Gastroenterology[JOURNAL]
Sun
200 papers
Uncommon initial presentation of a gastric mass in a patient with primary plasma cell leukemia: a case report.
Cui SJ, Yin H, Xu CL … +3 more , Chen Y, Wu ZY, Huang DP
BMC Gastroenterol · 2026 Jul · PMID 42399824 · Full text
BACKGROUND: Extramedullary infiltration is a recognized manifestation of primary plasma cell leukemia (pPCL); however, presentation as a gastric mass is rarely reported. This report describes a rare case of pPCL complica...
BACKGROUND: Extramedullary infiltration is a recognized manifestation of primary plasma cell leukemia (pPCL); however, presentation as a gastric mass is rarely reported. This report describes a rare case of pPCL complicated with prostate cancer, initially presenting as a gastric mass, and outlines the pathogenic mechanisms and clinical management course. A 68-year-old man presented with intermittent epigastric pain. Contrast-enhanced abdominal computed tomography (CT) revealed a gastric mass measuring 97 mm × 131 mm × 63 mm, subsequently confirmed as an extramedullary plasmacytoma on pathological examination. Bone marrow biopsy and peripheral blood immunophenotyping established the diagnosis of pPCL with gastric involvement. In view of an elevated prostate-specific antigen level, a targeted prostate biopsy was performed, confirming concomitant prostate cancer. The patient received three cycles of the Dara-RVD regimen for pPCL, along with leuprolide acetate and bicalutamide for prostate cancer. Follow-up evaluation demonstrated partial remission of pPCL. CONCLUSION: Additional case accumulation and further investigation of pathogenic mechanisms are warranted to optimize diagnostic approaches and improve therapeutic outcomes.
Examining the effect of nurse navigation programme on stoma adjustment, quality of life, and prevention of complications in patients with stoma: a randomized controlled trial.
Yurdagül G, Tosun N
BMC Gastroenterol · 2026 Jul · PMID 42399788 · Full text
BACKGROUND: While the care of the stoma poses a problem for individuals, the presence of complications, lack of stoma adjustment, and impaired quality of life can be more exhausting for patients, as well. METHODS: This t...
BACKGROUND: While the care of the stoma poses a problem for individuals, the presence of complications, lack of stoma adjustment, and impaired quality of life can be more exhausting for patients, as well. METHODS: This thesis study was designed and conducted as a multicenter, randomised controlled intervention study with repetitive measurements in a pretest-posttest order. Patients, who underwent intestinal stoma in 5 hospitals, (one of which was private), in a city in the south-eastern Turkey between 20 March and December 31, 2021, participated in the study. Seventy-four patients, who were regarded eligible, were randomised and divided into experimental and control groups. A patient information form, the Stoma Complications Evaluation Form, the Stoma-Related Problems Form, the Ostomy Adjustment Inventory-23, and the Stoma Quality of Life Scale were used to collect data. RESULTS: Results of the study revealed a significant difference between the groups based on quality of life and stoma adjustment. CONCLUSIONS: The nurse navigation programme not only increases the quality of life and stoma adjustment in patients with stoma but also reduces stoma complications. TRIAL REGISTRATION: ClinicalTrials.gov NCT05809661 (Registered: 30/03/2023). Retrospectively registered.
Determinants of eligibility for second-line chemotherapy following gemcitabine plus nab-paclitaxel therapy in patients with unresectable pancreatic cancer: a retrospective study.
Ueda T, Miyagawa K, Shibata M … +10 more , Mori Y, Oe S, Kajitani K, Uchihara D, Shinohara N, Ogino N, Kumei S, Honma Y, Watanabe T, Harada M
BMC Gastroenterol · 2026 Jul · PMID 42399778 · Full text
BACKGROUND: Second-line chemotherapy (2L) is recommended after gemcitabine plus nab-paclitaxel (GnP) first-line chemotherapy (1L) for unresectable pancreatic cancer (UR-PC). However, in routine clinical practice, not all...
BACKGROUND: Second-line chemotherapy (2L) is recommended after gemcitabine plus nab-paclitaxel (GnP) first-line chemotherapy (1L) for unresectable pancreatic cancer (UR-PC). However, in routine clinical practice, not all patients proceed to 2L. This retrospective study aimed to identify baseline clinical and biological factors associated with 2L eligibility. METHODS: We retrospectively reviewed the data of 124 consecutive patients with UR-PC who received 1L GnP between 2016 and 2024 at a single center, excluding those with postoperative recurrence. Patients were grouped by 2L receipt [2L( +), n = 63] or non-receipt [2L( -), n = 61]. Ascites was assessed based on baseline imaging findings and additionally classified as none, mild, or moderate-to-severe. Overall survival (OS) was assessed from completion or discontinuation of 1L GnP, and progression-free survival (PFS) was assessed from 1L GnP initiation, using Kaplan-Meier and Cox regression analyses. Cox regression analysis for OS included only baseline variables. RESULTS: The 2L( +) group less frequently had baseline ascites and better Eastern Cooperative Oncology Group performance status. The distribution of ascites severity also differed significantly between the groups. Median OS was 7.1 vs. 1.9 months (p < 0.001) and median PFS was 5.9 vs. 3.0 months (p = 0.004) for 2L( +) vs. 2L( -). Multivariate Cox analysis identified the absence of ascites as an independent factor associated with longer OS (hazard ratio [HR] 0.595, 95% confidence interval 0.367-0.963; p = 0.035). Multivariate logistic regression revealed that the absence of ascites independently predicted 2L eligibility (adjusted odds ratio 4.435, 95% CI 1.583 - 12.423, p = 0.005). CONCLUSIONS: Baseline ascites was independently associated with reduced eligibility for 2L after 1L GnP in patients with UR-PC. Nevertheless, patients who received 2L had longer survival than those who did not, including among those with baseline ascites. However, this association should be interpreted cautiously because of the retrospective design and potential treatment-selection bias. These findings may support individualized reassessment and proactive supportive care to maximize opportunities for sequential chemotherapy.
Integrating WGCNA and machine learning to identify and validate key biomarkers in MASLD.
Zhang J, Liang Q, Xu X … +2 more , Wang P, Yan B
BMC Gastroenterol · 2026 Jul · PMID 42399771 · Full text
BACKGROUND: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) represents the most prevalent chronic liver disease worldwide. The absence of approved pharmacotherapies is largely attributed to their profoun...
BACKGROUND: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) represents the most prevalent chronic liver disease worldwide. The absence of approved pharmacotherapies is largely attributed to their profound molecular heterogeneity. The identification of novel hub genes in MASLD is therefore critical for unraveling the complex molecular mechanisms driving disease pathogenesis and progression. METHODS: We employed an integrative systems-biology approach utilizing Weighted Gene Co-expression Network Analysis (WGCNA) followed by multi-algorithm machine learning (LASSO, Random Forest, SVM-RFE) across GEO datasets (GSE89632, GSE63067) to identify hub genes. Key hub genes were validated in vitro with FFA-treated HepG2 cells and in vivo with an HFD-fed mouse model. RESULTS: Bioinformatic analyses revealed two distinct pathological networks. First, a lipogenesis-associated cluster revealed FMO1 and C10orf140 as upregulated, alongside JUNB downregulation. In vitro, the expression of these genes was significantly associated with the activation of the SREBP-1c/FASN lipogenic pathway. Second, WGCNA revealed a co-expression module that exhibited high correlation with inflammation (R = 0.59, p = 4e-05), from which 11 hub genes relating to inflammation (such as MAP3K8, PFKFB3) were identified. In vivo, HFD mice developed severe steatosis and demonstrated a key pathological paradox: high-level activation of both the pro-lipogenic p-AKT and the inhibitory p-AMPK pathways. CONCLUSION: Our study identified the hub genes FMO1, C10orf140, and JUNB as novel regulators of MASLD lipogenesis through the SREBP-1c pathway. Additionally, we showed that co-activated p-AKT and p-AMPK in steatotic livers indicates "AMPK Resistance". Ultimately, we describe a mechanism of pro-lipogenic signaling that is not curtailed and is accompanied by the inability to compensate for the inhibitory path. All findings reveal potential therapeutic targets for MASLD.
Predictive factors and nomogram for post-endoscopic retrograde cholangiopancreatography pancreatitis.
Yuan H, Wang H
BMC Gastroenterol · 2026 Jul · PMID 42393582 · Full text
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a cornerstone of minimally invasive diagnosis and treatment for pancreaticobiliary diseases. However, post-ERCP pancreatitis (PEP), the most common com...
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a cornerstone of minimally invasive diagnosis and treatment for pancreaticobiliary diseases. However, post-ERCP pancreatitis (PEP), the most common complication, occurs with a relatively high incidence and can lead to organ failure or even death in severe cases. The effectiveness of existing preventive measures is highly dependent on accurate risk stratification, while empirical clinical judgment lacks consistency, underscoring the urgent need for objective and individualized predictive tools. OBJECTIVE: To identify independent risk factors for PEP and to construct a nomogram prediction model for individualized risk assessment in patients undergoing ERCP. METHODS: Clinical data from 289 patients who underwent ERCP at Jinzhong First People's Hospital between January 2020 and October 2025 were retrospectively analyzed. Patients were divided into PEP and non-PEP groups according to the consensus diagnostic criteria. Univariate analysis was performed to compare demographic characteristics, clinical factors, procedural details, and laboratory parameters between the two groups. Least absolute shrinkage and selection operator (LASSO) regression was used for feature selection, followed by multivariate logistic regression analysis to identify independent risk factors for PEP. A nomogram prediction model was constructed based on these factors. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA) in the training cohort (n = 202) and validation cohort (n = 87). RESULTS: The incidence of PEP in this cohort was 10.73% (31/289). Multivariate logistic regression analysis identified five independent risk factors for PEP: sphincter of Oddi dysfunction, history of pancreatitis, pancreatic duct opacification, difficult cannulation, and guidewire access to the pancreatic duct (≥ 3 times). Elevated total bilirubin (TBil) level was identified as an independent protective factor against PEP. The nomogram incorporating these factors demonstrated excellent predictive performance, with AUC values of 0.922 (95%CI: 0.865-0.980) in the training cohort and 0.915 (95%CI: 0.878-0.951) in the validation cohort. Calibration curves showed good agreement between predicted probabilities and actual observations (Hosmer-Lemeshow test P > 0.05), and DCA confirmed the model's clinical utility across a wide range of threshold probabilities. CONCLUSION: The nomogram model constructed in this study integrates six easily accessible clinical and operational factors, provides an effective and reliable tool for individualized prediction of PEP risk. This model can assist clinicians in early identification of high-risk patients, facilitating targeted preventive interventions and potentially improving the safety of ERCP procedures.
Associations between childhood behavior and current cognitive and emotional function in adults with irritable bowel syndrome-a cross sectional retrospective study.
Billing J, Pfabigan DM, Steinsvik EK … +3 more , Lied GA, Berentsen B, Lundervold AJ
BMC Gastroenterol · 2026 Jul · PMID 42393543 · Full text
BACKGROUND: Childhood behavior may influence emotional regulation and cognitive processing capacities in adulthood. Associations between childhood behavior and present emotional and cognitive functions in adults with Irr...
BACKGROUND: Childhood behavior may influence emotional regulation and cognitive processing capacities in adulthood. Associations between childhood behavior and present emotional and cognitive functions in adults with Irritable Bowel Syndrome (IBS) are not yet established. OBJECTIVE: To explore relationships between retrospectively reported childhood behavior and current emotional and cognitive function in adults with IBS vs healthy controls (HCs). METHODS: Adults with IBS (n = 57) and HCs (n = 38) completed the Wender Utah Rating Scale (WURS) to assess childhood behavior. Emotional functioning was assessed with the Hospital Anxiety and Depression Scale (HADS), and cognitive functioning with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). WURS responses were subjected to principal component analysis (PCA) to identify underlying factors, which were then examined for associations with current emotional and cognitive functioning. RESULTS: The WURS PCA yielded four factors: (1) Behavioral Self-Regulation and Social Functioning (2) Emotional Reactivity and Temperament, (3) Psychological Vulnerability and Distress, and (4) Academic/Cognitive Challenges. IBS patients scored significantly higher than healthy controls on Factors 3 and 4. Significant correlations were found between Factor 3 and HADS in the HC group, and between Factor 4 and RBANS in the IBS group. CONCLUSIONS: This study demonstrates that IBS patients report more childhood psychological vulnerability and academic/cognitive challenges than controls, and that these retrospectively reported behaviors show distinct associations with adult cognitive functioning. The findings suggest that developmental trajectories, such as neurocognitive traits and early stress-related mechanisms, contribute to the heterogeneity of IBS. TRIAL REGISTRATION: The project is registered at www. CLINICALTRIALS: gov (#NCT04296552), first submitted 2020.03.04.
A rare case of abdominal pain caused by Enterobius vermicularis.
Shen LF, Yi QQ, Tian YH … +3 more , Yao J, Wang LS, Li DF
BMC Gastroenterol · 2026 Jul · PMID 42380810 · Full text
Small bowel involvement of Enterobius vermicularis infection is exceptionally rare, with few cases reported. A female presented with persistent abdominal pain for one month. Gastroscopy and colonoscopy were unremarkable,...
Small bowel involvement of Enterobius vermicularis infection is exceptionally rare, with few cases reported. A female presented with persistent abdominal pain for one month. Gastroscopy and colonoscopy were unremarkable, but computed tomography revealed localized small bowel wall thickening. Laboratory tests showed elevated eosinophil counts, though parasite antibody screening was negative. Double-balloon enteroscopy identified multiple shallow ulcers and a live worm in the small intestine, confirmed as Enterobius vermicularis on pathological examination. The patient was treated with anthelmintic therapy, and her symptoms resolved without recurrence.
Diagnostic accuracy of circulating long noncoding RNAs in hepatocellular carcinoma: a systematic review and meta-analysis.
Babajani N, Saeedian B, Shirmard FO … +4 more , Pourfaraji SM, Jodeiri F, Delavari A, Taheri E
BMC Gastroenterol · 2026 Jun · PMID 42380806 · Full text
BACKGROUND: Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, largely due to late diagnosis and the limited sensitivity of current screening biomarkers such as alpha-fetoprotei...
BACKGROUND: Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide, largely due to late diagnosis and the limited sensitivity of current screening biomarkers such as alpha-fetoprotein (AFP). Circulating long noncoding RNAs (lncRNAs) have recently emerged as promising, noninvasive biomarkers that may reflect the molecular mechanisms underlying hepatocarcinogenesis. This systematic review and meta-analysis aimed to comprehensively evaluate the diagnostic accuracy of circulating lncRNAs for detecting HCC. METHODS: A systematic search of PubMed, Scopus, Web of Science, and Embase was performed up to March 2025 following the PRISMA-DTA guidelines. Eligible studies reporting the diagnostic performance of circulating lncRNAs for HCC were included. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated using a bivariate random-effects model. Subgroup analyses were conducted according to sample type, detection method, and reference standard. RESULTS: Eighty-one studies encompassing over 6,000 participants were included. The pooled sensitivity and specificity of circulating lncRNAs were 0.83 (95% CI: 0.80-0.86) and 0.80 (95% CI: 0.75-0.84), respectively, with an area under the summary receiver operating characteristic (SROC) curve of 0.88. Serum-based assays showed slightly higher accuracy than plasma-based assays. lncRNAs also demonstrated good diagnostic performance in discriminating HCC from cirrhotic patients, as well as from patients with HBV-positive and HCV-positive status. CONCLUSION: Circulating lncRNAs exhibit high diagnostic accuracy and hold significant potential as complementary biomarkers to AFP for early HCC detection. Their mechanistic roles in tumor proliferation and immune regulation underscore their value in molecular diagnosis and personalized management of liver cancer.
A nationwide retrospective study of the July effect on nonvariceal upper GI bleeding outcomes in teaching hospitals in the United States.
Adenusi A, Asifat O, Nwatamole B … +5 more , Nabeta G, Amadi C, Atarere J, Awolumate O, Annor E
BMC Gastroenterol · 2026 Jun · PMID 42380778 · Full text
BACKGROUND: "July effect" also known as "July phenomenon" are adverse patient outcomes related to the changeover of medical residents in teaching hospitals in the United States at a particular time of the year. This stud...
BACKGROUND: "July effect" also known as "July phenomenon" are adverse patient outcomes related to the changeover of medical residents in teaching hospitals in the United States at a particular time of the year. This study aims to explore this phenomenon on hospital outcomes among patients with nonvariceal upper gastrointestinal bleeding (UGIB). METHODS: The National Inpatient Sample data from Jan 1, 2016, to Dec. 31, 2020, was used. Patients admitted in teaching hospitals between May and August were stratified patients into two groups; May & June; as (Non-July Effect), July & August as (July Effect). The study involved a comprehensive assessment and comparison of various clinical outcomes, including the likelihood of mortality, length of hospital stay, and the utilization and timing of esophagogastroduodenoscopy (EGD). These analyses were conducted while controlling factors such as socio-demographic variables, hospital characteristics, and associated comorbidities to ensure accurate and meaningful results. RESULTS: A total of 53,710 patients had non-variceal UGIB. There is no significant difference in Mortality risk (aOR = 1.10, 95% CI: 0.86-1.40, p = 0.4406), Length of hospitalization (0.98, 0.91-1.05, p = 0.5410), EGD (1.04, 0.94-1.32, p = 0.4412), and Early EGD (0.97, 0.80-1.19, p = 0.7759) between the July effect and non-July effect groups. CONCLUSIONS: The analysis reveals no significant differences in mortality rates, length of hospitalization, or endoscopy and its timing among patients with UGIB during the July effect compared to those not affected by this phenomenon. Our study corroborates previous research on the July phenomenon while also exploring this phenomenon in upper gastrointestinal bleeding.
Correction: Validation of the C-WATCH score for predicting severity in patients with upper gastrointestinal bleeding at a tertiary public hospital in Lima, Peru.
Espinoza-Ríos J, Ruiz-Cortez R, Santiago B … +1 more , Huerta-Mercado J
BMC Gastroenterol · 2026 Jun · PMID 42380777 · Full text
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Painful gastric glitch: an acute epigastric pain triggered by specific food as a new phenotype of postprandial epigastric pain syndrome.
Ambros GE, Kreutz LC, Naim I … +4 more , Rodriguez R, Morassutti AL, Farré R, Fornari F
BMC Gastroenterol · 2026 Jun · PMID 42374305 · Full text
BACKGROUND AND AIM: Postprandial epigastric pain syndrome was recently suggested as a disorder of gut-brain interaction. We assessed gastroduodenal motility and histology in patients with acute epigastric pain triggered...
BACKGROUND AND AIM: Postprandial epigastric pain syndrome was recently suggested as a disorder of gut-brain interaction. We assessed gastroduodenal motility and histology in patients with acute epigastric pain triggered by specific foods. METHODS: In this case-control, exploratory study, patients with epigastric pain and matched controls underwent upper endoscopy to exclude organic disease and gastroduodenal biopsies for histology. All participants underwent a dynamic gastroduodenal MRI, with a baseline acquisition followed by a food-trigger intake and three MRI acquisitions at 15-minute intervals. RESULTS: We studied seven pairs of participants (57% women, 33.3 ± 10.7 years old), all with unrevealing endoscopy. During the MRI, epigastric pain patients had pain crises that scored 6.6 ± 2.4 of a maximum of 10 points, triggered by caipirinha, red wine, banana, and coffee. No control subject had a pain crisis. Epigastric pain patients and controls did not differ in gastric motor parameters (P > 0.05), including accommodation, wall motion, and gastric emptying. Epigastric pain patients showed a negative correlation between pain score and wall motion time to peak (r = -0.81, P = 0.027). The duodenal mast cell count was higher in epigastric pain patients than in controls [median 140 (interquartile 25-75%: 117-153) vs. 86 (76-117); P = 0.020]. CONCLUSIONS: In patients presenting with acute epigastric pain following specific food intake, pain intensity might correlate with gastric wall motion parameters and duodenal mast cell infiltration. After confirmatory studies, such a postprandial epigastric pain syndrome might be recognized as a painful gastric glitch.
Dietary total antioxidant capacity and its dietary sources in association with non-alcoholic fatty liver disease: a case-control study.
Rohani FS, Emrani AS, Sasanfar B … +2 more , Toorang F, Hosseinzadeh M
BMC Gastroenterol · 2026 Jun · PMID 42374282 · Full text
BACKGROUND: Total antioxidant capacity (TAC) indicates the quality of individuals' diet. It has been proposed as a valuable measure for evaluating the potential protective effects of dietary antioxidants. The aim of this...
BACKGROUND: Total antioxidant capacity (TAC) indicates the quality of individuals' diet. It has been proposed as a valuable measure for evaluating the potential protective effects of dietary antioxidants. The aim of this study is to assess the relationship between the dietary TAC and odds of non-alcoholic fatty liver disease (NAFLD) in Yazd, Iran. METHODS: This case-control study included 115 patients diagnosed with non-alcoholic fatty liver disease (NAFLD) and 102 age- and sex-matched controls without NAFLD, all recruited from the same medical clinic. After 12 h of fasting, serum concentration of liver enzymes, fasting blood glucose and lipid profile of case and control groups were measured. To evaluate the participants' dietary intake during the past year a semi-quantitative Food Frequency Questionnaire which was validated for Iranian population, were used. RESULTS: There was no significant association between TAC and the risk of NAFLD in the whole population. However, risk of NAFLD in men those in top tertile of vegetable oil TAC were higher than men in the lowest tertile in crude model (OR = 3.81, CI: 1.19-12.2; P = 0.01). This relationship was attenuated and no longer statistically significant after adjusting for confounding variables. CONCLUSIONS: In the current study, no significant association was observed between NAFLD and dietary TAC, although in men who had a higher intake of vegetable oil TAC, a higher risk of NAFLD was observed. Further well-designed prospective studies are warranted to clarify these relationships.
Clinical characteristics, etiology, and outcomes of acute pancreatitis at a tertiary referral center in Latvia: a retrospective cohort study.
Varlamov D, Al-Dawoudi A, Dalain M … +3 more , Kopytko N, Staka A, Freimanis D
BMC Gastroenterol · 2026 Jun · PMID 42374262 · Full text
BACKGROUND: Acute pancreatitis is a common cause of gastrointestinal hospitalization, but detailed clinical cohort data from the Baltic region are limited. We aimed to characterize the clinical features, etiologies, como...
BACKGROUND: Acute pancreatitis is a common cause of gastrointestinal hospitalization, but detailed clinical cohort data from the Baltic region are limited. We aimed to characterize the clinical features, etiologies, comorbidities, and in-hospital outcomes of acute pancreatitis at a tertiary-center in Latvia. METHODS: We conducted a retrospective single-center cohort study of adults hospitalized with acute pancreatitis between 2020 and 2024, including only the index admission for each patient. Cases were identified using ICD-10 codes and confirmed according to the Revised Atlanta Classification. Demographic characteristics, etiologic factors, comorbidities, and clinical outcomes were analyzed. Multivariable logistic regression was used to identify factors independently associated with in-hospital complications. RESULTS: A total of 1,047 patients were included; the median age was 50 years (interquartile range, IQR 39-64.5), and 62.0% were male. Alcohol-related pancreatitis was the most common etiology (37.0%), followed by gallstone pancreatitis (24.7%). Overall, 215 patients (20.5%) developed at least one in-hospital complication. In multivariable analysis, alcohol-related pancreatitis (Odds ratio, OR 2.63, 95% Confidence interval, CI 1.59-4.36) and other etiologies (OR 2.89, 95% CI 1.79-4.65) were associated with higher odds of complications than gallstone pancreatitis. Diabetes mellitus (OR 1.69, 95% CI 1.10-2.56) and heart failure (OR 1.70, 95% CI 1.01-2.86) were also associated with increased risk. Median length of hospital stay was 6 days (IQR 4-9), intensive care unit admission occurred in 1.4% of patients, and in-hospital mortality was 5.3%. CONCLUSIONS: In this tertiary-center cohort, alcohol-related pancreatitis predominated and was associated with higher odds of the composite in-hospital complication endpoint than gallstone pancreatitis. These findings suggest a region-specific etiologic pattern and indicate that alcohol-related disease may contribute substantially to the acute pancreatitis case burden and adverse in-hospital outcomes in this setting.
Risk score for esophageal and gastric cancer in the over 50-year-old population based on self-reported information -the RISC-GAP project.
Schmitz T, Reizner J, Sha S … +6 more , Schöttker B, Brenner H, Roser D, Messmann H, Meisinger C, Linseisen J
BMC Gastroenterol · 2026 Jun · PMID 42374258 · Full text
BACKGROUND: The aim was to build a risk score (RS) for gastric and esophageal cancer (GEC) based on self-reported information as a first step to develop a risk-adapted screening modality for GEC or precursor lesions in a...
BACKGROUND: The aim was to build a risk score (RS) for gastric and esophageal cancer (GEC) based on self-reported information as a first step to develop a risk-adapted screening modality for GEC or precursor lesions in a non-high incidence region in the framework of the RISC-GAP project. METHODS: Data from 375,280 participants aged 50 years and older in the UK Biobank project were used. The outcome was incident esophageal or gastric cancer. Various variables, including sociodemographic data, medical conditions, medication, lifestyle factors and diet, were initially considered. To be able to use the RS as a screening tool in the general population, only variables that can be determined by self-report were selected. For variable selection, we used COX regression models with LASSO penalization; the main criterion was 5- and 10-years AUC. RESULTS: The final score included the following eight variables: sex, age, smoking status, drinking status, body mass index, history of esophagitis, medication with gastric acid inhibitors and surgery in the stomach/esophagus area. 10-fold cross-validation revealed a discrimination of 0.740 (5-year AUC) and 0.724 (10-year AUC), respectively. High-risk individuals were defined as those with a 10-year cancer risk of 1% or more (around 6% of the study population). CONCLUSION: The RS allows a reasonable discrimination of individuals with an elevated risk of gastric or esophageal cancer. In further steps of the RISC-GAP project it will be evaluated whether selection of a high-risk population can be further improved by additional clinical and biomarker information.
Association of postoperative day 1 procalcitonin levels with short-term mortality after liver transplantation: a single-center retrospective cohort study.
Chen T, Mai H, Li H … +13 more , Zhong X, Wang N, Hao P, Guo R, Han H, Zhang K, Zhong G, Cheng H, Jiang B, Zhu S, Zhuang S, Chen Y, He Q
BMC Gastroenterol · 2026 Jun · PMID 42374251 · Full text
BACKGROUND: Postoperative complications, especially infections, are important causes of poor prognosis after liver transplantation. Procalcitonin (PCT) has been proven to be a sensitive marker of infection and inflammati...
BACKGROUND: Postoperative complications, especially infections, are important causes of poor prognosis after liver transplantation. Procalcitonin (PCT) has been proven to be a sensitive marker of infection and inflammation in many diseases. As a result, the purpose of this study was to determine the connection between early postoperative PCT levels and mortality in liver transplant patients. METHODS: We included 205 liver transplant recipients who underwent orthotopic allogeneic liver transplantation at Sun Yat-sen University's Sun Yat-sen Memorial Hospital. We grouped the patients according to the tertile of PCT levels on postoperative day one (POD 1) and divided the patients into three groups: Q1 (≤ 2.0 ng/ml), Q2 (2.1-5.0 ng/ml), and Q3 (≥ 5.1 ng/ml). To analyze the curvilinear association between PCT levels and 90-day mortality and in-hospital mortality, we used Spearman's rank correlation coefficient. The Kaplan-Meier method was used to assess survival rates at 30, 60 and 90 days after liver transplantation. The Log-rank test was used to analyze differences in survival rates between different PCT groups. RESULTS: Higher POD1 PCT levels were associated with increased 90-day and in-hospital mortality. Furthermore, this study revealed a statistically significant decrease in ICU-free days at 28-day, hospital-free days at 28-day, CRRT-free hours at 28-day, and hospital-free days at 60-day among patients in the group of high PCT level. CONCLUSIONS: Higher POD1 PCT levels were associated with worse short-term postoperative outcomes after liver transplantation. However, POD1 PCT should be interpreted as a potential early risk-associated biomarker rather than as an established independent prognostic factor.
Non-HDL-to-HDL-cholesterol ratio and metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis.
Patankar SF, Ramdass PVAK
BMC Gastroenterol · 2026 Jun · PMID 42374245 · Full text
BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide and is linked to dyslipidemia and cardiometabolic dysfunction. The non-HDL cholesterol to...
BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide and is linked to dyslipidemia and cardiometabolic dysfunction. The non-HDL cholesterol to HDL cholesterol ratio (NHHR) has emerged as a composite lipid biomarker that reflects the balance between atherogenic and anti-atherogenic lipoproteins and may have utility in MASLD risk stratification. However, the strength and consistency of the association between NHHR and MASLD remain uncertain. This systematic review and meta-analysis aimed to synthesize the available evidence regarding the association between NHHR and MASLD and evaluate its diagnostic performance. METHODS: A systematic search of PubMed, Embase, and Google Scholar was conducted from database inception through January 2026 in accordance with PRISMA guidelines. Original human studies evaluating the relationship between NHHR and MASLD were included. Random-effects meta-analyses were performed to calculate pooled standardized mean differences (SMDs) in NHHR between individuals with and without MASLD, pooled odds ratios (ORs) for MASLD according to NHHR levels, and pooled area under the receiver operating characteristic curve (AUC) to evaluate diagnostic performance. Study quality was assessed using the Newcastle-Ottawa Scale. RESULTS: Twenty-four studies were included in the systematic review, and 19 studies comprising 120,985 participants were included in the quantitative synthesis. Individuals with MASLD had significantly higher NHHR values than controls (pooled SMD = 1.01, 95% CI: 0.17-1.84; p = 0.018). Higher NHHR levels were associated with increased odds of MASLD (pooled OR = 1.56, 95% CI: 1.25-1.96; p < 0.001). A clear dose-response relationship was observed, with progressively greater odds of MASLD across increasing NHHR categories: OR = 1.60 (95% CI: 1.21-2.13) for Q2/T2 versus Q1/T1, OR = 1.87 (95% CI: 1.67-2.09) for Q3 versus Q1, and OR = 2.19 (95% CI: 1.77-2.70) for Q4/T3 versus Q1/T1. Twelve studies evaluating diagnostic accuracy demonstrated a pooled AUC of 0.73 (95% CI: 0.70-0.75), indicating moderate discriminatory ability of NHHR for identifying MASLD. CONCLUSIONS: NHHR is significantly associated with MASLD and demonstrates a graded relationship with disease association, whereby higher NHHR levels correspond to progressively greater odds of MASLD. Furthermore, NHHR exhibits moderate diagnostic accuracy for identifying MASLD. As a simple, inexpensive, and widely available metric derived from routine lipid testing, NHHR may serve as a practical adjunctive biomarker for MASLD risk stratification and may help identify individuals who could benefit from further evaluation.
Silymarin-loaded phytosomal nanoparticles mitigate dyslipidemia, oxidative damage, and hepatic injury in high-fat diet-induced metabolic dysfunction-associated steatotic liver disease in rats.
Kattan SW, Almars AI, Tounsi WA … +5 more , Turkistani AA, Mohamed AM, Elghareeb MM, Elmorsy EM, H E Ali S
BMC Gastroenterol · 2026 Jun · PMID 42374242 · Full text
BACKGROUND: High-fat diets (HFDs) play a central role in the onset and progression of metabolic syndrome. This study investigated the protective effects of silymarin (SM)-loaded phytosomal nanoparticles (SM-PNPs) against...
BACKGROUND: High-fat diets (HFDs) play a central role in the onset and progression of metabolic syndrome. This study investigated the protective effects of silymarin (SM)-loaded phytosomal nanoparticles (SM-PNPs) against high-fat diet (HFD)-induced hepatic dysfunction and metabolic disorders, with emphasis on antioxidant and anti-inflammatory mechanisms. METHODS: Sixty rats were randomly divided into six groups: control, SM-treated (200 mg/kg body weight), SM-PNPs-treated (200 mg/kg body weight), HFD-treated, and two combination groups receiving HFD along with either SM or SM-PNPs (200 mg/kg body weight) for 5 weeks during the final phase of a 20-week HFD feeding period. RESULTS: SM-PNPs therapy demonstrated stronger hepatoprotective activity than unencapsulated SM. It significantly improved metabolic abnormalities, including insulin resistance, dyslipidemia, and hepatopathy in HFD-fed rats. Moreover, SM-PNPs ameliorated HFD-induced alterations in fasting glucose and insulin levels and improved HOMA-IR indices, thereby restoring glucose homeostasis. Treatment also markedly reduced oxidative stress while enhancing the antioxidant defense system. RT-PCR analysis revealed significant downregulation of key inflammatory genes, including interleukin-1 beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), nuclear factor kappa B (NF-κB), and inducible nitric oxide synthase (iNOS), along with a significant reduction in systemic inflammation, as indicated by decreased high-sensitivity C-reactive protein (hsCRP) levels, as well as apoptosis caspases activities. The in-silico analysis revealed significant interactions of SM with crucial proteins involved in regulating antioxidant defense and inflammatory pathways. Histopathological and ultrastructural examinations further supported these biochemical findings, showing that SM-PNPs attenuated hepatic steatosis, collagen deposition, and fibrosis. CONCLUSIONS: SM-PNPs exert a significant protective effect against HFD-induced hepatic damage and metabolic disturbances and represent a promising therapeutic strategy for metabolic dysfunction-associated steatotic liver disease (MASLD), potentially due to improved solubility, bioavailability, and sustained release in the nanoparticle formulation.
In vitro cytotoxic and apoptotic effects of chitosan-coated gold nanoparticles on HT-29 human colorectal adenocarcinoma cells.
Jodat J, Aghaei M, Ekrami A … +2 more , Dayer D, JalaliFar MA
BMC Gastroenterol · 2026 Jun · PMID 42374234 · Full text
BACKGROUND: Colorectal cancer is a major cause of cancer-related mortality worldwide. Nanotechnology has introduced nanoparticles as a promising therapeutic approach in cancer treatment. Gold nanoparticles (AuNPs) can in...
BACKGROUND: Colorectal cancer is a major cause of cancer-related mortality worldwide. Nanotechnology has introduced nanoparticles as a promising therapeutic approach in cancer treatment. Gold nanoparticles (AuNPs) can influence critical cellular processes in cancer cells. This study evaluates the effects of chitosan-coated gold nanoparticles (CH-AuNPs) on cell viability, mitochondrial membrane potential, reactive oxygen species (ROS) production, and apoptosis-related gene expression in the human colorectal adenocarcinoma HT-29 cell line. METHODS: CH-AuNPs were synthesized and characterized using dynamic light scattering (DLS), UV-Vis spectroscopy, and atomic force microscopy (AFM). Cell viability was assessed using the MTT assay. Apoptosis, mitochondrial membrane potential (Δψm), and ROS production were analyzed via flow cytometry using Annexin V-FITC/PI, Rhodamine 123, and DCFH-DA, respectively. A clonogenic assay was used to measure colony-forming ability, and real-time qPCR was performed for gene expression analysis. RESULTS: The nanoparticles had an average size of 12.3 nm. The IC50 was 33 µM (approximately 6.5 µg/mL). They significantly reduced colony formation, decreased mitochondrial membrane potential, and induced apoptosis in HT-29 cells. ROS levels remained unchanged. BAX, Caspase-3, and CYT C gene expression increased, while anti-apoptotic BCL2 expression decreased. CONCLUSIONS: Chitosan-coated gold nanoparticles exhibit cytotoxic and apoptotic effects on HT-29 cells under in vitro conditions. These preliminary findings suggest the need for further investigation, including validation in additional colorectal cancer cell lines, assessment of selectivity, and in vivo studies, before any therapeutic application can be considered.
Microsatellite instable early gastric cancers; a distinct molecular profile with HER2 over-expression and increased multiple lesion risk.
Lim NR, Chung WC
BMC Gastroenterol · 2026 Jun · PMID 42374226 · Full text
BACKGROUND/AIMS: Microsatellite instability (MSI) associated gastric cancers (GCs) have a large burden of mutational risk. In advanced gastric cancers (AGCs), the pre-treatment evaluation of MSI and over-expression of HE...
BACKGROUND/AIMS: Microsatellite instability (MSI) associated gastric cancers (GCs) have a large burden of mutational risk. In advanced gastric cancers (AGCs), the pre-treatment evaluation of MSI and over-expression of HER2 / EGFR could be crucial for prognosis. However, the significance of MSI state, HER2, and EGFR over-expression in early gastric cancer (EGC) are still under investigation. METHOD: A consecutive study was undertaken from March 2020 to March 2022, and we analyzed 325 gastric cancer tissues (165 EGCs; 160 AGCs) from the patients who had received gastrectomy or endoscopic submucosal dissection. RESULTS: The frequencies of MSI and HER2 over-expression were 21.8% (71/ 325), and 14.5% (47/ 325), respectively. The frequency of EGFR over-expression was 48.9% (159/ 325). The infection rate of Helicobacter pylori was 50.8% (165/325), and the infection rate in EGC (58.8%, 97/165) was significantly higher than that in AGC (42.5%, 68/160) (P < 0.01). EGFR overexpression was more frequent in AGC than in EGC (P = 0.03), and there was no statistical difference for MSI and HER2. In MSI positive GCs, HER2 over-expression (P = 0.03) and H. pylori infection (P = 0.03) were more frequent than in microsatellite stable GCs. HER2 over-expression was outstanding in MSI EGCs (P < 0.01), and multiple lesions were observed more clinically. CONCLUSION: The frequency of H. pylori infection and HER2 over-expression occurred more frequently in MSI positive GCs. In particular, HER2 overexpression was more evident in MSI-EGC. MSI-EGC is a group of diseases with unique molecular biological characteristics and may show rapid tumor growth potential, so special treatment measures may be needed.
Conservative management of delayed perforation after colorectal endoscopic submucosal dissection: a single-center experience.
Guan J, Li W, Guo X … +2 more , Li L, Ding Z
BMC Gastroenterol · 2026 Jun · PMID 42374217 · Full text
BACKGROUND: Delayed perforation is a rare but serious complication of colorectal endoscopic submucosal dissection (ESD). This study aimed to evaluate the clinical characteristics and outcomes of patients undergoing conse...
BACKGROUND: Delayed perforation is a rare but serious complication of colorectal endoscopic submucosal dissection (ESD). This study aimed to evaluate the clinical characteristics and outcomes of patients undergoing conservative management for delayed perforation after colorectal ESD. METHODS: We retrospectively reviewed the medical records of 21 patients with delayed perforation after colorectal ESD treated between May 2011 and May 2025. Among them, 19 patients who received initial conservative management were included. These patients were divided into two groups: the Success Group (SG, n = 14), where conservative management succeeded, and the Failure Group (FG, n = 5), which required conversion to surgery. A comparative analysis of clinical, endoscopic, and laboratory findings between the two groups was performed. RESULTS: Compared with the FG, the SG had lower baseline serum creatinine (median 67.0 vs. 90.0 µmol/L, P = 0.023), higher baseline albumin (mean 41.2 vs. 36.4 g/L, P = 0.042), and a significantly higher rate of complete endoscopic closure (P = 0.013) during the procedure. During conservative management, the SG exhibited a slower rise and a more rapid decline in serum procalcitonin (PCT) levels compared to the FG. CONCLUSIONS: In this small single-center cohort, successful conservative management of delayed perforation after colorectal ESD appeared to be associated with adequate intraoperative defect closure and a relatively better baseline physiological profile, including lower preprocedural serum creatinine and higher preprocedural albumin levels. These findings should be interpreted as exploratory associations rather than definitive predictive indicators. Serial monitoring of serum PCT may provide additional information during conservative management, but treatment escalation should be determined through comprehensive clinical, laboratory, imaging, and multidisciplinary assessment. TRIAL REGISTRATION: Clinical trial number not applicable.
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