BMC Gastroenterology最新文献

{"title":"Factors predicting conversion from colon capsule endoscopy to conventional optical endoscopy-findings from the CESCAIL study.","authors":"Ian Io Lei, Ioanna Parisi, Anirudh Bhandare, Francisco Porras Perez, Thomas Lee, Chander Shehkar, Mary McStay, Simon Anderson, Angus Watson, Abby Conlin, Rawya Badreldin, Kamran Malik, John Jacob, Andrew Dixon, Jeffrey Butterworth, Nicholas Parsons, Anastasios Koulaouzidis, Ramesh P Arasaradnam","doi":"10.1186/s12876-025-03828-9","DOIUrl":"10.1186/s12876-025-03828-9","url":null,"abstract":"<p><strong>Background: </strong>Colon capsule endoscopy (CCE) has become an alternative to traditional colonoscopy for low-risk patients. However, CCE's low completion rate and inability to take biopsies or remove polyps often result in a CCE-to-conventional colonoscopy conversion (CCC).</p><p><strong>Objective(s): </strong>The aim is to identify the factors that predict issues with bowel cleansing, capsule excretion rates, pathology detection, and the need for CCC.</p><p><strong>Methods: </strong>This prospective study analysed data from patients who underwent CCE as part of the CESCAIL study from Nov 2021 till June 2024. Predictive factors were examined for their association with CCC, including patient demographics, comorbidities, medications, and laboratory results from symptomatic and surveillance groups. Statistical methods such as LASSO, linear, and logistic regression were applied.</p><p><strong>Results: </strong>Six hundred and three participants were analysed. Elevated f-Hb levels (OR = 1.48, 95% CI:1.18-1.86, p = 0.0002) and smoking (OR = 1.44, 95% CI: 1.01-2.11, p = 0.047) were significantly associated with CCC. The area under the curve (AUC) of elevated f-Hb for predicting CCC was 0.62 after adjusting for confounders. Diabetes was linked to poor bowel preparation (OR = 0.40, 95%CI:0.18-0.87, p = 0.022). Alcohol (p = 0.004), smoking (p = 0.003), psychological conditions (p = 0.001), and haemoglobin levels (p = 0.046) were significantly associated with the number of polyps, whilst antidepressants (p = 0.003) and beta-blockers (p = 0.001) were linked to the size of polyps.</p><p><strong>Conclusion: </strong>Non-smokers with lower f-Hb levels are less likely to need conventional colonoscopy (CCC). Patient selection criteria are key to minimising the colonoscopy conversion rate. Our findings would benefit from validation in different populations to develop a robust CCE Conversion Scoring System (CECS) and ultimately improve the cost-effectiveness.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"363"},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975546","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":"Association of biological aging and the prevalence of nonalcoholic fatty liver disease: a population-based study.","authors":"Gang Liu, Qingsong Mao, Xinling Tian, Chenwei Zhang, Yukai Zhang, Jiarong He, Yuzhe Kong","doi":"10.1186/s12876-025-03955-3","DOIUrl":"10.1186/s12876-025-03955-3","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the relationship between biological aging and the prevalence of NAFLD.</p><p><strong>Method: </strong>We used the recommended sampling weights to account for the complex survey design of NHANES. The analysis, utilizing data from 2005 to 2016, aimed to investigate the impact of biological aging on NAFLD prevalence using various statistical methods. A restricted cubic spline (RCS) model was applied to explore the dose-response relationship, while logistic regression examined linear associations. The robustness of the association across different subgroups was also tested.</p><p><strong>Result: </strong>The study included 2786 participants. We found significant associations between NAFLD and the following biological aging metrics: AL score (OR (95%CI) = 1.1932 (1.0597 ~ 1.3435), P = 0.0035), HD (OR (95%CI) = 1.2092 (1.0565 ~ 1.3839), P = 0.0058), and PA (OR (95%CI) = 1.7564 (1.1949 ~ 2.5818), P = 0.0042). All biological aging metrics were identified as independent predictors. PA was most associated with the prevalence of NAFLD. The associations persisted across most subgroups.</p><p><strong>Conclusion: </strong>The prevalence of NAFLD was associated with biological aging, emphasizing the importance of addressing potential health risks related to aging.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"368"},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963804","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":"Eradication of Helicobacter pylori that contributes to hepatogenic ulcer is beneficial to the healing of hepatogenic ulcer.","authors":"Guanen Qiao, Le Feng, Meng Wang, Chaoyang Wang, Changjuan Li, Shuxiang Han, Yanmei Wang, Shubo Li, Shuanli Xin","doi":"10.1186/s12876-025-03769-3","DOIUrl":"10.1186/s12876-025-03769-3","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to explore the role of Helicobacter pylori (Hp) eradication in patients with hepatogenic ulcer (HU).</p><p><strong>Methods: </strong>Patients with HU, patients with liver cirrhosis without peptic ulcer and patients with functional dyspepsia (FD) were selected and the relationship between complications of liver cirrhosis and Hp infection in HU patients was evaluated retrospectively. Furthermore, 60 HU patients with Hp infection were randomly divided into the treatment group with rabeprazole plus amoxicillin and levofloxacin, and the control group with rabeprazole alone and the therapeutic effects then were recorded. This trial was registered at the China Clinical Research Registration Center (Trial registration number: ChiCTR2200061355, 2022/06/21).</p><p><strong>Results: </strong>The Hp positive rate in the HU group was significantly higher compared with the liver cirrhosis without ulcer group or the FD group. Moreover, the positive rate of Hp in HU patients with mild esophageal varices was higher than that in HU patients with moderate and severe esophageal varices. Additionally, the rate of Hp eradication and ulcer healing in the treatment group was significantly higher than that in the control group. Importantly, the remission time of ulcer-related symptoms in the treatment group was shorter compared with the control group.</p><p><strong>Conclusion: </strong>Hp is a contributor to HU and an integrated strategy consisting of rabeprazole, amoxicillin and levofloxacin is effective in the treatment of HU, providing a potential application for HU patients.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"359"},"PeriodicalIF":2.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977833","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":"A network meta-analysis of different interventional treatment strategies for unresectable hepatocellular carcinoma.","authors":"Xing-Yan Le, Jun-Bang Feng, Xiao-Li Yu, Sui-Li Li, Xiaocai Zhang, Jiaqing Li, Chuan-Ming Li","doi":"10.1186/s12876-025-03980-2","DOIUrl":"10.1186/s12876-025-03980-2","url":null,"abstract":"<p><strong>Background: </strong>The optimal clinical management of unresectable hepatocellular carcinoma (uHCC) is challenging for clinicians. Bayesian network meta-analysis was conducted to compare the efficacy and safety of different interventional strategies for uHCC.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Embase, the Cochrane Library, Web of Science, and CNKI databases. Bayesian network meta-analysis was applied to evaluate the disease control rate (DCR), 1-year survival rate and 2-year survival rate, as well as the incidence of serious adverse events associated with seven interventional strategies. Odds ratios (ORs) were estimated using pairwise and network meta-analysis with random effects. Treatment rankings utilized surface under the cumulative ranking curve (SUCRA), whereas heterogeneity was examined via I-square and meta-regression.</p><p><strong>Results: </strong>A total of 40 randomized controlled studies were included. Compared with transarterial chemoembolization (TACE) alone, all of the combination treatments, including TACE with radiofrequency ablation (RFA), microwave ablation (MWA), high-intensity focused ultrasound (HIFU), percutaneous ethanol injection (PEI), and radiotherapy (RT), significantly improved the DCR. TACE combined with RFA was observed to be superior to hepatic arterial infusion chemotherapy (HAIC) (OR: 1.91; 95% CI: 1.03-3.81) and TACE (OR: 3.85; 95% CI: 2.66-5.69), with the highest probability (SUCRA 0.836). TACE combined with HIFU ranks highest 1-year survival (SUCRA 0.919) and 2-year survival (SUCRA 0.925) rates, and also exhibited a better 1-year survival rate than HAIC (OR: 2.99; 95% CI: 1.09-9.03). Compared with TACE alone, HAIC exhibited a greater DCR (OR: 2.02; 95% CI: 1.15-3.40) and a potential advantage in 2-year survival (OR: 1.95; 95% CI: 1.02-3.78). No significant differences in serious adverse events were observed across treatments.</p><p><strong>Conclusions: </strong>Compared with TACE alone, combined treatments for uHCC patients demonstrates better efficacy and survival. Moreover, compared with TACE and HAIC, TACE combined with RFA provides better efficacy, whereas TACE combined with HIFU offers the highest 1-year survival rate. HAIC alone outperforms TACE in DCR and 2-year survival rate.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"360"},"PeriodicalIF":2.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977829","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":"Evaluating the diagnostic significance of the R2* value on 3.0T MRI for assessing the severity of warm hepatic ischemia-reperfusion injury.","authors":"Shichao Xu, Qian Ji, Jing Xu","doi":"10.1186/s12876-025-03947-3","DOIUrl":"10.1186/s12876-025-03947-3","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging (MRI) may be a non-invasive tool for managing warm hepatic ischemia-reperfusion injury (WHIRI).</p><p><strong>Purpose: </strong>We aimed to evaluate the diagnostic utility of the R2* values derived from 3.0T blood oxygen level-dependent (BOLD) MRI in assessing the severity of WHIRI.</p><p><strong>Methods: </strong>Fifty healthy adult New Zealand white rabbits were randomly divided into 5 groups with 10 rabbits in each. The experimental groups (40 rabbits) underwent clamping of the hepatic artery and the portal vein for 10, 20, 30, or 40 min, followed by 6 h of reperfusion to induce WHIRI. The other 10 rabbits comprised the normal control group. All animals were underwent conventional 3.0 T and BOLD MRI. Animals were euthanized and the serum levels of biochemical indicators were determined. Correlations between R2* values, biochemical indicators, and WHIRI staging were assessed using Spearman's rank correlation coefficient. The diagnostic efficacy of R2* values was evaluated using ROC curves.</p><p><strong>Results: </strong>R2* values increased gradually with prolonged warm ischemia with significant differences across groups (F = 133.25, P < 0.05). A strong positive correlation was detected between R2* values and WHIRI staging (r = 0.878, P = 0.000). Biochemical indicators (ALT, AST, LDH, MDA, and MPO) increased significantly, while SOD levels decreased with prolonged warm ischemia (P < 0.05). R2* values exhibited a strong positive correlation with biochemical indicators (r > 0.495) and a negative correlation with SOD levels (r=-0.658). The diagnostic efficacy of the R2* values was highest for predicting WHIRI above stage S4 (AUC = 1.000).</p><p><strong>Conclusion: </strong>R2* values on BOLD MRI provide a sensitive and accurate method for assessing WHIRI. The diagnostic efficacy of the R2* values was the best for predicting WHIRI above stage S4.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"361"},"PeriodicalIF":2.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973275","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":"Association of clinicopathological factor with lymph node metastasis in rectal cancer patients: a retrospective cohort study.","authors":"Yangfeng Lin, Zhijie You, Zhijing Lin, Siming Wang, Guohua Yang","doi":"10.1186/s12876-025-03960-6","DOIUrl":"10.1186/s12876-025-03960-6","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic inflammatory response (SIR) indicators serve as predictive factors for lymph node metastasis (LNM) in various cancers. This study aimed to investigate the association of platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) with LNM in rectal cancer and to identify clinicopathological factors linked to LNM.</p><p><strong>Methods: </strong>We retrospectively analyzed 181 rectal cancer patients who underwent surgical resection. Preoperative NLR and PLR were calculated from blood samples, with optimal cutoff values determined by receiver operating characteristic (ROC) analysis. Associations between NLR/PLR and clinicopathological features were evaluated, risk factors for LNM were analyzed via univariate and multivariate logistic regression.</p><p><strong>Results: </strong>No significant differences were observed between the high NLR (H-NLR) and low NLR (L-NLR) groups in terms of clinicopathological characteristics, including TNM stage, perineural invasion (PNI), lymphovascular invasion (LVI), or serum levels of CEA and CA19-9 respectively (p > 0.05).In contrast, the high PLR (H-PLR) group showed significantly higher prevalence of several adverse pathological features: The H-PLR group had a higher positive PNI (54.2% vs.25.0%,p = 0.04), greater positive LVI(51.6% vs.28.6%,p = 0.025),and more positive TDs (14.4% vs.0,p = 0.028), increased lymph node metastasis (52.9% vs.17.9%,p < 0.001), more elevated CEA (43.1% vs.14.3%,p = 0.005) and more advanced tumor stage (stage II + stage III,81% vs.67.9%,p = 0.003).Univariate analysis identified several factors significantly associated with LNM: T stage (OR = 3.156, 95%CI:1.580-6.303),positive PNI (OR = 6.182,95%CI:3.242-11.787),positive LVI (OR = 10.271,95%CI:5.177-20.375),H-PLR(OR = 5.175,95%CI:1.870-14.321),positive TDs (OR = 3.390,95%CI:1.261-9.117),TLN(OR = 1.053,95%CI:1.005-1.103),elevated CEA(OR = 3.313,95%CI:1.655-5.920) and elevated CA199 (OR = 2.248,95%CI:1.012-4.992) were correlated with LNM using univariate analysis, but only positive LVI(adjusted OR = 6.203,95%CI:2.892-13.303,p < 0.001) and positive PNI (adjusted OR = 3.086,95%CI:1.341-7.102,p = 0.008) were the independent risk factors for LNM using multivariate analysis.</p><p><strong>Conclusion: </strong>H-PLR but not H-NLR may be associated with LNM, positive LVI and PNI were independent risk factors for LNM in RC.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"358"},"PeriodicalIF":2.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980381","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":"ERMAP attenuates DSS-induced colitis in mice by regulating macrophage and T cell functions.","authors":"Lu Xia, Yiwen Pan, Xianbin Wang, Rong Hu, Jie Gao, Wei Chen, Keke He, Dongbin Cui, Youbo Zhao, Lu Liu, Laijun Lai, Min Su","doi":"10.1186/s12876-025-03840-z","DOIUrl":"10.1186/s12876-025-03840-z","url":null,"abstract":"<p><strong>Background & aims: </strong>Both macrophages and T cells play a critical role in inflammatory bowel disease (IBD) development. Since our previous studies have shown that a novel immune checkpoint molecule erythrocyte membrane-associated protein (ERMAP) affects macrophage polarization and negatively regulates T cell responses, we investigated the effects of ERMAP on DSS-induced colitis progression in mice.</p><p><strong>Methods: </strong>C57BL/6 mice developed a dextran sodium sulfate (DSS) colitis model, treated with control Fc protein (Control Ig) and ERMAP-Fc fusion protein (ERMAP-Ig) for 12 days to assess colitis severity by disease activity index (DAI), weight loss, colon length, histology, flow cytometry, Q-PCR, WB, ELISA, and the effect of adoptive transfer of ERMAP knockout mice (ERMAP^-/-) peritoneal macrophages on DSS colitis mice. In vitro, the effects of the RAW264.7 macrophage cell line that interfered with ERMAP expression on macrophage polarization and T cells were analyzed by flow cytometry.</p><p><strong>Results: </strong>We show here that administration of ERMAP protein significantly increases the proportion of anti-inflammatory M2-type macrophages and inhibits T cell activation and proliferation in DSS-induced colitis mice. Knockdown of ERMAP in RAW264.7 macrophages reduces M2-type macrophage polarization and increases T cell responses. Adoptive transfer of macrophages from ERMAP^-/- exacerbates DSS-induced colitis. Global gene expression analysis by RNA-seq shows that ERMAP inhibits the NOD-like receptor (NLR) protein family pathway in macrophages.</p><p><strong>Conclusions: </strong>In summary, our results suggest that administration of ERMAP can protect DSS-induced colitis in mice by regulating T cell and macrophage functions. This study adds to the evidence for various mechanistic pathways associated to the pathogenesis of IBD, which could subsequently be translated to novel therapeutics.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"362"},"PeriodicalIF":2.5,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973167","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":"Dual energy CT-derived quantitative parameters and hematological characteristics predict pathological complete response in neoadjuvant chemoradiotherapy esophageal squamous cell carcinoma patients.","authors":"Miaomiao Li, Yongbin Cui, Yuanyuan Yan, Junfeng Zhao, Xinjun Lin, Qianyu Liu, Shushan Dong, Mingming Nie, Yong Huang, Baosheng Li, Yong Yin","doi":"10.1186/s12876-025-03964-2","DOIUrl":"https://doi.org/10.1186/s12876-025-03964-2","url":null,"abstract":"<p><strong>Purpose: </strong>There is no gold standard method to predict pathological complete response (pCR) in esophageal squamous cell carcinoma (ESCC) patients before surgery after neoadjuvant chemoradiotherapy (nCRT). This study aims to investigate whether dual layer detector dual energy CT (DECT) quantitative parameters and clinical features could predict pCR for ESCC patients after nCRT.</p><p><strong>Patients and methods: </strong>This study retrospective recruited local advanced ESCC patients who underwent nCRT followed by surgical treatment from December 2019 to May 2023. According to pCR status (no visible cancer cells in primary cancer lesion and lymph nodes), patients were categorized into pCR group (N = 25) and non-pCR group (N = 28). DECT quantitative parameters were derived from conventional CT images, different monoenergetic (MonoE) images, virtual non-contrast (VNC) images, Z-effective (Zeff) images, iodine concentration (IC) images and electron density (ED) images. Slope of spectral curve (λHU), normalized iodine concentration (NIC), arterial enhancement fraction (AEF) and extracellular volume (ECV) were calculated. Difference tests and spearman correlation were used to select quantitative parameters for DECT model building. Multivariate logistic analysis was used to build clinical model, DECT model and combined model.</p><p><strong>Results: </strong>A total of 53 patients with locally advanced ESCC were enrolled in this study who received nCRT combined with surgery and underwent DECT examination before treatment. After spearman correlation analysis and multivariate logistic analysis, AEF and ECV showed significant roles between pCR and non-pCR groups. These two quantitative parameters were selected for DECT model. Multivariate logistic analysis revealed that LMR and RBC were also independent predictors in clinical model. The combined model showed the highest sensitivity, specificity, PPV and NPV compared to the clinical and DECT model. The AUC of the combined model is 0.893 (95%CI: 0.802-0.983). Delong's test revealed the combined model significantly different from clinical model (Z =-2.741, P = 0.006).</p><p><strong>Conclusion: </strong>Dual-layer DECT derived ECV fraction and AEF are valuable predictors for pCR in ESCC patients after nCRT. The model combined DECT quantitative parameters and clinical features might be used as a non-invasive tool for individualized treatment decision of those ESCC patients. This study validates the role of DECT in pCR assessment for ESCC and a large external cohort is warranted to ensure the robustness of the proposed DECT evaluation criteria.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"357"},"PeriodicalIF":2.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969181","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":"A novel framework for esophageal cancer grading: combining CT imaging, radiomics, reproducibility, and deep learning insights.","authors":"Muna Alsallal, Hanan Hassan Ahmed, Radhwan Abdul Kareem, Anupam Yadav, Subbulakshmi Ganesan, Aman Shankhyan, Sofia Gupta, Kamal Kant Joshi, Hayder Naji Sameer, Ahmed Yaseen, Zainab H Athab, Mohaned Adil, Bagher Farhood","doi":"10.1186/s12876-025-03952-6","DOIUrl":"https://doi.org/10.1186/s12876-025-03952-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to create a reliable framework for grading esophageal cancer. The framework combines feature extraction, deep learning with attention mechanisms, and radiomics to ensure accuracy, interpretability, and practical use in tumor analysis.</p><p><strong>Materials and methods: </strong>This retrospective study used data from 2,560 esophageal cancer patients across multiple clinical centers, collected from 2018 to 2023. The dataset included CT scan images and clinical information, representing a variety of cancer grades and types. Standardized CT imaging protocols were followed, and experienced radiologists manually segmented the tumor regions. Only high-quality data were used in the study. A total of 215 radiomic features were extracted using the SERA platform. The study used two deep learning models-DenseNet121 and EfficientNet-B0-enhanced with attention mechanisms to improve accuracy. A combined classification approach used both radiomic and deep learning features, and machine learning models like Random Forest, XGBoost, and CatBoost were applied. These models were validated with strict training and testing procedures to ensure effective cancer grading.</p><p><strong>Results: </strong>This study analyzed the reliability and performance of radiomic and deep learning features for grading esophageal cancer. Radiomic features were classified into four reliability levels based on their ICC (Intraclass Correlation) values. Most of the features had excellent (ICC > 0.90) or good (0.75 < ICC ≤ 0.90) reliability. Deep learning features extracted from DenseNet121 and EfficientNet-B0 were also categorized, and some of them showed poor reliability. The machine learning models, including XGBoost and CatBoost, were tested for their ability to grade cancer. XGBoost with Recursive Feature Elimination (RFE) gave the best results for radiomic features, with an AUC (Area Under the Curve) of 91.36%. For deep learning features, XGBoost with Principal Component Analysis (PCA) gave the best results using DenseNet121, while CatBoost with RFE performed best with EfficientNet-B0, achieving an AUC of 94.20%. Combining radiomic and deep features led to significant improvements, with XGBoost achieving the highest AUC of 96.70%, accuracy of 96.71%, and sensitivity of 95.44%. The combination of both DenseNet121 and EfficientNet-B0 models in ensemble models achieved the best overall performance, with an AUC of 95.14% and accuracy of 94.88%.</p><p><strong>Conclusions: </strong>This study improves esophageal cancer grading by combining radiomics and deep learning. It enhances diagnostic accuracy, reproducibility, and interpretability, while also helping in personalized treatment planning through better tumor characterization.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"356"},"PeriodicalIF":2.5,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963217","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":"Association of cardiometabolic index with gallstone disease and insulin resistance based on NHANES data.","authors":"Liu Yuan, Shuqi Wang, Dong Wang, Enbo Wang","doi":"10.1186/s12876-025-03950-8","DOIUrl":"https://doi.org/10.1186/s12876-025-03950-8","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic index (CMI) is an index integrating visceral obesity and dyslipidemia. This study intends to scrutinize the connection between CMI and gallstone disease (GSD) and to elucidate the association between CMI and insulin resistance (IR) in patients with GSD.</p><p><strong>Methods: </strong>To explore the potential nonlinear association and determine the inflection point, a restricted cubic spline (RCS) analysis was performed. Following categorization of CMI based on the identified inflection point, multivariate logistic regression models, subgroup analyses, and interaction tests were utilized to assess the connection between CMI and GSD, as well as between CMI and IR in GSD patients. The homeostasis model assessment for IR (HOMA-IR) and triglyceride-glucose (TyG) index was applied to evaluate IR. Spearman analysis was implemented to investigate the connection between CMI and HOMA-IR. The predictive performance of each indicator was evaluated by the receiver operating characteristic (ROC) curve and the area under the curve (AUC).</p><p><strong>Results: </strong>The study included 2311 individuals, with a GSD prevalence of 10.90%. RCS analysis revealed a nonlinear positive correlation between CMI and GSD (nonlinear P < 0.001), as well as between CMI and IR (nonlinear P < 0.001). In the fully adjusted multivariable logistic regression analysis of covariates, compared with the low-category CMI group, the high-category CMI was significantly associated with the risk of GSD (OR = 1.547, 95% CI: 1.143-2.092, P = 0.005), IR (OR = 4.990, 95% CI: 2.517-9.892, P < 0.001). Subgroup analysis demonstrated that the correlation between CMI and GSD was stronger in females. Spearman correlation analysis showed a positive association between CMI and HOMA-IR in GSD patients (r = 0.548, P < 0.001). The ROC curve demonstrated the predictive performance of the CMI model for GSD (AUC = 0.743), which was superior to conventional indicators such as Body Mass Index and Waist Circumference; the predictive performance of CMI (AUC = 0.772) for IR was consistent with that of TyG (AUC = 0.772).</p><p><strong>Conclusion: </strong>Our research demonstrates that CMI exhibits a nonlinear positive correlation with the incidence of GSD and IR. This suggests that CMI may serve as a novel and valuable indicator for further investigating the intricate relationships among metabolic syndrome, obesity, and GSD.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"354"},"PeriodicalIF":2.5,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958209","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}