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Complete Resection of Duodenal Cyst With Adenoma by Using Clips Anchored Endloop of Protrusion Roots to Ligation. 夹锚固定十二指肠突出根末端环结扎术完全性切除十二指肠囊肿伴腺瘤。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-27 DOI: 10.1111/jgh.70265
Tengwei Deng, Binbo He, Chao Lan, Tao Zhang
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引用次数: 0
Comment on "Comparative Efficacy and Safety of 0.8-L Versus 2-L Polyethylene Glycol-Ascorbic Acid Solutions in Colonoscopy Preparation: A Prospective, Multicenter, Randomized, Controlled Trial". 评论“0.8 l与2 l聚乙二醇-抗坏血酸溶液在结肠镜制剂中的比较疗效和安全性:一项前瞻性、多中心、随机、对照试验”。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-26 DOI: 10.1111/jgh.70262
Xin Zhou
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引用次数: 0
Identifying a Novel Six-LncRNA Signature Evaluates Survival and Reveals AC129507.1 as the m6A-Target to Regulate Ferroptosis in Gastric Cancer. 鉴定新的6 - lncrna特征评估生存并揭示AC129507.1作为m6a靶点调节胃癌铁下垂
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-23 DOI: 10.1111/jgh.70255
Yunshu Ma, Yizhe Zhang, Xiaomu Hu, Zhikai Jiang, Xinju Zhang, Xiao Xu, Ensi Ma, Jing Zhao

Gastric cancer (GC) has become a serious threat to global health with escalating incidence and mortality. There is a lack of effective approach to evaluate prognostic survival and stratify high-risk patients due to the highly heterogeneous characteristics of GC. In this study, we integrated N6-methyladenosine (m6A) RNA modification, ferroptosis gene sets, and lncRNA transcriptomic data together, established and validated a novel six-lncRNA profile associating with the survival of GC. The m6A-ferroptosis lncRNA signature could identify high-risk GC patients and characterize the immunosuppressive tumor microenvironment (TME). In our GC cohort, the 3- and 5-year survival rates of the high-risk compared with low-risk subgroup were 27.8% versus 54.8% and 22.2% versus 50.0%, respectively. Multiplex immunofluorescence assays indicated that high-risk GC samples frequently had less infiltration of CD8+ T cells but exhibited abundant immunosuppressive M2-polarized macrophages and Tregs. The differentially expressed genes were primarily enriched in oxidative stress response, reactive oxygen species, RNA metabolic processes, the PI3K-Akt signaling axis, and leukocyte transendothelial migration pathways. Accordingly, high-risk patients might be sensitive to inhibitors targeted at PDK1, tyrosine kinase, PI3K, and HIF-proly1 hydroxylase, whereas the low-risk subgroup might benefit from blockade of ErbB, TrkA, PARP, and Ribosomal S6 kinase. Moreover, we demonstrated that the high-risk factor AC129507.1 in the lncRNA signature was a novel target of the m6A regulatory axis WTAP/YTHDF3/ALKBH5, and depletion of AC129507.1 could markedly induce ferroptosis in GC. Collectively, these findings provide a candidate strategy for risk classification and better clinical management of GC and shed new insight into the underlying mechanism of AC129507.1 in GC development.

胃癌(GC)的发病率和死亡率不断上升,已成为全球健康的严重威胁。由于胃癌的高度异质性,缺乏有效的方法来评估预后生存和对高危患者进行分层。在这项研究中,我们整合了n6 -甲基腺苷(m6A) RNA修饰、铁死亡基因集和lncRNA转录组学数据,建立并验证了与GC存活相关的新型6个lncRNA谱。m6a -铁下垂lncRNA标记可以识别高危胃癌患者,并表征免疫抑制肿瘤微环境(TME)。在我们的GC队列中,高风险亚组与低风险亚组的3年和5年生存率分别为27.8%对54.8%和22.2%对50.0%。多重免疫荧光分析表明,高危GC样品中CD8+ T细胞浸润较少,但具有丰富的免疫抑制性m2极化巨噬细胞和Tregs。差异表达基因主要富集于氧化应激反应、活性氧、RNA代谢过程、PI3K-Akt信号轴和白细胞跨内皮迁移途径。因此,高风险患者可能对靶向PDK1、酪氨酸激酶、PI3K和hif -脯氨酸1羟化酶的抑制剂敏感,而低风险亚组可能受益于阻断ErbB、TrkA、PARP和核糖体S6激酶。此外,我们证实lncRNA特征中的高危因子AC129507.1是m6A调控轴WTAP/YTHDF3/ALKBH5的新靶点,并且AC129507.1的缺失可以显著诱导GC中的铁下垂。总的来说,这些发现为胃癌的风险分类和更好的临床管理提供了候选策略,并为AC129507.1在胃癌发展中的潜在机制提供了新的见解。
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引用次数: 0
Impact of BRAF Gene Mutation in Nonmetastatic Colorectal Cancer on Disease Progression and Survival Outcomes 非转移性结直肠癌BRAF基因突变对疾病进展和生存结果的影响
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-23 DOI: 10.1111/jgh.70215
Caroline Lum, Harrison Boka, Mohammad Asghari-Jafarabadi, Shehara Mendis, Lauren Cohen, Helen E. Abud, Rebekah M. Engel, Paul J. McMurrick

Background and Aim

Colorectal cancer (CRC) is a major global health concern, with molecular and histopathological subtypes influencing disease progression. Mutations in the v-Raf murine sarcoma viral oncogene homolog B (BRAF) gene, particularly the V600E variant, define a subset associated with aggressive features. The impact of BRAF mutations on early-stage CRC prognosis and their interaction with mismatch repair (MMR) status remains less characterized.

Methods

We conducted a retrospective analysis of prospectively collected data from two tertiary institutions on Stage II–III CRC patients. BRAF/MMR subgroups were defined (BRAFmut/pMMR, BRAFmut/dMMR, BRAFwt/pMMR, and BRAFwt/dMMR). Associations with patient/tumor characteristics, adjuvant treatment, and long-term outcomes were assessed. Univariate and multivariate analyses were used to evaluate disease recurrence and mortality.

Results

Of 157 eligible patients, univariate analyses indicated poorer outcomes for those with pMMR CRC. Multivariate analysis examining disease recurrence and death highlights that pMMR patients perform worse, but significantly, this analysis revealed that BRAFmut is a significant predictor of mortality in the nonmetastatic setting, irrespective of MMR status.

Conclusions

Nonmetastatic BRAFmut CRC carries a dismal prognosis, irrespective of MMR status. Routine testing for BRAFV600E mutation alongside MMR assessment is advocated to inform personalized management, potentially impacting surveillance, adjuvant therapy decisions, and eligibility for targeted therapies.

背景和目的:结直肠癌(CRC)是一个主要的全球健康问题,分子和组织病理学亚型影响疾病进展。v-Raf小鼠肉瘤病毒癌基因同源物B (BRAF)基因的突变,特别是V600E变异,定义了一个与侵袭性特征相关的子集。BRAF突变对早期结直肠癌预后的影响及其与错配修复(MMR)状态的相互作用尚不清楚。方法:我们对来自两所高等院校的II-III期CRC患者的前瞻性数据进行了回顾性分析。定义BRAF/MMR亚组(BRAFmut/pMMR、BRAFmut/dMMR、BRAFwt/pMMR和BRAFwt/dMMR)。评估了与患者/肿瘤特征、辅助治疗和长期预后的关系。采用单因素和多因素分析评估疾病复发率和死亡率。结果:157例符合条件的患者中,单变量分析显示pMMR结直肠癌患者预后较差。检查疾病复发和死亡的多变量分析强调pMMR患者表现更差,但值得注意的是,该分析显示,无论MMR状态如何,BRAFmut是非转移性情况下死亡率的重要预测因子。结论:与MMR状态无关,非转移性BRAFmut CRC预后不佳。建议对BRAFV600E突变进行常规检测,同时进行MMR评估,为个性化管理提供信息,这可能会影响监测、辅助治疗决策和靶向治疗的资格。
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引用次数: 0
Hemostatic Powder for Non-Malignant Upper Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 止血粉治疗非恶性上消化道出血:随机对照试验的系统回顾和荟萃分析。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-23 DOI: 10.1111/jgh.70249
Paula Santo, Gilmara Coelho Meine, Renan Martins Gomes Prado, Fernanda Pessorrusso, Mohammad Bilal, Fauze Maluf-Filho

Background and aim: The effectiveness of standard endoscopic treatment (SET) for non-variceal upper gastrointestinal bleeding (NVUGIB) may vary, particularly depending on the bleeding site, lesion size, and etiology. Recent studies suggest that hemostatic powder (HP) may effectively control bleeding secondary to malignant upper gastrointestinal lesions, but its efficacy in benign etiology for NVUGIB remains uncertain. This systematic review and meta-analysis aimed to compare the effectiveness of HP versus SET as first-line therapy for patients with non-malignant causes of NVUGIB.

Methods: We systematically searched PubMed, Embase, and Cochrane Library databases for randomized controlled trials (RCTs) from inception to January 2025. We used risk ratios (RR) for binary outcomes and mean differences (MD) for continuous outcomes with their corresponding 95% confidence intervals (CIs).

Results: We included 5 RCTs (708 patients). Compared to SET, HP was associated with marginally lower risk of further bleeding during esophagogastroduodenoscopy (EGD) (RR 1.04; 95% CI [1.001, 1.084]; p = 0.04) and similar rebleeding rate within 1, 3, 7, 15, and 30 days. The need for a second endoscopic treatment and the mean procedure time were similar between the groups. Subgroup analyses showed that HP has a lower risk of further bleeding during EGD only when analyzing Forrest IIa lesions, but not in active bleeding.

Conclusions: In patients with non-malignant NVUGIB, HP demonstrated lower risk of further bleeding during EGD in cases with non-bleeding visible vessels. There was no statistically significant difference in further bleeding during EGD for active bleeding, nor in rebleeding risk at 1, 3, 7, 15, or 30 days.

背景和目的:标准内镜治疗(SET)对非静脉曲张性上消化道出血(NVUGIB)的效果可能会有所不同,特别是取决于出血部位、病变大小和病因。最近的研究表明,止血粉(HP)可以有效控制恶性上消化道病变继发出血,但其对NVUGIB良性病因的疗效尚不确定。本系统综述和荟萃分析旨在比较HP与SET作为一线治疗非恶性原因NVUGIB患者的有效性。方法:我们系统地检索PubMed、Embase和Cochrane图书馆数据库,检索从建立到2025年1月的随机对照试验(rct)。我们对二元结果使用风险比(RR),对连续结果使用平均差异(MD)及其相应的95%置信区间(ci)。结果:我们纳入5项rct(708例患者)。与SET相比,HP与食管胃十二指肠镜检查(EGD)中进一步出血的风险略微降低相关(RR 1.04; 95% CI [1.001, 1.084]; p = 0.04), 1、3、7、15和30天内的再出血率相似。两组间第二次内镜治疗的需要和平均手术时间相似。亚组分析显示,仅在分析Forrest IIa病变时,HP在EGD期间进一步出血的风险较低,而在活动性出血时则没有。结论:在非恶性NVUGIB患者中,没有可见血管出血的HP患者在EGD期间进一步出血的风险较低。活动性出血在EGD期间的进一步出血,以及1、3、7、15和30天的再出血风险没有统计学上的显著差异。
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引用次数: 0
Large, White Globe Appearance–Like Endoscopic Findings: Stomach Lymphatic Invasion Distant From Advanced Gastric Cancer 大的白色球体样内窥镜表现:远离晚期胃癌的胃淋巴浸润。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-21 DOI: 10.1111/jgh.70256
Kohei Uyama, Hiroyoshi Iwagami, Yasuki Nakatani, Yoshito Uenoyama, Kazuo Ono

A 62-year-old man presented with neurological symptoms, and head computed tomography revealed multiple brain metastases. Subsequent evaluation identified a 30-mm Type 2 ulcerative lesion in the lower gastric body, diagnosed as moderately differentiated tubular adenocarcinoma. In addition, numerous small, patchy white lesions with a large “white globe appearance (WGA)–like” appearance were observed endoscopically throughout the stomach. Histological analysis confirmed lymphatic invasion of adenocarcinoma in these areas. These findings suggest that a large WGA-like appearance may reflect lymphatic dissemination and could serve as endoscopic markers for evaluating tumor invasion depth and metastatic potential in gastric cancer.

一名62岁男性表现为神经系统症状,头部计算机断层扫描显示多发性脑转移。随后的检查发现下胃体有一个30mm的2型溃疡性病变,诊断为中分化管状腺癌。此外,胃镜下观察到整个胃内可见许多小的、斑片状的白色病变,呈大的“白色球体样”外观。组织学分析证实淋巴管浸润腺癌在这些区域。这些发现提示,大的wga样外观可能反映了淋巴播散,可以作为内镜下评估胃癌肿瘤侵袭深度和转移潜力的标志。
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引用次数: 0
A 73-Year-Old Man With Intermittent Dysphagia and Esophageal Wall Thickening: What Is the Diagnosis? 73岁男性间歇性吞咽困难伴食管壁增厚:如何诊断?
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-20 DOI: 10.1111/jgh.70257
Qingqing Zhang, Xuelian Xiang, Jun Song

This case report describes a 73-year-old man with more than 1 year of intermittent dysphagia, initially suspected of having esophageal malignancy based on imaging and endoscopic findings. However, multiple mucosal biopsies revealed only mild dysplasia without eosinophilic infiltration. Endoscopic ultrasound performed at our hospital revealed a preserved four-layer esophageal wall structure with diffuse thickening of the muscularis propria at 30-40 cm from the incisors. Definitive diagnosis was ultimately achieved through peroral endoscopic myotomy (POEM) combined with biopsy, which revealed marked eosinophilic infiltration confined to the muscularis propria, consistent with eosinophilic esophageal myositis. POEM provided both diagnostic and therapeutic benefits, leading to substantial clinical improvement and weight gain over 1 year of follow-up without the use of corticosteroids.

本病例报告描述了一名73岁男性,间歇性吞咽困难超过1年,最初根据影像学和内镜检查结果怀疑患有食管恶性肿瘤。然而,多次粘膜活检显示只有轻度异常增生,无嗜酸性粒细胞浸润。在本院行超声内镜检查,发现距门牙30- 40cm处有一保存完好的四层食管壁结构及弥漫性固有肌层增厚。最终通过经口内窥镜下肌切开术(POEM)结合活检确诊,结果显示明显的嗜酸性粒细胞浸润局限于固有肌层,与嗜酸性粒细胞性食管肌炎一致。POEM提供了诊断和治疗两方面的益处,在不使用皮质类固醇的情况下,在1年的随访中导致了实质性的临床改善和体重增加。
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引用次数: 0
Letter: Concerns Regarding the Paradoxical Renal Outcomes in Patients Switching From Entecavir to Tenofovir Alafenamide in the Study by Ogawa et al. 信函:对Ogawa等人研究中从恩替卡韦切换到替诺福韦阿拉芬胺患者的矛盾肾脏结局的担忧。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-20 DOI: 10.1111/jgh.70240
Jingru Ge, Jianyi Wang
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引用次数: 0
Novel Liquid Biopsy in Gastrointestinal Cancers 新型液体活检在胃肠道肿瘤中的应用。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-20 DOI: 10.1111/jgh.70219
Li-Chun Chang, Tang-Long Shen, Takahiro Ochiya

Gastrointestinal (GI) cancers represent a significant global health burden, being among the leading causes of cancer-related deaths. The prognosis for patients remains unsatisfactory, largely because most cancers are detected at advanced stages. Traditional diagnostic methods, such as radiological and histopathological examinations and serum tumor markers like AFP, CEA, CA-125, and CA-199, possess limitations in sensitivity and specificity, particularly for early screening. A major drawback of tissue biopsy is its inability to fully capture the inherent heterogeneity within tumors, as mutations can differ between primary and metastatic sites. In this context, liquid biopsy has emerged as a promising, minimally invasive alternative for detecting cancer-associated materials present in various body fluids. The concept of liquid biopsy, initially centered on circulating tumor cells, has expanded to encompass other critical biomarkers such as circulating tumor DNA, extracellular vesicles, and circulating tumor RNA. Analyzing these biomarkers using advanced techniques like next-generation sequencing or proteomics can unveil a wealth of potential information. Liquid biopsy offers numerous advantages, being less invasive, more convenient, potentially more cost-effective, and providing a dynamic, real-time snapshot of the entire tumor burden that reflects both intertumoral and intratumoral heterogeneity. This review provides an overview of key liquid biopsy biomarkers and their associated detection technologies, discusses their burgeoning clinical applications across various GI cancer types, and highlights the current challenges and future directions in this rapidly evolving field.

胃肠道癌症是一个重大的全球健康负担,是癌症相关死亡的主要原因之一。患者的预后仍然不令人满意,主要是因为大多数癌症在晚期才被发现。传统的诊断方法,如放射学和组织病理学检查以及血清肿瘤标志物,如AFP、CEA、CA-125和CA-199,在敏感性和特异性方面存在局限性,特别是在早期筛查方面。组织活检的一个主要缺点是它不能完全捕获肿瘤内部固有的异质性,因为突变在原发和转移部位之间可能不同。在这种情况下,液体活检已经成为一种有前途的、微创的检测各种体液中存在的癌症相关物质的替代方法。液体活检的概念最初以循环肿瘤细胞为中心,现已扩展到包括其他关键的生物标志物,如循环肿瘤DNA、细胞外囊泡和循环肿瘤RNA。使用下一代测序或蛋白质组学等先进技术分析这些生物标记物可以揭示大量潜在信息。液体活检具有许多优点,侵入性更小,更方便,可能更具成本效益,并提供整个肿瘤负荷的动态实时快照,反映肿瘤间和肿瘤内的异质性。本文综述了主要的液体活检生物标志物及其相关检测技术,讨论了它们在各种胃肠道癌症类型中的快速临床应用,并强调了这一快速发展领域当前的挑战和未来的方向。
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引用次数: 0
Blood Urea Nitrogen-to-Creatinine Ratio to Differentiate Upper From Lower Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis 血尿素氮-肌酐比值用于鉴别上消化道出血和下消化道出血:一项系统回顾和荟萃分析。
IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2026-01-19 DOI: 10.1111/jgh.70224
Daniel Martin Simadibrata, Thai Hau Koo, Murlidhar Murlidhar, Ramesh Lamichhane, Derren David Christian Homenta Rampengan, Pojsakorn Danpanichkul, Richard C. K. Wong

Background and Aim

Determining the location of gastrointestinal (GI) bleeding is critical for guiding diagnostic and therapeutic strategies but often results in patients receiving pan-endoscopy with upper endoscopy, colonoscopy, and small bowel capsule endoscopy, which can be unnecessary, costly, and waste limited healthcare resources. The blood urea nitrogen-to-creatinine ratio (BUN/Cr) may help discriminate between upper GI bleeding (UGIB) and lower GI bleeding (LGIB). This study aims to assess the diagnostic performance of the BUN/Cr in distinguishing UGIB from LGIB.

Methods

A literature search was conducted in MEDLINE, EMBASE, and Cochrane Library to identify diagnostic test accuracy studies published from inception through January 31, 2025, which evaluated BUN/Cr in patients with UGIB versus LGIB. A linear mixed-effects model meta-analysis was conducted using the “diagmeta” package. The pooled sensitivity, specificity, diagnostic odds ratio, and area under the summary receiver operating characteristic curve (AUC) were estimated, and optimal threshold was determined using the Youden index.

Results

Seventeen studies were included in this meta-analysis. The pooled mean difference in BUN/Cr between UGIB and LGIB patients was 11.44 (95% confidence interval [95% CI] 8.35–14.52). At a threshold of > 30, pooled sensitivity was 38.8% (95% CI 28.1%–50.8%) and specificity was 89.3% (95% CI 81.0%–94.2%). At the optimal cut-off of 22, sensitivity was 66.2% (95% CI 57.8%–73.7%), specificity was 71.0% (95% CI 58.5%–81.0%), and AUC was 0.740 (95% CI 0.683–0.794).

Conclusion

BUN/Cr demonstrates moderate diagnostic accuracy for distinguishing UGIB from LGIB, particularly at a threshold of ≥ 22. This readily accessible and inexpensive blood test may assist in early clinical triage and assessment of the location of GI bleeding, particularly in those patients where the clinical presentation is obscure.

背景和目的:确定胃肠道(GI)出血的位置对于指导诊断和治疗策略至关重要,但通常导致患者接受泛内窥镜检查、上镜检查、结肠镜检查和小肠胶囊内窥镜检查,这些检查可能是不必要的、昂贵的,并且浪费了有限的医疗资源。尿素氮与肌酐比值(BUN/Cr)可用于鉴别上消化道出血(UGIB)和下消化道出血(LGIB)。本研究旨在评估BUN/Cr在区分UGIB和LGIB中的诊断性能。方法:在MEDLINE、EMBASE和Cochrane图书馆中进行文献检索,以确定从成立到2025年1月31日发表的诊断测试准确性研究,这些研究评估了UGIB与LGIB患者的BUN/Cr。使用“诊断”软件包进行线性混合效应模型元分析。估计合并敏感性、特异性、诊断优势比和总受试者工作特征曲线(AUC)下面积,并使用约登指数确定最佳阈值。结果:本荟萃分析纳入了17项研究。UGIB和LGIB患者BUN/Cr的合并平均差异为11.44(95%可信区间[95% CI] 8.35-14.52)。阈值为bbb30时,合并敏感性为38.8% (95% CI 28.1%-50.8%),特异性为89.3% (95% CI 81.0%-94.2%)。在最佳临界值为22时,敏感性为66.2% (95% CI 57.8% ~ 73.7%),特异性为71.0% (95% CI 58.5% ~ 81.0%), AUC为0.740 (95% CI 0.683 ~ 0.794)。结论:BUN/Cr在区分UGIB和LGIB方面具有中等的诊断准确性,特别是在阈值≥22时。这种容易获得和廉价的血液检查可以帮助早期临床分诊和评估胃肠道出血的位置,特别是在那些临床表现不明确的患者。
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引用次数: 0
期刊
Journal of Gastroenterology and Hepatology
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