict cancer-specific survival in elderly patients with gastric adenocarcinoma after radical surgery.","authors":"Lei Wang, Jingjing Ge, Yihua Fang, Huiqiong Han, Yanru Qin","doi":"10.1186/s12876-025-03813-2","DOIUrl":"10.1186/s12876-025-03813-2","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate the efficacy of the log odds of positive lymph nodes (LODDS) in survival prediction of elderly patients with gastric adenocarcinoma (GAC) after gastrectomy, and to construct a relevant survival prediction model.</p><p><strong>Methods: </strong>In this study, patient data was collected from both the Surveillance, Epidemiology, and End Results (SEER) database and a medical records database at a hospital in China. Least absolute shrinkage and selection operator (LASSO) regression and multivariate Cox analysis were used to identify independent risk factors for cancer-specific survival (CSS) and a nomogram was constructed based on the results of multivariate Cox regression. Using consistency index (C-index), calibration curve, time-dependent receiver operating characteristic curve (tdROC) and decision curve analysis (DCA) to evaluate the predictive performance of nomogram. Generating Kaplan-Meier survival curves to show the difference in CSS between different groups.</p><p><strong>Results: </strong>Multivariate Cox analysis indicated that race, site, T stage, size, and LODDS were independently associated with the CSS. The C-index and AUC of the nomogram both exceed 0.71, while the calibration curve suggests that the nomogram accurately predicts CSS. Additionally, DCA curve results demonstrate superior clinical net benefits of the nomogram over TNM staging. High-risk patients identified by the predictive model exhibit inferior survival outcomes compared to low-risk patients. In addition, group comparison showed that only high-risk patients or high-LODDS group could benefit from chemotherapy and radiotherapy.</p><p><strong>Conclusions: </strong>The LODDS is an independent prognostic factor for elderly GAC patients after gastrectomy. The nomogram based on LODDS has better predictive ability than the traditional TNM staging system, assisting clinical doctors in evaluating patient prognosis and guiding treatment.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"215"},"PeriodicalIF":2.5,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771321","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":"CDH1 genetic variants and its aberrant expression are the risk factors for colorectal cancer metastasis.","authors":"Yunbo Wu, Ying Yu, Danyan Li, Yunkai Dai, Jianyu Wu, Zijing Zhang, Huaigeng Pan, Weijing Chen, Ruliu Li, Ling Hu","doi":"10.1186/s12876-025-03797-z","DOIUrl":"10.1186/s12876-025-03797-z","url":null,"abstract":"<p><p>E-cadherin, encoded by the CDH1 gene, plays an essential role in epithelial cellular adhesion, and the loss of it has been reported to be associated with tumor progression and metastasis, potentially offer a glimpse in to the development of colorectal cancer. The present study aimed to explore effect of CDH1-160 polymorphism, CDH1 transcription and its protein E-cadherin expression on colorectal cancer, meanwhile uncovering the underlying mechanism. Specimens from cancer loci, adjacent cancer tissue, and distal normal tissue from colorectal cancer patients were collected for Hematoxylin-eosin staining to detect the histopathological change of colorectal mucosa. Direct sequencing and Quantitative Real-Time PCR were used to detect the CDH1 genotype and its mRNA expression, respectively. E-cadherin expression was detected using the ElivisionTM plus method. As a result, we found that the A allele of the CDH1-160 may be a protective gene against colorectal cancer, and the C > A polymorphism may regulate its transcription activity and expression of E-cadherin. The decrease of the CDH1 mRNA transcription level and the absence of E-cadherin on the cytomembrane may promote intestinal mucosal carcinogenesis and accelerate cancer cell metastasis. Deficiency of cytomembrane expression of E-cadherin protein may have some early warning signs for malignant lesions of the gut mucosa.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"214"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763041","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":"In vitro susceptibility of clinical Clostridioides difficile isolates in Israel to metronidazole, vancomycin, fidaxomicin, ridinilazole and ibezapolstat.","authors":"Orna Schwartz, Maya Azrad, Avi Peretz","doi":"10.1186/s12876-025-03800-7","DOIUrl":"10.1186/s12876-025-03800-7","url":null,"abstract":"<p><strong>Background: </strong>Antibiotics are currently the primary treatment of Clostridioides difficile (C. difficile) infection. Yet, due to rapid development of resistance and high recurrences rates, there is an unmet need for new antimicrobials for C. difficile infections. This study assessed the in vitro susceptibility of clinical isolates from Israel to two recently developed antibiotics, ridinilazole (RDZ) and ibezapolstat (IBZ), and to standard-of-care antibiotics.</p><p><strong>Methods: </strong>C. difficile isolates (n = 313) recovered from patients at both community and hospital medical centers across Israel, were typed to different sequence types (ST) by multi-locus sequencing typing (MLST). Susceptibility to metronidazole (MTZ) and vancomycin (VAN) was determined using the gradient strip test (Etest). Susceptibility to fidaxomicin (FDX), RDZ and IBZ was determined by agar dilution.</p><p><strong>Results: </strong>ST42 (39; 12.5%) and ST2 (36; 11.5%) were the most prevalent STs. Resistance to MTZ and VAN was low (2.2%, 1.6%, respectively), while 23 (7.35%) isolates were FDX-resistant. RDZ MIC ranged between 0.06 and 0.5 mg/L, and MIC_50/90 was 0.25/0.5 mg/L. IBZ had an MIC_50/90 of 4 mg/L. No significant differences were noted in IBZ MIC of different strains.</p><p><strong>Conclusions: </strong>RDZ and IBZ demonstrated potent in vitro activity against 313 C. difficile isolates belonging to different STs. These two antimicrobials may serve as effective agents for C. difficile infection.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"209"},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751069","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":"Deciphering the integrated immunogenomic landscape of colorectal cancer: insights from Mendelian randomization and immune-stratified molecular subtyping.","authors":"Ke-Jie He, Guoyu Gong","doi":"10.1186/s12876-025-03776-4","DOIUrl":"10.1186/s12876-025-03776-4","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to decipher the intricate interplay between the immune landscape and CRC pathogenesis, elucidating how distinct immunophenotypes causally influence disease susceptibility and stratify patient outcomes.</p><p><strong>Methods: </strong>We obtained the immunocyte phenotypes and CRC data from their respective genome-wide association studies. The primary analysis used the inverse variance weighting (IVW) method. We also simultaneously employed MR-Egger, weighted mode, simple mode, and weighted median approaches to strengthen the findings. Consensus clustering stratified 619 TCGA CRC patients by immunome expression. Functional assays examined the tumor suppressor GPD1L.</p><p><strong>Results: </strong>The IVW MR analysis identified 17 immunocyte phenotypes positively potentially associated with increased CRC risk (P < 0.05, OR > 1), and 18 phenotypes negatively potentially associated with decreased CRC risk (P < 0.05, OR < 1). These associations were not confounded by heterogeneity or horizontal pleiotropy (P > 0.05). Reverse MR analysis further revealed 4 additional immunocyte phenotypes positively potentially associated with CRC (P < 0.05, OR > 1). Clustering resolved prognostic C1/C2 subtypes dependent on coordinated immunophenotypic programs. GPD1L knockdown promoted CRC cell proliferation.</p><p><strong>Conclusions: </strong>Genetic interrogation delineated causal immunome-CRC relationships at single-cell resolution. Immune-stratified CRC subtyping stratified patient outcomes. GPD1L exhibited tumor-suppressive functions. Our findings establish an integrated immunogenomic framework elucidating CRC pathogenesis with implications for precision immunotherapies.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"213"},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751068","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":"Predictors of pathological complete response after total neoadjuvant treatment using short course radiotherapy for locally advanced rectal cancer.","authors":"Haythem Yacoub, Yosr Zenzri, Dhouha Cherif, Hajer Ben Mansour, Najla Attia, Cyrine Mokrani, Khadija Ben Zid, Feryel Letaief, Nadia Maamouri, Amel Mezlini","doi":"10.1186/s12876-025-03709-1","DOIUrl":"10.1186/s12876-025-03709-1","url":null,"abstract":"<p><strong>Background: </strong>Total neoadjuvant treatment (TNT) has become a standard treatment approach for locally advanced rectal cancer (LARC). Patients achieving pathological complete response (pCR) following TNT have better outcomes (overall survival, relapse free survival). However, not all patients treated for LARC with neoadjuvant treatment achieve pCR.</p><p><strong>Aim: </strong>The aim of our study was to assess the rate and predictors of pCR.</p><p><strong>Materials and methods: </strong>We performed a retrospective study at medical oncology unit in a tertiary care teaching hospital. All consecutive LARC patients without any evidence of distant metastasis who underwent neoadjuvant chemoradiotherapy and surgery between June 2020 and January 2023 were included in the research. Pathological response to neoadjuvant treatment was assessed using Mandard grading system and response was categorized as pCR or not‑pCR. Two different standardized protocols for the neoadjuvant treatment were used: the first group was treated with induction chemotherapy followed by short course radiotherapy and the second group was treated with the RAPIDO protocol. Correlation between different studied parameters and pCR was determined using univariate and multivariate logistic regression analysis.</p><p><strong>Results: </strong>The mean age of the 91 included patients (46 men and 45 women) was 58.53 ± 10.3 years. Twenty (22%) were found to have a pCR (Mandard TRG1) in the operative specimen. In univariate analysis, patients less than 60 years, continuation of chemotherapy and patients treated with the induction chemotherapy followed by short course radiotherapy showed a better pCR as compared to patients treated with Rapido protocol (p = 0.043, p = 0.0001 and p = 0.021 respectively). Patients with mucinous component had low pCR rates (p = 0.021). On logistic regression analysis, chemotherapy continuation (OR = 10.27, 95% CI = 2,14-49.32), and absence of mucinous component (OR = 12.6, 95% CI = 3.1-40.32) were significant predictors of pCR. The median survival was 37.7 months.</p><p><strong>Conclusion: </strong>Mucinous component and chemotherapy interruption are associated with lower pCR rates. Integrating these factors into personalized treatment algorithms may help optimize therapeutic strategies and improve outcomes for patients with LARC.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"208"},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751070","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":"The usefulness of percutaneous bile duct metal stent insertion for malignant biliary obstruction: a retrospective study.","authors":"Hideki Izumi, Hisamichi Yoshii, Rika Fujino, Shigeya Takeo, Masaya Mukai, Junichi Kaneko, Hiroyasu Makuuchi","doi":"10.1186/s12876-025-03767-5","DOIUrl":"10.1186/s12876-025-03767-5","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous transhepatic bile duct stent insertion is a useful alternative to the endoscopic approach for malignant biliary strictures. This study retrospectively reviewed the cases of percutaneous metallic stent insertion at our institution to evaluate its safety and usefulness.</p><p><strong>Methods: </strong>The study included cases of percutaneous bile duct stent insertion performed between April 2016 and August 2024. All patients included those with malignant biliary obstruction and those in whom an endoscopic approach was first attempted but could not reach or cannulate the papilla of Vater. Two procedures were used: a two-stage procedure, in which a drain was inserted to create an external or internal fistula, followed by stent insertion, and a one-stage procedure, in which the stent was inserted at the same time as the approach to the bile duct. The causes of biliary strictures and complications were examined.</p><p><strong>Results: </strong>The study included 14 cases: seven patients had pancreatic head cancer, including biliary tract cancer (n = 4) and postoperative gastric cancer (n = 3); three patients who underwent a one-stage insertion. The number of inserted stents tended to increase in patients with postoperative cholangiocarcinoma recurrence. No complication occurred in any patient. One patient had severe cholangitis, eight had moderate cholangitis, and four had mild cholangitis; two patients who underwent one-stage procedures had moderate cholangitis and one had mild cholangitis. In cases of two-stage expandable metal stent (EMS) insertion, the average time from initial drainage to EMS insertion was 10.5 days (4-25).</p><p><strong>Conclusions: </strong>The stent can be safely inserted in a one-stage procedure without compromising the patient's quality of life. Therefore, one-stage insertion of EMS for malignant biliary stricture may be performed aggressively unless the patient has severe cholangitis.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"211"},"PeriodicalIF":2.5,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751072","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}