World Journal Of Gastrointestinal Oncology[JOURNAL]
Sun
200 papers
5'-transfer RNA halve-lysine-CTT as a promising biomarker for early detection of hepatocellular carcinoma.
Yuan J, Gu WC, Xu TX … +5 more , Shen XJ, Li X, Shen L, Zhang Y, Ju SQ
World J Gastrointest Oncol · 2025 Nov · PMID 41281472 · Full text
BACKGROUND: Hepatocellular carcinoma (HCC) is a globally prevalent malignancy associated with high morbidity and mortality. Transfer RNA (tRNA)-derived small RNAs (tsRNAs), a class of small non-coding RNAs originating fr...
BACKGROUND: Hepatocellular carcinoma (HCC) is a globally prevalent malignancy associated with high morbidity and mortality. Transfer RNA (tRNA)-derived small RNAs (tsRNAs), a class of small non-coding RNAs originating from tRNA, have emerged as potential therapeutic targets in cancers, including HCC. However, the specific tsRNAs involved in HCC and their precise mechanisms remain largely unknown. In this study, we identify and characterize specific tsRNAs involved in the development and progression of HCC, discovering their potential as novel biomarkers for early detection and potential therapeutic targets. AIM: To investigate differentially expressed tsRNAs in HCC, identify potential biomarkers, and elucidate the functions and mechanisms of tsRNAs in HCC. METHODS: Differentially expressed tsRNAs in Barcelona Clinic Liver Cancer 0/A-stage HCC tissues were identified through high-throughput sequencing. Agarose gel electrophoresis, Sanger sequencing, and quantitative polymerase chain reaction were conducted to detect 5'-tRNA halve (tiRNA)-lysine (Lys)-CTT in tissues and serum samples. The diagnostic performance of 5'-tiRNA-Lys-CTT was evaluated using receiver operating characteristic analysis. HCC cell proliferation was examined using the Cell Counting Kit-8 assay, colony formation assay, and 5-ethynyl-2'-deoxyuridine staining. Additionally, the migratory capability of HCC cells was investigated using Transwell assays. RESULTS: The 5'-tiRNA-Lys-CTT demonstrated excellent stability and can be easily detected. Its expression was significantly upregulated in 50 HCC tissues, 110 HCC serum samples, and 5 HCC cell lines control groups, and the differences were all significant. This elevated expression was strongly associated with clinicopathological characteristics, particularly tumor size, Barcelona Clinic Liver Cancer stage, and cirrhosis of the liver. Receiver operating characteristic analysis revealed superior detection efficiency of 5'-tiRNA-Lys-CTT exhibits for early-stage HCC compared to established markers. Functional assays revealed that 5'-tiRNA-Lys-CTT overexpression promoted cell proliferation and migration, while its inhibition had the opposite effect. Bioinformatics predictions suggest that 5'-tiRNA-Lys-CTT may influence the development and progression of liver cancer by targeting downstream mRNA metabolic pathways, cancer pathways, and HCC-specific pathways. CONCLUSION: The 5'-tiRNA-Lys-CTT levels were higher in early HCC patients. 5'-tiRNA-Lys-CTT is a promising diagnostic biomarker for early-stage HCC and may play an oncogenic role in HCC by interacting with downstream mRNA targets specific pathways.
Targeting the Osteopontin-regulated PI3K/AKT signaling pathway: A molecular approach to overcome drug resistance and metastasis in gastrointestinal tumors.
Nian H, Bai Y, Wang HY … +7 more , Yu H, Zhang ZL, Shi RH, Zhang S, Wu YB, Zhou DH, Du QC
World J Gastrointest Oncol · 2025 Nov · PMID 41281471 · Full text
Osteopontin (OPN), a key extracellular matrix protein, promotes gastrointestinal tumor progression by activating the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) pathway. OPN enhances tumor proliferation a...
Osteopontin (OPN), a key extracellular matrix protein, promotes gastrointestinal tumor progression by activating the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) pathway. OPN enhances tumor proliferation and survival through mechanistic target of rapamycin and B-cell lymphoma 2 upregulation (, denticleless E3 ubiquitin protein ligase homolog in hepatocellular carcinoma) and drives metastasis PI3K/AKT-mediated epithelial-mesenchymal transition and androgen receptor (AR) activation (, the OPN-RAN-AR axis in pancreatic cancer). Additionally, OPN induces chemoresistance by activating anti-apoptotic proteins (, XIAP CXCR3/PI3K/AKT in colorectal cancer) and remodels the tumor microenvironment through VEGF-dependent angiogenesis and cluster of differentiation 44-PI3K/AKT-mediated immune evasion. Its interaction with TLR4, WNT, and other pathways amplifies oncogenic effects. Therapies targeting the OPN-PI3K/AKT axis (, PI3K inhibitors like LY294002) or combination treatments (, with EGFR-TKIs) show promise for reversing drug resistance. Future research should focus on OPN isoform specificity, clinical translation, and interactions with autophagy and long non-coding RNAs to refine precision therapies. This review summarizes recent advances in understanding the molecular mechanisms, therapeutic targets, and clinical challenges of the OPN-PI3K/AKT axis in gastrointestinal tumors, providing a foundation for overcoming resistance and developing precision therapies.
Pancreatic cancer initially presenting with acute renal infarction: A case report.
Wang QY, Xia WH, Wan W … +1 more , Liu JP
World J Gastrointest Oncol · 2025 Nov · PMID 41281470 · Full text
BACKGROUND: Pancreatic carcinoma is recognized as one of the most prothrombotic malignancies, carrying a high risk of thrombotic events, which may even precede the diagnosis of the underlying occult tumor. Acute renal in...
BACKGROUND: Pancreatic carcinoma is recognized as one of the most prothrombotic malignancies, carrying a high risk of thrombotic events, which may even precede the diagnosis of the underlying occult tumor. Acute renal infarction (ARI) as the initial presenting feature in patients with pancreatic cancer is a rare occurrence, and misdiagnosis is common during early evaluation. CASE SUMMARY: We report a patient who presented with ARI as the initial manifestation prior to the diagnosis of pancreatic cancer. The 50-year-old male was admitted to our emergency department with sharp, left-sided abdominal pain and was subsequently transferred to our department following the detection of a pancreatic space-occupying lesion on computed tomography (CT). CT angiography promptly identified the cause of his pain, confirming right renal infarction. Urgent interventional treatment was initiated to alleviate symptoms and restore renal perfusion. Despite aggressive thrombolytic and anticoagulant therapy, the thrombotic event rapidly worsened, leading to multiple cerebral infarctions. The patient's condition ultimately deteriorated under palliative care. CONCLUSION: This case illustrates that arterial thromboembolism, when diagnosed at an advanced stage of pancreatic cancer, appears to be a terminal event that portends a poor prognosis. Establishing an arterial thrombosis prediction model will potentially identify the profile of high-risk patients with thrombotic consequences for primary prevention.
Short-term and long-term effects of sevoflurane inhalation propofol total intravenous anesthesia in gastrectomy for gastric cancer.
Wang Z, Cheng JW, Yu KY
World J Gastrointest Oncol · 2025 Nov · PMID 41281469 · Full text
BACKGROUND: Gastric cancer is a major global health issue, and the perioperative period critically influences patient outcomes. The different effects of sevoflurane inhalation anesthesia and propofol total intravenous an...
BACKGROUND: Gastric cancer is a major global health issue, and the perioperative period critically influences patient outcomes. The different effects of sevoflurane inhalation anesthesia and propofol total intravenous anesthesia on intraoperative stability, postoperative complications, and long-term oncologic outcomes in patients with gastric cancer undergoing radical gastrectomy remain unclear. AIM: To compare the effects of sevoflurane inhalation anesthesia and propofol total intravenous anesthesia on clinical outcomes, including intraoperative indicators, postoperative complications, adverse effects, pain scores, and survival. METHODS: This single-center retrospective cohort study included 204 patients who underwent radical gastrectomy for gastric cancer from February 2019 to December 2022. Patients were assigned to either the sevoflurane group ( = 103) or the propofol group ( = 101) based on intraoperative anesthetic regimen. Standardized protocols for anesthesia management, intraoperative monitoring, and postoperative analgesia were applied. Baseline characteristics; intraoperative metrics; adverse events; complications; Visual Analog Scale (VAS) scores at 2, 4, 6, 24, and 48 hours; and survival outcomes were retrospectively collected. Group comparisons were performed using for categorical variables, test for continuous variables, and Kaplan-Meier analysis for survival outcomes. RESULTS: Baseline demographic and clinical characteristics were similar between groups. No significant differences were observed in intraoperative indicators or most 30-day postoperative outcomes, including length of stay, emergency department visits, and readmission rates. The propofol group showed elevated mean VAS pain score at 24 hours postoperatively, but no differences were found at other time points. The propofol group also had significantly higher postoperative nausea incidence and transiently higher systolic/diastolic blood pressure and heart rate at the time of incision than the sevoflurane group. No significant differences were seen in overall rates or severity of postoperative complications, intraoperative adverse events, or in overall survival and progression-free survival. CONCLUSION: In patients undergoing radical gastrectomy for gastric cancer, sevoflurane and propofol anesthesia demonstrated similar profiles regarding intraoperative safety, postoperative complications, adverse events, postoperative pain, and long-term survival. The selection of anesthesia can be personalized without significantly affecting perioperative or oncologic outcomes.
Methionyl-tRNA synthetase 1 participates in hepatocellular carcinoma and its regulated gene profile possesses potent prognostic ability.
Bu HY, Huang H, Li J … +13 more , Huang ZB, Huang Y, Huang YK, Wang AM, Wu L, Yuan J, Wang RJ, Lu M, Yu SM, Yi PP, Chen YY, Jiang YP, Hu XW
World J Gastrointest Oncol · 2025 Sep · PMID 41262077 · Full text
BACKGROUND: Hepatocellular carcinoma (HCC) is a significant global health challenge with rising incidence rates and poor prognoses. Aminoacyl-tRNA synthetases (ARSs) are important regulators implicated in the occurrence...
BACKGROUND: Hepatocellular carcinoma (HCC) is a significant global health challenge with rising incidence rates and poor prognoses. Aminoacyl-tRNA synthetases (ARSs) are important regulators implicated in the occurrence and progression of several cancers. However, their specific function in HCC remains unclear, and -related prognostic factors for patient stratification are lacking. AIM: To investigate the ARSs-related mechanisms of HCC and establish an effective prognostic risk model for stratifying patients with HCC. METHODS: We screened genes of interest using differential gene expression, mutation, and survival analysis. Western blot and Immunohistochemistry were used to analyze MARS1 expression in the liver tissues of patients with HCC. Functional studies, including CCK-8 cell viability assay, EdU cell proliferation assay, cell cycle assays, Transwell migration and invasion assays, and tumor xenograft models, were conducted to comprehensively elucidate the specific role of MARS1 in HCC. Moreover, the -related prognostic score (MRPS) was established by LASSO regression and Cox regression analysis in The Cancer Genome Atlas-HCC and GSE14520 cohorts. Patients' immunotherapy and chemotherapy responses were predicted by immunomicroenvironment and drug susceptibility analysis in both subgroups. RESULTS: was selected as a target gene from a series of genes, with markedly higher expression observed in HCC tissues compared to adjacent non-cancerous tissues. Silencing considerably impeded the proliferation, migration, invasion, and tumorigenic abilities of HCC cells and . Moreover, high MRPSs were associated with poor overall survival, altered infiltration of T cells, macrophages, monocytes, elevated immune checkpoint expression (PD-L1, CTLA4, LAG3), and reduced drug sensitivity in HCC. CONCLUSION: MARS1 promotes HCC development and represents a potential therapeutic target for HCC management. Furthermore, MRPS serves as an independent prognostic factor for survival and a predictor of tumor treatment response.
Gut microbiota and metabolite changes in metastatic colorectal cancer 16S rRNA and metabolomics.
Deng P, Lin H, Zeng H … +1 more , Guo F
World J Gastrointest Oncol · 2025 Oct · PMID 41114121 · Full text
BACKGROUND: Distant metastasis causes most colorectal cancer (CRC) deaths. Gut microbiota (GM) dysbiosis and altered metabolites drive metastasis progression, serving as potential diagnostic biomarkers. AIM: To investiga...
BACKGROUND: Distant metastasis causes most colorectal cancer (CRC) deaths. Gut microbiota (GM) dysbiosis and altered metabolites drive metastasis progression, serving as potential diagnostic biomarkers. AIM: To investigate alterations in GM and metabolites between patients with non-metastatic and distant metastatic CRC. METHODS: According to the inclusion criteria, fresh fecal samples were collected from 14 non-metastatic CRC patients and 15 distant metastatic CRC patients. We performed 16S rRNA sequencing to analyze the composition, diversity, and differential abundance of GM, along with predictive functional profiling of microbial communities. Additionally, all samples underwent liquid chromatography-mass spectrometry (LC-MS)-based untargeted metabolomic sequencing to identify metabolic changes and predict their biological functions. RESULTS: The cohort comprised 16 non-metastatic CRC patients (designated as the S group) and 16 distant metastatic CRC patients (designated as the DZ group). Sequence analysis (16S rRNA) identified a total of 35016 operational taxonomic units (OTUs) across both groups (16886 OTUs in the S group; 16270 in the DZ group; 1860 shared between groups). Inter-group microbial diversity analysis revealed notable differences in the β-diversity group ( < 0.05). Comparative analysis of GM revealed significant taxonomic composition differences between groups ( < 0.05), with higher relative abundances of , , in the S group, , , and in the DZ group (all < 0.05). Functional analysis of differential microbiota revealed predominant enrichment in metabolic pathways. LC-MS-based untargeted metabolomics detected 91 differential metabolites in both positive and negative ionization modes. GM-derived metabolites showed significant alterations in the DZ group. Kyoto Encyclopedia of Genes and Genomes and Human Metabolome Database analyses revealed associated pathways involving nucleic acids, organic heterocyclic compounds, alkaloids, lipids/lipid-like molecules, and nucleotides. These metabolites may function synergistically, as evidenced by positive correlations between diazoxide, hydroquinidine, aurapten, and triptophenolide. Differential metabolites were primarily involved in aminoacyl-tRNA biosynthesis, central carbon metabolism in cancer, phenylalanine metabolism, vitamin B6 metabolism, and protein digestion and absorption pathways. CONCLUSION: GM and microbial metabolites differ significantly between CRC patients with distant metastasis and those without metastasis. Metabolites involved in nucleic acid, alkaloid, and lipid metabolism pathways potentially contribute to distant metastasis in CRC.
Lipid metabolic reprogramming in colorectal cancer: Insights to mechanisms and therapeutics.
Wang CD, Zhang BX, Song J
World J Gastrointest Oncol · 2025 Oct · PMID 41114120 · Full text
Colorectal cancer (CRC) exhibits profound lipid metabolic reprogramming, a hallmark of malignant transformation that supports tumorigenesis, immune evasion, and therapeutic resistance. Dysregulated lipid metabolism in CR...
Colorectal cancer (CRC) exhibits profound lipid metabolic reprogramming, a hallmark of malignant transformation that supports tumorigenesis, immune evasion, and therapeutic resistance. Dysregulated lipid metabolism in CRC involves altered fatty acid synthesis, uptake, oxidation, and cholesterol metabolism, which collectively drive cancer cell proliferation, metastasis, and interactions with the tumor microenvironment (TME). This review synthesizes current insights into lipid metabolic rewiring in CRC, its role in shaping immunosuppressive TME dynamics, and emerging therapeutic strategies targeting lipid pathways.
Molecular mechanism of modified Yigong San formula against colorectal cancer EZH2/METTL3/SOX4 pathway-mediated apoptosis.
Wang J, Zhang XW, Tang BW … +2 more , Li Z, Song N
World J Gastrointest Oncol · 2025 Oct · PMID 41114119 · Full text
BACKGROUND: Colorectal cancer (CRC) is a malignant tumor characterized by high global incidence and mortality rates. Contemporary therapeutic modalities remain limited by suboptimal efficacy and adverse effects, thereby...
BACKGROUND: Colorectal cancer (CRC) is a malignant tumor characterized by high global incidence and mortality rates. Contemporary therapeutic modalities remain limited by suboptimal efficacy and adverse effects, thereby necessitating the pursuit of more efficacious treatment strategies. Within traditional Chinese medicine, spleen deficiency is regarded as a central pathogenic mechanism in CRC, persisting throughout the entire disease course. AIM: To elucidate the mechanism by which modified Yigong San confers therapeutic efficacy against CRC, potentially exerting its effects through apoptosis regulation mediated by the enhancer of zeste homolog 2 (EZH2)/methyltransferase-like 3 (METTL3)/SRY-box transcription factor 4 (SOX4) axis. METHODS: In the clinical study, CRC tissues and corresponding adjacent normal samples that fulfilled inclusion criteria were procured. Quantitative reverse transcription polymerase chain reaction was employed to determine the transcriptional expression of and mRNA. For experimentation, SW-480 cells were allocated into five experimental conditions: Control, control + serum, control + negative control, control + overexpressing-EZH2, and control + overexpressing-EZH2 + serum. The mRNA expression levels of , , , B-cell lymphoma 2, and across groups were quantified quantitative reverse transcription polymerase chain reaction, while protein levels were assessed using western blot analysis. The presence of EZH2 binding sites within the METTL3 promoter region was verified through chromatin immunoprecipitation polymerase chain reaction. The optimal concentration of drug-containing serum (5%, 10%, 15%) was determined using the Cell Counting Kit-8 assay. Cell migratory ability was evaluated scratch assays, and apoptotic activity was quantified by flow cytometry. RESULTS: The clinical findings demonstrated significantly elevated transcriptional levels of and mRNA in tumor tissues compared to their adjacent normal counterparts ( < 0.05). , cells treated with modified Yigong San exhibited a substantial downregulation of EZH2, METTL3, SOX4, B-cell lymphoma 2, and Bax mRNA and protein levels ( < 0.05), relative to the control group. Apoptotic rates were markedly increased, while migratory capacity was significantly attenuated. Furthermore, in EZH2-overexpressing cells treated with modified Yigong San, similar reductions in both mRNA and protein levels of the aforementioned targets were observed ( < 0.05), concomitant with enhanced apoptosis and reduced migration. Chromatin immunoprecipitation polymerase chain reaction analysis confirmed EZH2 occupancy at specific loci within the METTL3 promoter. CONCLUSION: Modified Yigong San exhibits both preventive and therapeutic potential against CRC, likely mediated through the regulation of apoptosis the EZH2/METTL3/SOX4 signaling pathway.
Predicting esophageal cancer response to neoadjuvant therapy with magnetic resonance imaging radiomics.
Yang RH, Fan WX, Zhong Y … +4 more , Lin ZP, Chen JP, Jiang GH, Dai HY
World J Gastrointest Oncol · 2025 Oct · PMID 41114118 · Full text
BACKGROUND: Predicting the pathological response of esophageal cancer (EC) to neoadjuvant therapy (NAT) is of significant clinical importance. AIM: To evaluate the pathological response of NAT in EC patients using multip...
BACKGROUND: Predicting the pathological response of esophageal cancer (EC) to neoadjuvant therapy (NAT) is of significant clinical importance. AIM: To evaluate the pathological response of NAT in EC patients using multiple machine learning algorithms based on magnetic resonance imaging (MRI) radiomics. METHODS: This retrospective study included 132 patients with pathologically confirmed EC, were randomly divided into a training cohort ( = 92) and a validation cohort ( = 40) in a 7:3 ratio. All patients underwent a preoperative MRI scan from the neck to the abdomen. High-throughput and quantitative radiomics features were extracted from T2-weighted imaging (T2WI). Radiomics signatures were selected using minimal redundancy maximal relevance and the least absolute shrinkage and selection operator. Nine classification algorithms were used to build the models, and the diagnostic performance of each model was evaluated using the area under the curve (AUC), sensitivity (SEN), and specificity (SPE). RESULTS: A total of 1834 features were extracted. Following feature dimension reduction, ten radiomics features were selected to construct radiomics signatures. Among the nine classification algorithms, the ExtraTrees algorithm demonstrated the best diagnostic performance in both the training (AUC: 0.932; SEN: 0.906; SPE: 0.817) and validation cohorts (AUC: 0.900; SEN: 0.667; SPE: 0.700). The Delong test proved no significance in the diagnostic efficiency within these models ( > 0.05). CONCLUSION: T2WI radiomics may aid in determining the pathological response to NAT in EC patients, serving as a noninvasive and quantitative tool to assist personalized treatment planning.
Constructing a prediction model for delayed wound healing after gastric cancer radical surgery based on three machine learning algorithms.
An Y, Sun YG, Feng S … +3 more , Wang YS, Chen YY, Jiang J
World J Gastrointest Oncol · 2025 Oct · PMID 41114117 · Full text
BACKGROUND: Delayed wound healing is a common clinical complication following gastric cancer radical surgery, adversely affecting patient prognosis. With advances in artificial intelligence, machine learning offers a pro...
BACKGROUND: Delayed wound healing is a common clinical complication following gastric cancer radical surgery, adversely affecting patient prognosis. With advances in artificial intelligence, machine learning offers a promising approach for developing predictive models that can identify high-risk patients and support early clinical intervention. AIM: To construct machine learning-based risk prediction models for delayed wound healing after gastric cancer surgery to support clinical decision-making. METHODS: We reviewed a total of 514 patients who underwent gastric cancer radical surgery under general anesthesia from January 1, 2014 to December 30, 2023. Seventy percent of the dataset was selected as the training set and 30% as the validation set. Decision trees, support vector machines, and logistic regression were used to construct a risk prediction model. The performance of the model was evaluated using accuracy, recall, precision, F1 index, and area under the receiver operating characteristic curve and decision curve. RESULTS: This study included five variables: Sex, elderly, duration of abdominal drainage, preoperative white blood cell (WBC) count, and absolute value of neutrophils. These variables were selected based on their clinical relevance and statistical significance in predicting delayed wound healing. The results showed that the decision tree model outperformed the logistic regression and support vector machine models in both the training and validation sets. Specifically, the decision tree model achieved higher accuracy, F1 index, recall, and area under the curve (AUC) values. The support vector machine model also demonstrated better performance than logistic regression, with higher accuracy, recall, and F1 index, but a slightly lower AUC. The key variables of sex, elderly, duration of abdominal drainage, preoperative WBC count, and absolute value of neutrophils were found to be strong predictors of delayed wound healing. Patients with longer duration of abdominal drainage had a significantly higher risk of delayed wound healing, with a risk ratio of 1.579 compared to those with shorter duration of abdominal drainage. Similarly, preoperative WBC count, sex, elderly, and absolute value of neutrophils were associated with a higher risk of delayed wound healing, highlighting the importance of these variables in the model. CONCLUSION: The model is able to identify high-risk patients based on sex, elderly, duration of abdominal drainage, preoperative WBC count, and absolute value of neutrophils can provide valuable insights for clinical decision-making.
Machine learning model-based approach using cellular proliferation marker expression for preoperative clinical decision-making in patients with hepatocellular carcinoma.
Kumar S, Singh MP, Goyal LD
World J Gastrointest Oncol · 2025 Oct · PMID 41114116 · Full text
The investigation by Zhu on the assessment of cellular proliferation markers to assist clinical decision-making in patients with hepatocellular carcinoma (HCC) using a machine learning model-based approach is a scientif...
The investigation by Zhu on the assessment of cellular proliferation markers to assist clinical decision-making in patients with hepatocellular carcinoma (HCC) using a machine learning model-based approach is a scientific approach. This study looked into the possibilities of using a Ki-67 (a marker for cell proliferation) expression-based machine learning model to help doctors make decisions about treatment options for patients with HCC before surgery. The study used reconstructed tomography images of 164 patients with confirmed HCC from the intratumoral and peritumoral regions. The features were chosen using various statistical methods, including least absolute shrinkage and selection operator regression. Also, a nomogram was made using Radscore and clinical risk factors. It was tested for its ability to predict receiver operating characteristic curves and calibration curves, and its clinical benefits were found using decision curve analysis. The calibration curve demonstrated excellent consistency between predicted and actual probability, and the decision curve confirmed its clinical benefit. The proposed model is helpful for treating patients with HCC because the predicted and actual probabilities are very close to each other, as shown by the decision curve analysis. Further prospective studies are required, incorporating a multicenter and large sample size design, additional relevant exclusion criteria, information on tumors (size, number, and grade), and cancer stage to strengthen the clinical benefit in patients with HCC.
Intensive care unit outcomes and prognostic factors of colorectal cancer.
Dong Q, Xia R, Xing XZ … +32 more , Wang CS, Ma G, Wang HZ, Zhu B, Zhao JH, Zhou DM, Zhang L, Huang MG, Quan RX, Ye Y, Zhang GX, Jiang ZY, Huang B, Xu SL, Xiao Y, Zhang LL, Lin RY, Ma SL, Qiu YA, Zheng Z, Sun N, Xian LW, Li J, Zhang M, Guo ZJ, Tao Y, Zhou XZ, Chen W, Wang DX, Chi JY, Wang DH, Liu KZ
World J Gastrointest Oncol · 2025 Oct · PMID 41114115 · Full text
BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers and CRC patients are among the most common intensive care unit (ICU) admitted cancer patients. However, their prognosis and evaluation methods are rar...
BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers and CRC patients are among the most common intensive care unit (ICU) admitted cancer patients. However, their prognosis and evaluation methods are rarely studied. AIM: To determine the short-term mortality outcome and identify the potential prognostic factors of CRC cancer patients admitted to the ICU. METHODS: A multicenter cross-sectional study was performed from May 10, 2021 to July 10, 2021 at the ICU departments of 37 cancer specialized hospitals in China, and included patients aged ≥ 14 years with ICU duration ≥ 24 hours. Clinical records of patients with a primary CRC diagnosis were reviewed. Patients were separated into groups according to 90-day survival. Characteristics between groups were compared. Univariate and multivariate regression tests were used to analyze the correlated factors of ICU outcomes. Predictive values of disease severity scores were assessed using receiver operating characteristic curve analysis. RESULTS: In total, 189 CRC patients were included in the study. The 90-day mortality was 12.2%. Patients who died showed differences compared to patients who survived mostly in terms of disease severity and ICU complications. It appears that patients admitted to the ICU from a clinical ward due to emergencies may have a higher risk of mortality while surgical management was associated with better survival. In multivariate analysis, only chemotherapy, elective surgery and conventional oxygen therapy were identified as independently correlated with 90-day mortality. Sequential organ failure assessment and acute physiology and chronic health evaluation II scores had moderate accuracy in predicting short-term mortality. CONCLUSION: ICU admitted CRC patients appear to have low short-term mortality which requires further confirmation in prospective studies. The prognostic tools for these patients need further optimization.
Sleep disorders in hepatocellular carcinoma.
Qian J, Ruan MH, Wang ZJ … +4 more , Dong W, Jia JY, Feng XC, Liu H
World J Gastrointest Oncol · 2025 Oct · PMID 41114114 · Full text
As one of the most prevalent malignant tumors, hepatocellular carcinoma (HCC) represents a major global public health burden. Traditionally, HCC pathogenesis has been attributed to chronic liver diseases (viral hepatitis...
As one of the most prevalent malignant tumors, hepatocellular carcinoma (HCC) represents a major global public health burden. Traditionally, HCC pathogenesis has been attributed to chronic liver diseases (viral hepatitis, cirrhosis) and aflatoxin exposure. However, with evolving lifestyles and environmental changes, sleep disorders have become increasingly prevalent. Emerging evidence suggest that sleep disorders may contribute to hepatocarcinogenesis through multiple mechanisms, including immunity environment disorder, oxidative stress, metabolic dysregulation, disruption of gut microbiota, and circadian rhythm disruption, thereby influencing disease progression and patient prognosis. This review summarizes epidemiological evidence on the relationship between sleep disorders and HCC incidence, explores the underlying mechanisms through which sleep disorders contribute to HCC, and discusses clinical challenges and potential intervention strategies. Our objective is to provide novel insights into HCC prevention and therapeutic approaches.
Effectiveness of multi-region 16S rRNA gene sequencing in studying the microbiome of gastric cancer tissues.
Wu TT, Zhou X, Huang Q … +1 more , Yang Q
World J Gastrointest Oncol · 2025 Oct · PMID 41114113 · Full text
BACKGROUND: The gastric microbiome is closely associated with gastric cancer, and single-region 16S rRNA sequencing has limitations in analyzing its characteristics, necessitating the search for a better sequencing metho...
BACKGROUND: The gastric microbiome is closely associated with gastric cancer, and single-region 16S rRNA sequencing has limitations in analyzing its characteristics, necessitating the search for a better sequencing method. AIM: To evaluate the effectiveness of multi-region 16S rRNA gene sequencing in studying the microbiome of gastric cancer tissues. METHODS: Patients with gastric cancer ( = 118) who underwent surgery at Liyang People's Hospital from January 2022 to December 2024 were enrolled. Fifty-nine paraffin-embedded and 59 fresh tissue samples were obtained. The ZymoBIOMICS microbial community standard and ATCC 25922 were used as positive controls. Multi-region and single-region 16S rRNA gene sequencing were performed. Species identification, detection rates at varying microbial abundances, operational taxonomic unit (OTU) counts, and alpha diversity indices in gastric cancer tissues were compared between the two methods. RESULTS: Multi-region 16S rRNA sequencing identified more species (eight species and eight genera) in the positive controls compared with single-region sequencing (one species and six genera). Detection rates at concentrations of 10, 10, and 10 CFU/mg were significantly higher using multi-region sequencing ( < 0.05). Multi-region sequencing also revealed significantly higher OTU counts and alpha diversity indices (Shannon, Simpson, and Chao1) in gastric cancer tissues ( < 0.05). CONCLUSION: Compared with single-region sequencing, multi-region 16S rRNA gene sequencing demonstrates superior species resolution and detection sensitivity, providing a more comprehensive profile of microbial diversity in gastric cancer tissues.
Uridine diphosphate-glucose 6-dehydrogenase-mediated glucuronidation and its emerging role in gut-liver immune regulation.
Yang YQ, Li N, Liu S … +1 more , Yu YW
World J Gastrointest Oncol · 2025 Oct · PMID 41114112 · Full text
This editorial builds on a recent study by Cao , which identified uridine diphosphate-glucose 6-dehydrogenase (UGDH) as a pro-tumorigenic enzyme in hepatocellular carcinoma (HCC). UGDH, a key catalyst in glucuronidation,...
This editorial builds on a recent study by Cao , which identified uridine diphosphate-glucose 6-dehydrogenase (UGDH) as a pro-tumorigenic enzyme in hepatocellular carcinoma (HCC). UGDH, a key catalyst in glucuronidation, promotes tumor growth and correlates with immunosuppressive features in the HCC microenvironment. Expanding on these findings, we explore broader implications of UGDH within the gut-liver axis. We propose that UGDH regulates immune tone not only through detoxification of bile acids and microbial products, but also by maintaining intestinal barrier integrity. Its dysregulation may impair glucuronidation, leading to bile acid accumulation, increased gut permeability, and microbial translocation, collectively promoting hepatic immune tolerance. Additionally, emerging evidence suggests that gut microbiota-derived metabolites can modulate hepatic UGDH expression, forming a bidirectional feedback loop between microbial ecology and liver metabolism. In this context, UGDH may act as a metabolic immune checkpoint, linking metabolic dysfunction with immune escape mechanisms such as programmed cell death ligand 1 upregulation and cyclic guanosine monophosphate-adenosine monophosphate synthase-stimulator of interferon genes pathway activation. Targeting UGDH could therefore help restore gut-liver immune balance and delay gastrointestinal cancer progression, especially in metabolic HCC. This editorial integrates metabolic, microbial, and immunological perspectives to support a novel translational framework.
Tumor microenvironment phenotyping guides precision therapy in unresectable pancreatic cancer.
Zhao K, Xiao MM, Yang YS … +1 more , Xiao X
World J Gastrointest Oncol · 2025 Oct · PMID 41114111 · Full text
Treatment of locally advanced unresectable pancreatic cancer remains a major clinical challenge due to pronounced heterogeneity and resistance to standard regimens. Increasing evidence highlights the critical role of the...
Treatment of locally advanced unresectable pancreatic cancer remains a major clinical challenge due to pronounced heterogeneity and resistance to standard regimens. Increasing evidence highlights the critical role of the tumor microenvironment (TME) in shaping therapeutic response and driving drug resistance. In this minireview, we summarize recent advances in TME phenotyping and its potential to guide precision therapy. A four-dimensional framework integrating stromal, immune, genomic, and metabolic features has been proposed to better characterize TME heterogeneity. Preclinical and clinical studies indicate that strategies targeting the stroma, modulating immunity, or exploiting genomic vulnerabilities such as homologous recombination deficiency may enhance the efficacy of chemotherapy, immunotherapy, and targeted agents. Dynamic biomarkers, including circulating tumor DNA and carbohydrate antigen 19-9, also show promise for real-time therapy adaptation, although their clinical application remains limited. By synthesizing current evidence, we emphasize the importance of individualized treatment strategies that account for TME complexity. While encouraging, the translation of multiomics phenotyping and biomarker monitoring into routine clinical practice requires standardization, prospective validation, and integration of novel technologies. Future research should focus on establishing reproducible TME-guided models to enable dynamic and personalized therapy for patients with unresectable pancreatic cancer.
Rectal neuroendocrine tumors in a Latin American population: Insights from a Peruvian national cancer institute.
Cruz-Diaz WE, Leonardo A, Saavedra A … +9 more , Paitan V, Haro-Varas J, Mantilla R, Macetas J, Veramendi E, Pacheco C, Calderón M, Vidaurre T, Castro-Oliden V
World J Gastrointest Oncol · 2025 Oct · PMID 41114110 · Full text
BACKGROUND: Well-differentiated rectal neuroendocrine tumors (rNETs) represent approximately 28% of gastrointestinal neuroendocrine tumors, with a rising incidence over recent decades. However, data from Perú remains lim...
BACKGROUND: Well-differentiated rectal neuroendocrine tumors (rNETs) represent approximately 28% of gastrointestinal neuroendocrine tumors, with a rising incidence over recent decades. However, data from Perú remains limited. AIM: To assess overall survival (OS) in patients with rNETs and describe the clinical and pathological characteristics of the study population. METHODS: This retrospective study included patients diagnosed with rNETs at the Instituto Nacional de Enfermedades Neoplásicas between 2009 and 2024. Qualitative variables were evaluated using the test through contingency tables. OS was estimated using the Kaplan-Meier method, and differences between groups were assessed with the log-rank test. Cox proportional hazards models were used to evaluate variables associated with OS. All statistical analyses were conducted using R software. RESULTS: A total of 52 patients were included, with a mean age of 51.9 years (range: 27-74 years) and composed of 65.4% females. The most common stage at diagnosis was stage I (48.1%), followed by stage IV (36.5%). The median OS within the study population was 76 months. The 5-year OS for grade 1 tumors was 92.9% compared to 32.6% for grade 2 tumors ( = 0.00032). The median OS was 48 months for tumors exceeding 20 mm in size, whereas it was not reached for tumors measuring 20 mm or less ( = 0.0056). Similarly, the median OS for patients classified as lymph node involvement 1 was 46 months, while it was estimated at 112 months for those classified as lymph node involvement 0 ( = 0.0063). CONCLUSION: rNETs exceeding 2 cm in size, classified as grade 2, or presenting with lymph node involvement 1 status were correlated with advanced disease stages and diminished survival outcomes.
Microenvironmental code of pancreatic ductal adenocarcinoma: The prognostic symphony of budding, matrix and lymphocytes.
Zhou QQ, Ren YM, Shi SM … +1 more , Liu TF
World J Gastrointest Oncol · 2025 Oct · PMID 41114109 · Full text
This editorial discusses Alpsoy 's significant study of prognosis of pancreatic ductal adenocarcinoma (PDAC), which lacks histopathological markers. This study evaluated the synergistic prognolymphocytes. Peritumoral bud...
This editorial discusses Alpsoy 's significant study of prognosis of pancreatic ductal adenocarcinoma (PDAC), which lacks histopathological markers. This study evaluated the synergistic prognolymphocytes. Peritumoral budding is significantly correlated with tumor volume, while intratumoral budding is closely related to lymph node metastasis. Peritumoral budding and intratumoral budding are confirmed as independent adverse prognostic factors, and their high levels of expression are associated with immature stromal phenotypes, suggesting the key role of epithelial-mesenchymal transition. These breakthrough findings provide a new multidimensional biomarker system for the prognostic assessment of PDAC, and promote the clinical transformation process of incorporating tumor budding indicators into the pathological reporting process. However, the complexity and spatiotemporal heterogeneity of the tumor microenvironment require us to go beyond traditional morphological analysis and move towards multiomics integration and dynamic monitoring. Through standardized pathological assessment, innovative treatment strategies and interdisciplinary collaboration, it is expected to transform tumor microenvironment-related markers into clinically applicable indicators, ultimately improving the treatment predicament of PDAC. This editorial intended to summarize relevant studies and share some of our views, in order to offer perspectives for future research.
MEX3A: A promising prognostic marker and therapeutic target in hepatocellular carcinoma.
Yang XL, Yang XJ
World J Gastrointest Oncol · 2025 Oct · PMID 41114108 · Full text
This article discusses the recently published study by Ji on the role of MEX3A in hepatocellular carcinoma. The study reveals MEX3A's role, but has issues including a small sample size and unclear RORA-regulation. We pr...
This article discusses the recently published study by Ji on the role of MEX3A in hepatocellular carcinoma. The study reveals MEX3A's role, but has issues including a small sample size and unclear RORA-regulation. We propose new research directions. It is essential to analyze the immune cells in MEX3A-high tumors and test the impact of MEX3A-knockout on immunotherapy when exploring the relationship between MEX3A and the immune microenvironment. With regard to MEX3A and cancer stem cells, it is necessary to assess the effect of MEX3A on cancer stem cell self-renewal and use organoids to test the targeting ability of MEX3A-inhibitors. In addition, improvements such as larger-scale validation and in-depth mechanism research are required, which could boost hepatocellular carcinoma understanding and patient prognosis.
Artificial intelligence in the diagnosis and prognosis of intrahepatic cholangiocarcinoma: Applications and challenges.
Qiao L, Luo YG, Wang QY … +4 more , Yuan T, Xu M, Xiong GB, Zhu F
World J Gastrointest Oncol · 2025 Oct · PMID 41114107 · Full text
Intrahepatic cholangiocarcinoma (ICC) is a primary liver malignancy with increasing global incidence and mortality rates. The 5-year overall survival rate for patients with ICC is approximately 9%. Surgical resection cur...
Intrahepatic cholangiocarcinoma (ICC) is a primary liver malignancy with increasing global incidence and mortality rates. The 5-year overall survival rate for patients with ICC is approximately 9%. Surgical resection currently represents the only curative treatment option. However, due to the high aggressiveness, insidious onset, and atypical clinical presentation of ICC, many patients either miss the optimal surgical window or experience early postoperative recurrence and metastasis. This poses significant challenges for hepatobiliary surgeons worldwide. Artificial intelligence (AI), as a prominent driver of technological advancement, offers promising new avenues for managing ICC. By leveraging powerful machine learning and deep learning algorithms, AI has demonstrated promising outcomes in ICC diagnosis, particularly in differentiating it from hepatocellular carcinoma, and in predicting critical prognostic factors such as early recurrence, lymph node metastasis, and microvascular invasion. These innovations can support clinical decision-making and ultimately improve patient outcomes. Future efforts should prioritize robust clinical studies evaluating the effectiveness of AI in ICC management.
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