World Journal Of Gastrointestinal Oncology[JOURNAL]
Sun
200 papers
Machine learning survival prediction in esophageal cancer using radiomics and body composition from pretreatment and follow-up T12-level computed tomography.
Liu MC, Cheng YY, Lin SC … +7 more , Lin CH, Chuang CY, Chen WH, Liao CH, Hsieh CH, Hsieh MF, Liu YJ
World J Gastrointest Oncol · 2025 Dec · PMID 41480227 · Full text
BACKGROUND: Esophageal cancer carries a poor prognosis with low 5-year survival rates and limited early detection options. The skeletal muscle index at the L3 vertebral level is a well-established prognostic marker in es...
BACKGROUND: Esophageal cancer carries a poor prognosis with low 5-year survival rates and limited early detection options. The skeletal muscle index at the L3 vertebral level is a well-established prognostic marker in esophageal cancer, but most follow-up computed tomography (CT) scans do not extend to L3 and limiting its utility. Radiomics has emerged as a powerful tool for extracting prognostic information from medical images. AIM: To evaluate the influential features for esophageal cancer prognosis by integrating radiomic and body composition-based indices of skeletal muscle and adipose tissue at the T12 level from both pretreatment and follow-up CT images, in order to assess their value in predicting overall survival (OS). METHODS: This retrospective study included 212 esophageal cancer patients who underwent concurrent chemoradiotherapy, with both pretreatment and follow-up chest CT scans available. Body organ analysis (BOA) and radiomic features were extracted from skeletal muscle and adipose tissue at the T12 level using automated tools. Four feature subsets (no-radiomics, pretreatment only, follow-up only, and combined inputs) were developed using logistic regression (LR) with least absolute shrinkage and selection operator for feature selection, followed by Cox regression. Prognostic models - including nomogram, support vector classifier, LR, and extra trees classifier - were constructed to predict 1-, 2-, and 3-year OS. RESULTS: The model integrating both BOA and radiomics from pretreatment and follow-up CT, combined with clinical data, achieved the best performance for 2-year OS prediction, with an area under the time-dependent receiver operating characteristic curve of 0.91, sensitivity of 0.81, and specificity of 0.88 using the LR model. The most predictive features included both clinical variables, body composition indices, and radiomic features, particularly from follow-up VAT. Follow-up imaging contributed significantly to model performance, reinforcing its value in treatment response evaluation. CONCLUSION: This is the first study to demonstrate that BOA indices and their corresponding radiomics at the T12-level from both pretreatment and follow-up CT scans - combined with clinical data - can provide accurate prognostic information for esophageal cancer. This approach offers a practical alternative when L3-level imaging is unavailable and supports the clinical integration of automated T12-based imaging biomarkers. The integration of these imaging features with clinical parameters enhances the prediction of survival outcomes and contributes to non-invasive, personalized treatment planning.
Exosomal miR-191 promotes colorectal cancer progression by inducing M2 macrophage polarization and inhibiting ferroptosis.
Zhao QY, Wei SJ
World J Gastrointest Oncol · 2025 Dec · PMID 41480226 · Full text
BACKGROUND: Multiple exosomal microRNAs were reported to have a significant role in colorectal cancer (CRC) cells. The function and mechanism of exosomal miR-191 in CRC have not been clearly elucidated. AIM: To explore t...
BACKGROUND: Multiple exosomal microRNAs were reported to have a significant role in colorectal cancer (CRC) cells. The function and mechanism of exosomal miR-191 in CRC have not been clearly elucidated. AIM: To explore the roles of miR-191 in CRC. METHODS: Supernatant exosomes from CRC cells were extracted and identified. After coculture, macrophage polarization was determined using flow cytometry for the markers cluster of differentiation (CD) 68 and CD163, enzyme-linked immunosorbent assay for the cytokines interleukin (IL)-4 and IL-10, western blotting for chitinase-like protein 3 and arginase-1 expression, and immunofluorescent staining for 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate. Reactive oxygen species (ROS) level, ferroptosis-related proteins ( and ), and apoptosis were determined with flow cytometry, western blotting, and TUNEL staining. We performed in vivo experiments to determine the function of exosomal miR-191 and M2 macrophage polarization. RESULTS: We successfully isolated exosomes from CRC cells. Inhibition of miR-191 in CRC cells suppressed M2 polarization of macrophages. After coculture of macrophages, inhibition of miR-191 induced ROS production, ferroptosis, and apoptosis of CRC cells. Silencing of exosomal miR-191 from CRC cells prevented M2 polarization of macrophages, and weakened CRC development by inducing ferroptosis. Exosomal miR-191 accelerated cancer progression in CRC nude mice by promoting M2 polarization of macrophages. CONCLUSION: Inhibition of exosomal miR-191 attenuated CRC progression by inducing ferroptosis in macrophages. This study revealed a novel mechanism by which exosomal miR-191 modulates the tumor microenvironment.
Safety and efficacy of cryoablation in treating locally advanced pancreatic cancer.
Kang LM, He XL, Lang L … +7 more , Wang AY, Wang X, Liu YH, Zhao YH, Xu L, Yu FK, Zhang FW
World J Gastrointest Oncol · 2025 Dec · PMID 41480225 · Full text
BACKGROUND: Pancreatic cancer has an extremely poor prognosis. Although surgery is the first-line treatment for pancreatic cancer, its role is ultimately limited because patients often present too late for resection. Thu...
BACKGROUND: Pancreatic cancer has an extremely poor prognosis. Although surgery is the first-line treatment for pancreatic cancer, its role is ultimately limited because patients often present too late for resection. Thus, multidisciplinary treatment approaches are needed. In particular, chemotherapy, targeted therapy, and immunotherapy can be ineffective for locally advanced pancreatic cancer (LAPC) because of its resistance to these modalities, but cryoablation has shown significant promise for treating this entity and prolonging survival. AIM: To investigate the safety and efficacy of cryoablation for LAPC. METHODS: Clinical and laboratory data, including surgical procedure, postoperative complications, immunobiochemical markers (, carbohydrate antigen 19-9), and follow-up visits, of 24 LAPC patients treated with cryoablation at the department of hepatobiliary and pancreatic surgery of our hospital from January 2023 to December 2024 were retrospectively analyzed. RESULTS: Surgery was smooth in all patients, with no perioperative deaths. Postoperative pancreatic fistulas occurred in 18 patients (75.0%), including biochemical leak in 14 cases and grade B (fistula) in 4 cases. Three patients (12.5%) had delayed gastric emptying. The carbohydrate antigen 19-9 level remained low on postoperative day 30 ( < 0.05). Immune markers (natural killer cells and tumor necrosis factor-alpha) significantly increased on days 7 and 30 ( < 0.01 or < 0.05), whereas cluster of differentiation CD4+ T cells levels on day 30 significantly differed from baseline. Day 30 pain scores were significantly lower than preoperative ones ( < 0.01). Tumor volume was reduced on postoperative computed tomography. Survival was prolonged. The overall survival time of LAPC patients treated with cryoablation was 16.8 months. CONCLUSION: Cryoablation can directly inactivate LAPC and boost immunity, thus delaying tumor progression, alleviating pain, improving quality of life, and prolonging survivals. Therefore, it is a safe and effective treatment option for LAPC.
Exploring the improvement effect of intestinal network monitoring system on intestinal preparation quality of colonoscopy.
Xi MJ, Gong YP, Tao J … +6 more , Li F, Xu MY, Gu X, Bao H, Jiang S, Xu B
World J Gastrointest Oncol · 2025 Dec · PMID 41480224 · Full text
BACKGROUND: Colonoscopy quality relies heavily on adequate bowel preparation, yet traditional methods often result in suboptimal compliance. Emerging network-based monitoring systems offer promise for improving both prep...
BACKGROUND: Colonoscopy quality relies heavily on adequate bowel preparation, yet traditional methods often result in suboptimal compliance. Emerging network-based monitoring systems offer promise for improving both preparation quality and patient cooperation, potentially enhancing clinical outcomes. AIM: To evaluate the effectiveness of an intestinal network monitoring system in enhancing the quality of bowel preparation for colonoscopy and its impact on patient psychological and physiological responses, compliance, and adverse event rates. METHODS: Between July 2019 and July 2020, 800 enteroscopy patients who met the inclusion criteria in the outpatient clinic of the gastroenterology department of our hospital were randomly divided into 400 cases each in the experimental group (network monitoring group) and the control group (verbal + written preaching group), and the psychological and physiological stress response situation, colon Boston Bowel Preparation Scale, enteroscopy to blindness, arrival time to blindness, and polyp detection rate of the patients were compared before and after the intervention, compliance and adverse reactions were compared. RESULTS: There was no difference in anxiety and depression scores, heart rate and systolic blood pressure between the groups before the intervention ( > 0.05), and after the intervention, the patients' anxiety and depression scores were lower and lower in the study group ( < 0.05); heart rate and systolic blood pressure were elevated, but lower in the test group ( < 0.05). The left hemicolon, right hemicolon, transverse colon and total Boston Bowel Preparation Scale scores were lower in the test group than in the control group ( < 0.05), the colonoscopy arrival rate and polyp detection rate were higher than those in the control group, and the time to arrival and time to exit the scope were shorter than those in the control group ( < 0.05), and the dietary preparations, the preparations for taking medications and the total adherence scores were higher than those in the control group ( < 0.05). The incidence of adverse reactions in the experimental group was 11.00%, which was lower than that in the control group ( < 0.05). CONCLUSION: The Bowel Network Monitoring System has potential clinical promotion value in improving the quality of colonoscopic bowel preparation, which can effectively alleviate patient anxiety and depression, improve the quality of colonoscopic bowel preparation and patient compliance, and has a high degree of safety.
Early and late-onset colorectal cancer in African Americans during COVID-19.
Chirumamilla LG, Brim H, Challa SR … +13 more , Oskrochi G, Deverapalli M, Rashid R, Rashid M, Aduli F, Kibreab A, Laiyemo A, Sherif ZA, Shayegh N, Shokrani B, Zafar R, Carethers JM, Ashktorab H
World J Gastrointest Oncol · 2025 Dec · PMID 41480223 · Full text
BACKGROUND: The incidence of early-onset colorectal cancer (EOCRC, < 45 years of age at onset) is on the rise among adults, including African Americans (AA). AIM: To examine differences between EOCRC and late-onset color...
BACKGROUND: The incidence of early-onset colorectal cancer (EOCRC, < 45 years of age at onset) is on the rise among adults, including African Americans (AA). AIM: To examine differences between EOCRC and late-onset colorectal cancer (LOCRC) among AA patients and any effect during coronavirus disease (COVID) by comparing data during pre-COVID (2015-2019) and the COVID era (2020-2023). METHODS: We conducted a retrospective review of Howard University Hospital records from 2015 to 2023 for colorectal cancer patients that included demographics, clinicals, pathology, and colonoscopy records. A three-year interval analysis was performed to compare post-COVID era (2020-2023) to preceding years to discern temporal trends. RESULTS: The study included 138 LOCRC and 13 EOCRC cases of which > 80% of patients were AA. Compared to pre-COVID, LOCRC cases increased in number from 55 to 83, and EOCRC cases increased from 6 to 7 during COVID. There was no change in mean age for LOCRC (64.7 years 65.3 years) but mean age increased for EOCRC (37.3 years 41.5 years). Males predominated in both groups particularly during the pandemic. More than 65% of LOCRC patient colonoscopies were for diagnostic purposes. Gastrointestinal bleeding as a colonoscopy indication and reduced bowel preparation quality were increased during the pandemic. EOCRC patients showed a shift from stage 4 (49.2%) to stage 2 (30%) and LOCRC patients staging trends changed from stage 4 (40%) to stage 3 (28.6%). CONCLUSION: We report increase in colorectal cancer cases during the COVID-19 era, especially among young AA males. EOCRC and LOCRC patients showed distal location predominance, most commonly in recto-sigmoid region. The decrease in staging or metastasis, which might be due to growing awareness and earlier detection among patients.
Advanced gastric small cell carcinoma with immunotherapy-based treatment: A case report.
Zhang XL, Zhang JY, Xie L … +2 more , Li H, Wang L
World J Gastrointest Oncol · 2025 Dec · PMID 41480222 · Full text
BACKGROUND: The clinical and pathological characteristics of primary gastric small cell carcinoma (GSCC) resemble those of small cell lung cancer, which is less sensitive to chemotherapy and has a poor prognosis. Current...
BACKGROUND: The clinical and pathological characteristics of primary gastric small cell carcinoma (GSCC) resemble those of small cell lung cancer, which is less sensitive to chemotherapy and has a poor prognosis. Currently, platinum-etoposide chemotherapy is a primary chemotherapy regimen for small cell carcinoma, but it is still imperfect. Programmed cell death ligand 1 (PD-L1) inhibitors are recommended for the treatment of small cell lung cancer. However, to determine whether PD-L1 inhibitors are optimal for metastatic GSCC requires more clinical data. CASE SUMMARY: A 67-year-old male experienced upper abdominal pain without any obvious cause for 1 week. Gastroscopy examination revealed a mass in the gastric body. Pathological examination of the biopsy specimen combined with immunohistochemistry showed a high-grade neuroendocrine carcinoma (small cell carcinoma). Genetic tests showed , , , , , and gene mutations. Computed tomography (neck + chest + abdomen) showed multiple enlarged lymph nodes, occupying space in the greater curvature of the stomach and intrahepatic metastases. A regimen consisting of cisplatin and etoposide combined with durvalumab was administered every three weeks as palliative chemotherapy, for seven cycles. Durvalumab was then maintained every three weeks. However, the tumor recurred two months after the completion of chemotherapy. A regimen consisting of carboplatin and irinotecan combined with durvalumab was then given every three weeks. The tumor in the gastric body and liver shrank significantly, and the patient did not report any specific discomfort. CONCLUSION: GSCC is a highly malignant tumor with a poor prognosis. Whether immune-related drugs are optimal for metastatic GSCC requires further exploration.
Involvement of bile acids in cholangiocarcinoma progression the Hippo-yes-associated protein signaling pathway.
Hu J, Zhang G, Yang S … +4 more , Shen XF, Zhou M, Huang LS, Lan HM
World J Gastrointest Oncol · 2025 Dec · PMID 41480221 · Full text
BACKGROUND: Cholangiocarcinoma (CCA) is a highly aggressive malignancy with limited therapeutic options. Dysregulation of the Hippo-yes-associated protein (YAP) signaling pathway plays a key role in tumor progression, bu...
BACKGROUND: Cholangiocarcinoma (CCA) is a highly aggressive malignancy with limited therapeutic options. Dysregulation of the Hippo-yes-associated protein (YAP) signaling pathway plays a key role in tumor progression, but the effects of distinct bile acids on this pathway remain unclear. AIM: To investigate the roles of glycochenodeoxycholic acid (GDCA) and deoxycholic acid (DCA) in CCA progression through Hippo-YAP signaling and to evaluate the effects of YAP-targeted interventions. METHODS: The experiments were performed using HuCCT1 CCA cells treated with GDCA, DCA, and combinations with a YAP inhibitor (verteporfin) or agonist (GA-017). Key molecular changes in the Hippo-YAP pathway were assessed by western blot, immunofluorescence, and reverse transcription quantitative real-time polymerase chain reaction. Functional assays, including Cell Counting Kit-8, 5-ethynyl-2'-deoxyuridine, Transwell, and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-nick end labelling, were conducted to evaluate cell proliferation, migration, invasion, and apoptosis. , nude mice bearing subcutaneous HuCCT1 tumors were treated with GDCA, DCA, or combined YAP modulators. Tumor growth was monitored, and molecular analyses of tumor tissues were performed using western blot. RESULTS: The GDCA significantly activated YAP by reducing mammalian STE20-like protein kinase 1 and large tumor suppressor 1 phosphorylation, promoting YAP nuclear translocation, and enhancing tumor cell proliferation, migration, and invasion. In contrast, DCA inhibited YAP activation, suppressed tumor cell functions, and increased apoptosis. GDCA combined with YAP inhibitors attenuated its tumor-promoting effects, while DCA combined with YAP agonists reversed its inhibitory effects. , GDCA accelerated tumor growth, while DCA reduced tumor size and weight, with molecular changes consistent with findings. CONCLUSION: The GDCA and DCA exert opposing effects on CCA progression through Hippo-YAP signaling. GDCA promotes tumor growth YAP activation, while DCA inhibits these processes. YAP-targeted interventions demonstrate therapeutic potential, providing insights into new treatment strategies for CCA.
Optimized digital polymerase chain reaction enables detection of telomerase reverse transcriptase C228T mutation for prognostic assessment in hepatocellular carcinoma.
Aizimuaji Z, Hu N, Li HY … +8 more , Wang XJ, Ma S, Wang YR, Zheng RQ, Li Z, Zhao H, Rong WQ, Xiao T
World J Gastrointest Oncol · 2025 Dec · PMID 41480220 · Full text
BACKGROUND: Recurrence remains the leading cause of poor prognosis in hepatocellular carcinoma (HCC), particularly among patients infected with hepatitis B virus (HBV). The telomerase reverse transcriptase (TERT) promote...
BACKGROUND: Recurrence remains the leading cause of poor prognosis in hepatocellular carcinoma (HCC), particularly among patients infected with hepatitis B virus (HBV). The telomerase reverse transcriptase (TERT) promoter is the most frequently mutated site in HBV-related HCC; however, its prognostic significance is not fully established. AIM: To evaluate the prognostic impact of TERT promoter mutations and efficiency of digital polymerase chain reaction (dPCR). METHODS: A total of 66 HBV-related HCC patients who underwent hepatectomy were enrolled in this study. DNA extracted from fresh tumor tissues was analyzed for TERT promoter mutations using Sanger sequencing and dPCR. The dPCR assay was optimized by adding 7-deaza-dGTP, CviQ1, and ethylenediaminetetraacetic acid to improve detection sensitivity. Concordance between methods was assessed, and nomogram survival prediction models were developed to evaluate prognostic value based on mutation status. RESULTS: TERT promoter mutations were detected in 26/66 (39.39%) cases by Sanger sequencing and 30/66 (45.45%) by dPCR. The two methods showed high concordance (93.939%, = 0.876), with dPCR demonstrating 100% sensitivity and 90% specificity. Patients harboring TERT promoter mutations exhibited reduced overall survival and higher recurrence risk. Nomogram models successfully distinguished mutant from non-mutant cases for both overall survival (C-index: 0.7651) and disease-free survival (C-index: 0.6899). CONCLUSION: TERT promoter mutation predicts poor prognosis in HBV-related HCC and serves as a biomarker for risk stratification. Optimized dPCR outperforms Sanger sequencing, and nomograms with TERT status guide precision therapy.
Prognostic significance of preoperative C-reactive protein-triglyceride-glucose index in long-term outcomes after radical gastrectomy for gastric cancer.
Hao QL, Yao ZY, Shen YM … +5 more , Li ZY, Gao HC, Hong XY, Li GC, Gao C
World J Gastrointest Oncol · 2025 Dec · PMID 41480219 · Full text
BACKGROUND: Gastric cancer, a globally prevalent malignant tumor, continues to exhibit high incidence and mortality rates. Although radical gastrectomy remains the primary treatment for this disease, postoperative compli...
BACKGROUND: Gastric cancer, a globally prevalent malignant tumor, continues to exhibit high incidence and mortality rates. Although radical gastrectomy remains the primary treatment for this disease, postoperative complications frequently arise, negatively impacting short-term recovery and significantly reducing patients' quality of life. In this context, accurately predicting the risk of postoperative recurrence and metastasis, coupled with targeted interventions, could substantially improve patient outcomes. The C-reactive protein-triglyceride-glucose index (CTI), a composite biomarker that integrates metabolic disturbances and systemic inflammation, has garnered increasing attention in oncology. The prognostic nutritional index (PNI), a composite measure based on serum albumin and peripheral blood lymphocyte count, is used to evaluate both the nutritional status and systemic immune function of patients. In recent years, both the CTI and PNI have demonstrated significant prognostic value in predicting tumor outcomes, assessing treatment responses, and formulating personalized treatment strategies. AIM: To investigate whether the combined inflammation and insulin resistance marker, the CTI, can serve as a prognostic indicator for patients undergoing radical gastrectomy for gastric cancer. Additionally, it seeks to develop a predictive model by incorporating the PNI alongside CTI. METHODS: This retrospective study included a total of 300 patients who underwent radical gastrectomy. The patients were classified into high and low CTI groups based on their CTI index. Cox proportional hazards regression analysis was performed to identify independent prognostic factors influencing overall survival (OS) and disease-free survival (DFS), and two nomogram models were developed. RESULTS: Of the included patients, 131 had a high CTI and 169 had a low CTI. The DFS period of the low CTI group was significantly longer than that of the high CTI group. The number of postoperative adjuvant treatments, T stage, N stage, CTI, and PNI were identified as independent prognostic factors for DFS. The hazard ratio for CTI was 2.07 (95% confidence interval: 1.36-3.17, < 0.001). In terms of OS, the OS period of the low CTI group was significantly longer than that of the high CTI group. Whether adjuvant treatment was administered, T stage, CTI, and PNI were independent prognostic factors for OS. The hazard ratio for CTI was 2.47 (95% confidence interval: 1.44-4.23, = 0.001). The nomogram models for OS and DFS further emphasized the importance of CTI as a key predictor of patient prognosis. CONCLUSION: CTI is a long-term prognostic indicator for the outcome of radical gastrectomy for gastric cancer. Patients with lower CTI values have a better prognosis. The prediction models constructed by combining CTI with PNI has good predictive ability for DFS and OS after radical gastrectomy.
Cancer-associated fibroblasts, clinicopathological characteristics and prognosis of liver cancer: A systematic review and meta-analysis based on real-world research.
Wei YH, Jiang WJ, Wang SQ … +2 more , Cai YL, Ma XL
World J Gastrointest Oncol · 2025 Dec · PMID 41480218 · Full text
BACKGROUND: Cancer-associated fibroblasts (CAFs), crucial components of the tumor microenvironment in primary and metastatic tumors, can impact the activity of cancer cells and contribute to their progression. Given thei...
BACKGROUND: Cancer-associated fibroblasts (CAFs), crucial components of the tumor microenvironment in primary and metastatic tumors, can impact the activity of cancer cells and contribute to their progression. Given their extensive interactions with cancer cells and other stromal cells, we aimed to evaluate the prognostic value of CAFs in patients with liver cancer (LC). AIM: To investigate the association between CAF expression and clinicopathological characteristics as well as overall survival (OS) in patients with LC, including hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA). METHODS: We performed a meta-analysis of cohort studies with available data on the effects of CAF expression on both clinicopathological characteristics and OS hazard ratios (HRs) and risk ratios with 95% confidence intervals (CIs). Studies were subgrouped on the basis of CAF markers and cancer type, and the subgroup effects of CAF expression on both HCC and iCCA were analyzed through meta-regression. The Newcastle-Ottawa Scale was used to evaluate the included studies to guarantee their quality and minimize the possibility of bias. RESULTS: Nine trials were selected and included a total of 1518 patients. According to our primary meta-analysis, the expression of CAFs in LC patients was significantly associated with a decrease in OS (LC: HR: 1.62; 95%CI: 1.34-1.97; < 0.001; HCC: HR: 1.67; 95%CI: 1.34-2.07; < 0.001; iCCA: HR: 1.47; 95%CI: 0.97-2.23; = 0.07); nevertheless, it was not significantly associated with almost all clinicopathologic characteristics, including tumor size, venous infiltration, alpha-fetoprotein level, and differentiation grade. According to the subgroup analysis of smooth muscle actin (SMA) markers in both HCC patients and iCCA patients, high CAF expression in HCC (HR: 2.29; 95%CI: 1.01-5.22; = 0.048) and iCCA (HR: 2.04; 95%CI: 1.09-3.81; = 0.025) patients was a significant indicator of poor OS. Moreover, the clinicopathological characteristics were also verified by the SMA marker, which had a nearly significant effect on the venous infiltration of iCCA (risk ratio: 2.70; 95%CI: 0.97-7.49; = 0.057). CONCLUSION: High CAF expression, evaluated by both mixed markers and SMAs, is significantly associated with poor OS in patients with LC, including both HCC patients and iCCA patients. However, further research is necessary since how CAF expression and clinicopathologic features are related is yet unknown.
Novel insights into SLC16A8 in colorectal cancer.
Li JY, Ji G, Dang YQ
World J Gastrointest Oncol · 2025 Dec · PMID 41480217 · Full text
Colorectal cancer (CRC) ranks as the third most prevalent cancer globally, and hypoxia-induced metabolic reprogramming is considered a key driver of its malignant progression. We read with interest the article by Tian ,...
Colorectal cancer (CRC) ranks as the third most prevalent cancer globally, and hypoxia-induced metabolic reprogramming is considered a key driver of its malignant progression. We read with interest the article by Tian , which examines the role of solute carrier family 16 member 8 (SLC16A8) in regulating the tumor microenvironment. The study provides valuable evidence supporting the dual mechanisms by which SLC16A8 influences CRC pathogenesis and offers new directions for clinical research. This work demonstrates that activation of the HIF-1α/SLC16A8 axis under hypoxic conditions enhances glycolytic flux and lactate production. Additionally, SLC16A8 facilitates lactate transport, thereby inducing endothelial-mesenchymal transition-a finding that underscores its functional significance in shaping the tumor microenvironment. We believe the mechanistic insights presented in this study contribute meaningfully to the understanding of CRC biology. We would like to share our interpretations and hope to further discuss with the authors certain unexplored aspects and potential connections in this area.
Prognosis of intensive care unit patients with colorectal cancer.
Liao YT, Zhu WL
World J Gastrointest Oncol · 2025 Dec · PMID 41480216 · Full text
This letter provides commentary on the manuscript "Intensive care unit outcomes and prognostic factors of colorectal cancer". The study is the first to present multicenter data on the 90-day mortality of patients with co...
This letter provides commentary on the manuscript "Intensive care unit outcomes and prognostic factors of colorectal cancer". The study is the first to present multicenter data on the 90-day mortality of patients with colorectal cancer admitted to the intensive care unit, and identifies chemotherapy history, elective surgery, and conventional oxygen therapy as independent prognostic factors. We propose three refinements to enhance the study's clinical utility: Clarify chemotherapy details, including regimen and treatment phase, along with the surgical approach (curative palliative) and how preoperative tumor staging influences prognosis; elucidate the relationship between intensive care unit admission etiologies and prognosis; and incorporate colorectal cancer-specific biomarkers to optimize prognostic scoring systems. The study's core contribution is substantial, and refinement of the details will further enhance its clinical translational relevance.
Clinical significance of citrullinated glial fibrillary acidic protein in predicting outcomes in hepatocellular carcinoma.
Cho YA, Shin DW, Kim MJ … +7 more , Park JW, Choe JY, Lee JW, Moon SH, Ishigami A, Choi EK, Kim SE
World J Gastrointest Oncol · 2025 Dec · PMID 41480215 · Full text
BACKGROUND: Citrullination is a post-translational modification mediated by calcium-dependent peptidylarginine deiminases that results in notable changes in protein structure and function. Glial fibrillary acidic protein...
BACKGROUND: Citrullination is a post-translational modification mediated by calcium-dependent peptidylarginine deiminases that results in notable changes in protein structure and function. Glial fibrillary acidic protein (GFAP), which is highly vulnerable to peptidylarginine deiminases-mediated modification, has been found to be elevated in activated hepatic stellate cells, with GFAP-positive hepatic stellate cells and myofibroblasts accumulating within and around areas of hepatic fibrosis. Although recent studies have shown that the expression of citrullinated GFAP (cit-GFAP) increases during hepatic fibrosis, its expression pattern and functional roles in hepatocellular carcinoma (HCC) remain unclear. AIM: To determine whether cit-GFAP expression influences the recurrence and survival of patients undergoing hepatic resection for HCC. METHODS: We retrospectively analyzed 169 patients with HCC who underwent hepatic resection. Based on the immunohistochemical staining of resected specimens, the enrolled patients were stratified into two groups according to cit-GFAP expression: Low (-/1 +) or high (2 +/3 +) levels of expression. Kaplan-Meier survival curves were constructed to assess overall survival and recurrence-free survival, and comparisons between groups were performed using the log-rank test. RESULTS: The median follow-up duration was 33 months (range, 1-183). High cit-GFAP expression, identified in 81 patients (48.2%), was significantly associated with male sex, hepatitis B virus positivity, and higher Edmonson-Steiner grade. No associations were found between age, diabetes, hypertension, cirrhosis, Child-Pugh classification, major portal vein invasion, hematological or biochemical parameters, tumor size, or number. Patients exhibiting high cit-GFAP expression demonstrated significantly poorer overall survival. Multivariate Cox analysis identified large tumor size (hazard ratio: 2.967; 95% confidence interval: 1.097-8.024; 0.032) and high cit-GFAP expression (hazard ratio: 2.753; 95% confidence interval: 1.015-7.464; = 0.047) as independent predictors of poor postoperative survival. Although recurrence rates were high in patients with high cit-GFAP expression, the difference was not statistically significant. CONCLUSION: Following curative resection in patients with HCC, high cit-GFAP expression may serve as a potential prognostic biomarker, although further validation through independent cohort studies is warranted.
Investigating radiotherapy's impact on intestinal perforation risk in gastrointestinal tumor patients treated with bevacizumab.
He WM, Li WS
World J Gastrointest Oncol · 2025 Dec · PMID 41480214 · Full text
BACKGROUND: Gastrointestinal tumors are among the most common and deadly cancers globally, with radiotherapy and bevacizumab being key treatment strategies. Radiotherapy uses high-energy radiation to target DNA, reducing...
BACKGROUND: Gastrointestinal tumors are among the most common and deadly cancers globally, with radiotherapy and bevacizumab being key treatment strategies. Radiotherapy uses high-energy radiation to target DNA, reducing tumor size and alleviating symptoms. Bevacizumab, a targeted therapy, inhibits angiogenesis and tumor growth, particularly in advanced gastrointestinal cancers. However, both treatments can cause adverse gastrointestinal effects, such as intestinal mucosal damage and perforation. While research on the risk of intestinal perforation has grown, the underlying mechanisms remain underexplored. This study aims to compare the incidence of intestinal perforation and survival rates in patients treated with radiotherapy combined with bevacizumab bevacizumab alone. AIM: To investigate the effect of radiotherapy on the risk of intestinal perforation in patients with colon cancer treated with bevacizumab. METHODS: A total of 70 patients diagnosed with gastrointestinal malignancies admitted to our hospital from January 2023 to December 2024 were selected as research subjects. According to different treatment methods, 70 patients were divided into the bevacizumab only group (receiving bevacizumab treatment) and the bevacizumab + radiotherapy group (receiving radiotherapy combined with bevacizumab treatment), with 35 cases in each group. The two groups were compared in terms of clinical efficacy, incidence of intestinal perforation, serum tumor marker levels, overall survival and progression-free survival, levels of angiogenic factors, and adverse reactions. RESULTS: Compared with the group treated with bevacizumab alone, the group treated with bevacizumab plus radiotherapy showed significant improvements in effective rate, overall survival, and progression-free survival ( < 0.05); the probability of intestinal perforation in the bevacizumab + radiotherapy group was 13.33%, while the probability of intestinal perforation in the bevacizumab group was 0. There was a statistically significant difference in the incidence of intestinal perforation between the two groups ( = 0.039). Following treatment, the levels of carbohydrate antigen (CA) 125, CA199, and CA153 in patients were significantly reduced ( < 0.05). CONCLUSION: Radiation therapy may increase the risk of intestinal perforation in colon cancer patients receiving bevacizumab treatment. In clinical applications, the risks of combined use of radiotherapy and bevacizumab should be fully considered and personalized treatment plans should be formulated.
Transient receptor potential melastatin 6 and transient receptor potential melastatin 6/7 antagonists suppress colon adenocarcinoma HT-29 cells.
Kampuang N, Chamniansawat S, Pongkorpsakol P … +2 more , Treveeravoot S, Thongon N
World J Gastrointest Oncol · 2025 Dec · PMID 41480213 · Full text
BACKGROUND: Magnesium (Mg) plays a fundamental role in numerous cellular processes, including enzymatic reactions, DNA replication, oxidative stress response, and cytoskeletal dynamics. In fact, dysregulation of Mg homeo...
BACKGROUND: Magnesium (Mg) plays a fundamental role in numerous cellular processes, including enzymatic reactions, DNA replication, oxidative stress response, and cytoskeletal dynamics. In fact, dysregulation of Mg homeostasis has been increasingly associated with the development and progression of cancer, particularly colorectal cancer (CRC). Transient receptor potential melastatin (TRPM) channels, especially TRPM6 and TRPM7, are essential regulators of epithelial Mg influx. While TRPM7 promotes CRC progression, the role of TRPM6 and TRPM6/7 channels remains unclear. AIM: To investigate the role of membrane-localized TRPM6 and TRPM6/7 channels in Mg influx, spheroid (SP) formation, stemness, and migration. METHODS: We used parental and SP-derived HT-29 cells at comparable passages as models. Mass spectrometry confirmed full-length sequences, phosphorylation, and methionine oxidation of TRPM6 and TRPM7. Mg influx, total and free Mg levels were measured by fluorescence imaging and biochemical assays. TRPM6 / TRPM7 expression and markers were analyzed by western blot. Functional assays, including secondary SP formation and wound healing, assessed stemness and migration. Cells were treated with Mg transport inhibitors: Co(III)hexamine, 2-aminoethyl diphenylborinate (TRPM6/7 blocker), and Mesendogen (TRPM6 inhibitor). RESULTS: The expression of membrane-bound TRPM6, TRPM7, and TRPM6/7 was significantly higher in SP cells than in parental cells. Mass spectrometric analysis confirmed the presence of full-length TRPM6 and TRPM7 with increased phosphorylation and oxidation in SP cells. Enhanced Mg influx and total intracellular Mg levels were observed in SP cells. Free ionized intracellular Mg levels remained comparable across all experimental groups. Pharmacological inhibition of TRPM6 and TRPM6/7 significantly reduced Mg influx, decreased total Mg content, compromised CRC SP stability, abolished cancer stem-like properties, impaired cell migration, and downregulated pro-tumorigenic markers, including Nanog, cyclooxygenase-2, and matrix metalloproteinase-9. CONCLUSION: Membrane-localized TRPM6 and TRPM6/7 channels regulate Mg influx and promote CRC stemness, SP stability, and migration, highlighting their potential as therapeutic targets to inhibit CRC progression and metastasis.
Molecular mechanism of non-coding RNAs-mediated radiosensitivity regulation in colorectal cancer.
Li X, Hao XX, Zhu RQ … +1 more , Zhou HW
World J Gastrointest Oncol · 2025 Dec · PMID 41480212 · Full text
Colorectal cancer (CRC) remains a formidable global health challenge and is associated with dismal survival outcomes and high mortality among patients diagnosed at advanced stages. Despite advancements in early screening...
Colorectal cancer (CRC) remains a formidable global health challenge and is associated with dismal survival outcomes and high mortality among patients diagnosed at advanced stages. Despite advancements in early screening and therapeutic interventions, the outcomes of patients with advanced-stage CRC remain suboptimal, as these patients continue to exhibit a persistently low 5-year survival rate. Palliative radiotherapy (RT) is crucial for advanced CRC patients, but radioresistance remains a significant clinical challenge. This resistance is attributed to multiple mechanisms, such as genetic heterogeneity, dysregulated DNA damage repair and tumor microenvironment metabolic disorders. Recent studies have shown that noncoding RNAs (ncRNAs), mainly microRNAs, long ncRNAs (lncRNAs) and circular RNAs, play pivotal roles in regulating CRC radiosensitivity through diverse mechanisms, such as epithelial-mesenchymal transition, epigenetic reprogramming, posttranscriptional regulation and oncogenic signaling pathway activation. For example, microRNAs such as miR-141-3p and miR-630 enhance CRC radiosensitivity by targeting oncogenic pathways. In addition, lncRNAs, including the lncRNAs HOTAIR and LINC00630, influence the radiosensitivity of CRC through interactions with the DNA damage repair machinery and epigenetic modulators, respectively. In addition, circ_0124554 acts as a competitive endogenous RNA to regulate oncogenic signaling. ncRNAs also serve as potential biomarkers for predicting radiosensitivity and prognosis. This review synthesizes the current evidence on the ncRNA-mediated regulatory networks that influence CRC radiosensitivity, emphasizing their potential as therapeutic targets to overcome RT resistance and improve outcomes in advanced CRC. By bridging mechanistic insights with clinical applications, this work aims to guide future research and the implementation of precision RT strategies.
Bidirectional relationship between depression and the risk and prognosis of gastric cancer.
Chen Z, Gong TJ, Zhao L
World J Gastrointest Oncol · 2025 Dec · PMID 41480211 · Full text
Gastric cancer (GC) is a highly prevalent and life-threatening malignant tumor worldwide, posing a serious threat to human health. Depression is also highly prevalent among patients with GC. A complex bidirectional relat...
Gastric cancer (GC) is a highly prevalent and life-threatening malignant tumor worldwide, posing a serious threat to human health. Depression is also highly prevalent among patients with GC. A complex bidirectional relationship exists between the two. A total of 52 articles were included in this study to synthesize the evidence on the association between depression and the risk of GC as well as the prognosis of affected patients. The findings indicated that depression can activate the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, promote the release of catecholamine neurotransmitters, and influence the proliferation, invasion, and metastasis of GC through signaling pathways such as the β2-adrenergic receptor. Furthermore, the severity of depression is positively correlated with indicators of GC progression. At the same time, GC can induce or aggravate depression through psychological and cognitive factors, social environment interactions, and diverse pathophysiological mechanisms, including tumor biological characteristics, treatment-related damage, and metabolic disorders. These interactions form a vicious cycle. This minireview summarizes the existing evidence and provides a theoretical basis for clinical interventions aimed at improving treatment outcomes and quality of life in patients with GC.
Application of multimodal fusion technology in early recurrence prediction and pathological analysis of hepatocellular carcinoma.
Huang LH, Fang YJ, Zheng XJ … +7 more , Huang C, Li CL, Yu B, Huang MJ, Qin SJ, Huang DY, Lu DW
World J Gastrointest Oncol · 2025 Dec · PMID 41480210 · Full text
BACKGROUND: Early recurrence is an important factor affecting the prognosis of hepatocellular carcinoma (HCC), but its preoperative prediction remains challenging. AIM: To explore the value of a multimodal interpretable...
BACKGROUND: Early recurrence is an important factor affecting the prognosis of hepatocellular carcinoma (HCC), but its preoperative prediction remains challenging. AIM: To explore the value of a multimodal interpretable fusion model combining computed tomography (CT) habitat imaging (HI), radiomics, and clinical features in predicting early recurrence of HCC and analyze its correlation with pathological indicators. METHODS: The 191 HCC patients were categorized into early recurrence and non-early recurrence groups based on postoperative follow-up outcomes, and randomly divided into training and testing sets in a 7:3 ratio. Based on CT arterial phase and clinical data, the habitat model, radiomics model, clinical model, and fusion model were constructed and compared for their predictive ability in early recurrence of HCC. For the optimal model, SHapley Additive exPlanations (SHAP) analysis was performed to evaluate the contribution of different features in the model, and the correlation between HI and radiomics features with tumor microvascular invasion (MVI), Ki67 expression, GPC-3 expression, and pathological grading was analyzed. RESULTS: The fusion model demonstrated the best performance in predicting early recurrence of HCC, achieving the area under the curve of 0.933 on the validation set. The decision curve analysis curve indicated that the fusion model yielded the highest clinical net benefit. SHAP analysis provided valuable insights into explaining the fusion model's prediction of early HCC recurrence. Correlation analysis revealed significant associations between certain radiomics and Habitat features and pathological indicators such as MVI and Ki-67 expression in HCC. CONCLUSION: An interpretable fusion model integrating clinical, radiomic, and habitat features can assist clinicians in identifying early postoperative recurrence of HCC, offering significant potential for prognosis prediction and clinical management.
Clinical characteristics of colorectal polyps in patients with non-alcoholic fatty liver disease in high altitude areas.
Wang CY, Ma L, Zhao Y … +9 more , Zhang XJ, Li S, Liu YG, Guo HM, Qi JG, Wang JQ, Ye WX, Li JZ, Zhang T
World J Gastrointest Oncol · 2025 Dec · PMID 41480209 · Full text
BACKGROUND: Colorectal cancer has high global incidence and mortality rates. Colorectal polyps are relatively common, with adenomatous polyps having a higher risk of malignant transformation. Non-alcoholic fatty liver di...
BACKGROUND: Colorectal cancer has high global incidence and mortality rates. Colorectal polyps are relatively common, with adenomatous polyps having a higher risk of malignant transformation. Non-alcoholic fatty liver disease (NAFLD) has been identified as a risk factor for the development of colorectal adenomas. Here, inpatients with NAFLD from the Second People's Hospital of Xining, in Qinghai Province, and the Second People's Hospital of Tianjin were investigated, comparing the biochemical indicators, colonoscopy findings, and pathological results of polyps between patients from low-altitude (Tianjin) and high-altitude (Qinghai Province) areas. Risk factors associated with the occurrence of adenomatous polyps in NAFLD patients from high-altitude areas were also explored. AIM: To investigate the clinical characteristics of colorectal polyps in NAFLD patients from high-altitude areas. METHODS: A total of 848 patients with NAFLD were enrolled. Of these, 118 underwent colonoscopy between January 2021 and January 2024 at the Second People's Hospital of Tianjin (low-altitude), while the remaining 730 patients were assessed during the same period at the Second People's Hospital of Xining, Qinghai (high-altitude). All enrolled patients met the diagnostic criteria for NAFLD, and the excised colorectal polyps were analyzed pathologically. RESULTS: Colorectal polyps were found in 585 cases (80.1%) in the Qinghai cohort and 91 patients (77.1%) in the Tianjin group, indicating a slightly higher incidence in the Qinghai group, although the difference was non-significant ( = 0.449, > 0.05). The two groups showed no significant difference in sex ( = 0.153, > 0.05) but differed significantly in the proportion of younger patients ( < 0.01), although no differences were seen in terms of middle-aged and elderly patients ( > 0.05). No differences in polyp numbers were observed between the two regions ( > 0.05), while significant differences were found between the ≤ 0.5 cm and > 1 cm and ≤ 2 cm proportions in both regions ( < 0.05), with no differences in other size categories ( > 0.05). Polyp locations (proximal colon, distal colon) also differed significantly ( < 0.05). Patients in Qinghai were more prone to adenomatous polyps, accounting for 89.2% of polyps, compared to those from Tianjin ( < 0.05). Patients in Qinghai had a higher incidence of tubular adenomas with low-grade dysplasia, while tubular adenomas with high-grade dysplasia predominated in patients from Tianjin ( < 0.05). Patients in Tianjin had a significantly higher proportion of mixed hyperplastic-adenomatous polyps ( < 0.05), as well as greater proportions of mixed hyperplastic-adenomas with low-grade dysplasia ( < 0.05). The incidence of hyperplastic polyps was markedly higher in Tianjin, accounting for 58.4% ( < 0.05). Multivariate logistic regression indicated that sex [OR = 1.693, 95% confidence interval (CI): 1.131-2.536], smoking (OR = 0.604, 95%CI: 0.406-0.897), hypertension (OR = 0.683, 95%CI: 0.471-0.991), and white blood cell counts (WBC) (OR = 1.091, 95%CI: 1.015-1.173) were risk factors for the occurrence of adenomatous polyps in patients with NAFLD in high-altitude areas (Qinghai Province). CONCLUSION: Patients with NAFLD from high-altitude regions have a higher incidence of colorectal polyps, with a significantly higher incidence of adenomatous polyps compared to other polyp types. Sex, smoking, hypertension, and WBC are risk factors for adenomatous polyps in NAFLD patients in high-altitude regions.
Combining irreversible electroporation and immunotherapy for hepatocellular carcinoma: Reflections and directions for advancement.
Krishnan A, Mukherjee D
World J Gastrointest Oncol · 2025 Dec · PMID 41480208 · Full text
We read with great interest the recent article by Xing , which describes the synergy between irreversible electroporation and anti-programmed death-1 therapy in a murine hepatocellular carcinoma model. The study offers v...
We read with great interest the recent article by Xing , which describes the synergy between irreversible electroporation and anti-programmed death-1 therapy in a murine hepatocellular carcinoma model. The study offers valuable mechanistic insights into local ablation, enhancing the efficacy of immune checkpoint blockade. However, critical methodological limitations and an overstatement of mechanistic conclusions warrant cautious interpretation. We recommend clarifying experimental details, optimizing murine models, applying more robust statistical analyses, and tempering conclusions to reflect the correlative nature of the findings. Further work should investigate immune mechanisms, durability of response, and safety in clinically relevant models to maximize translational potential. These refinements will strengthen the study's impact in advancing ablation-immunotherapy strategies in hepatocellular carcinoma.
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