Turkish Journal of Gastroenterology最新文献

Background/aims: This study aimed to compare the efficacy of bolus versus infusion administration of terlipressin in patients with acute esophageal variceal bleeding and to elucidate any differences in clinical outcomes between the 2 approaches.

Materials and methods: This prospective study included patients divided into 2 groups. Group 1 received a 2 mg intravenous (IV) bolus followed by 1 mg IV every 4 hours. Group 2 received a 1 mg IV bolus followed by a 4 mg terlipressin infusion over 24 hours. Clinical and laboratory parameters, hospitalization duration, need for blood product transfusion, rebleeding or mortality within 6 weeks, and drug related side effects were evaluated.

Results: Among the 46 patients, 23 (50%) received terlipressin as an IV bolus (group 1), and 23 (50%) received it as an infusion (group 2). Treatment failure occurred in 4 patients (8.7%), all from group 1, though the difference was not statistically significant (P = .109). Six patients (13%) experienced rebleeding and death within 6 weeks, with no significant differences in clinical outcomes between the groups. No significant differences in creatinine and sodium levels were observed between the groups at baseline or at the end of treat ment (P = .654). Additionally, no difference in the incidence of portal vein thrombosis was noted between survivors and non-survivors (P = 1.000).

Conclusion: As no significant differences in efficacy or safety were observed between bolus and infusion administration, infusion ther apy may be preferred due to its potential benefits in patient comfort and ease of administration.   Cite this article as: Şenkaya A, Çelik F, Kurtulmuş Akgün İ, et al. Terlipressin treatment for acute esophageal variceal bleeding: Bolus or infusion? Turk J Gastroenterol. 2026;37(2):208-214.

Background/aims: To screen cuproptosis-related genes (CRGs) and construct a prognosis risk model for hepatocellular carcinoma (HCC) based on transcriptome data.

Materials and methods: Transcriptome, gene expression, and clinical data of HCC were downloaded from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases to screen CRGs. Differential genes were screened, and Cox analysis and LASSO regression analysis were performed. The clinical value of the constructed model for HCC patients was assessed. Patient survival rates were predicted. The expression of relevant genes in liver cancer tissues and adjacent tissues was verified, and the prognostic risk for patients was evaluated.

Results: Nineteen CRGs were identified, and 15 genes were expressed differently in tumor tissues and normal tissues. Multivariate analy sis and LASSO regression analysis showed that 15 genes related to prognostic risk were screened, based on which a prediction model of 9 CRGs was constructed. High-risk patients, as determined by the prognostic model, showed a significantly decreased survival rate rela tive to low-risk patients. Tumor microenvironment and drug sensitivity were closely related to risk scores. Nomograms predicted survival probabilities for liver cancer patients over 1-, 3-, and 5-year periods at 91.6%, 62.4%, and 56.3%, respectively. Reverse transcription quantitative polymerase chain reaction experiments verified the relevant gene expression that made up the model in liver cancer and adjacent tissues.

Conclusion: The constructed prognostic risk model can predict the prognosis of HCC well and may be used for risk stratification, immu notherapy evaluation, and drug susceptibility analysis.   Cite this article as: Huang W, Wu Q. Unsupervised clustering subtype analysis and prognostic risk model of cuproptosis-related genes for liver cancer. Turk J Gastroenterol. 2026;37(1):75-87.

Colonoscopy is a pivotal technique for screening and diagnosing colorectal diseases, particularly colorectal polyps and cancers. Early detection of lesions enables early diagnosis and treatment, thereby improving patient prognosis. The adequacy of bowel preparation is directly related to the quality and effectiveness of colonoscopy. However, the bowel cleansing process may disrupt the balance of gut microbiota, subsequently affecting the host's health status. Currently, there is a relative scarcity of reports on the specific impacts of different types of laxatives on gut microbiota. Therefore, this paper aims to deeply analyze and summarize the effects of various bowel preparations on gut microbiota and their potential adverse reactions following colonoscopy, providing a more comprehensive reference for the selection of bowel preparations in clinical practice.

Background/aims: Linked color imaging (LCI) has been shown to improve the visibility of gastric lesions and may enhance the detection of gastric superficial neoplasia (GSN). The aim was to compare the detection performance of LCI versus white light imaging (WLI) in patients referred for endoscopic resection of GSNs.

Materials and methods: In this randomized prospective comparative study, patients who were referred for endoscopic resection of gastric adenoma or early gastric cancer (ECG) were assigned to either the LCI or WLI group. Initial endoscopic evaluation was performed using the assigned mode (LCI or WLI), followed by a second examination using the alternate mode. The primary outcome was detection sensitivity for GSNs.

Results: Ninety-five patients with 104 lesions were analyzed: 48 in the LCI group and 47 in the WLI group. Detection sensitivity at first observation was 94.23% in the LCI group and 86.54% in the WLI group (P = .122). The mean tumor detection time was significantly shorter in the LCI group (54.2 ± 38.4 seconds) than in the WLI group (74.0 ± 55.5 seconds; P = .049). Tumors with type IIb morphology were significantly more likely to be missed than tumors with other morphologies (P = .014).

Conclusion: Linked color imaging may improve lesion detection performance and efficiency during the endoscopic evaluation of GSNs.   Cite this article as: Lee JG, Yoo IK, Lee SP, et al. Diagnostic performance of linked color imaging compared to white light imaging during secondary endoscopic evaluation in patients with gastric neoplasia referred for endoscopic resection: A randomized comparative study. Turk J Gastroenterol. 2026;37(1):44-54.

Globally, alcoholic beverages top the charts in both sales and consumption rates. However, prolonged intake of these drinks often leads to hepatic injury, potentially progressing to more severe conditions such as hepatic fibrosis, cirrhosis, and in extreme cases, hepatocellular carcinoma. Over the past 2 decades, pharmacological research has increasingly validated the therapeutic potential of natural botanicals and their bioactive derivatives in the clinical management of hepatic fibrosis. In this review, anti-fibrotic secondary metabolites targeting alcohol-induced liver injury have been systematically analyzed, focusing on their botanical origins, pharmacodynamic profiles, structural characteristics, and mechanistic underpinnings. It provides some reference for developing natural products in the treatment of liver fibrosis in the future.

Background/aims: Limited research exists on predictors of portal vein thrombosis (PVT) during endoscopic therapy. This study aims to develop a nomogram, utilizing inflammatory markers, to predict the development of PVT within 2 years following endoscopic treatment in cirrhotic patients with severe gastroesophageal varices.

Materials and methods: A retrospective analysis was conducted on clinical data from 127 patients who underwent endoscopic therapy for severe gastroesophageal varices or bleeding due to cirrhosis at Tianjin Third Central Hospital between January and December 2015, all of whom were free of PVT at baseline. Univariate and multivariate logistic regression models were applied to identify significant pre dictors. A nomogram for PVT occurrence was developed.

Results: Of the 127 patients, 20 developed PVT (PVT group), representing an incidence rate of 15.75% within 2 years. The remaining 107 patients did not develop PVT (non-PVT group). Multivariate logistic regression revealed that the model for end-stage liver disease score, monocyte-to-lymphocyte ratio (MLR), spleen diameter, and gastric varices sandwich therapy were independent predictors of PVT development. A nomogram was constructed, with the area under the receiver operating characteristic (ROC) curve (AUC) of 0.807 (95% CI: 0.703-0.911, P = .000) and a C-index of 0.807. The Hosmer-Lemeshow χ2 test score was 3.681 (P = .885). Bootstrap self-sampling confirmed the model's excellent calibration, while the decision curve analysis (DCA) indicated a higher net benefit at higher risk thresh old probabilities.

Conclusion: A nomogram predicting PVT development in cirrhotic patients with severe gastroesophageal varices within 2 years of the first endoscopic intervention  wassuccessfully established using inflammatory markers. This model offers an effective tool for predicting PVT risk in this patient population.   Cite this article as: Zhou J, Niu L, Chen X, et al. Construction of a nomogram for portal vein thrombosis after endoscopic therapy of severe gastroesophageal varices in cirrhotic patients. Turk J Gastroenterol. 2026;37(1):88-97.

Background/aims: The aim of this study is to reveal the contribution and clinical usability of endosonography in the differential diagnosis of patients presenting with dysphagia.

Materials and methods: The study included 77 patients with dysphagia. Age, gender, comorbidity, body mass index, history of radiotherapy and chemotherapy, history of trauma, and history of previous head and neck surgery were recorded from the patients' files. Duration of dysphagia complaints and Eckardt scores were calculated. High-resolution manometry (HRM) and endosonographic ultrasonography (EUS) results were evaluated retrospectively.

Results: Of the patients included in the study, 41 were male and 36 were female. Endosonographic ultrasonography muscularis mucosa, EUS muscularis propria, and EUS total wall thickness values of achalasia patients were found to be higher than those of the healthy control group (P < .05). Eckardt scoring of achalasia patients with IRP (Integrated relaxation pressure) pressure below 20 mmHg was higher than those with integrated relaxation pressure (IRP) pressure above 20 mmHg (P < .05).

Conclusion: In the differential diagnosis of dysphagia, EUS contributed to the diagnosis of HRM in the detection of malignancy. In addition, EUS esophageal wall thicknesses of achalasia patients were found to be significantly higher than those of the healthy group. Manometric examination of patients with increased esophageal wall thickness in patients undergoing EUS in the differential diagnosis of upper gastrointestinal (GI) pathologies will be useful in terms of motility disorder.

Background/aims: Hepatocellular carcinoma (HCC) stands as the foremost contributor to cancer-related mortality, underscoring its profound significance in the oncological landscape. This study explores the potential regulatory mechanisms of lncRNA CKMT2-AS1 in the functionality of HCC cells, thereby providing a basis for therapeutic approaches in the treatment of HCC.

Materials and methods: Quantitative polymerase chain reaction (qPCR) was utilized to evaluate the expression of CKMT2-AS1 and miR-142-5p in HCC tissues and cells. The interactions between CKMT2-AS1 and miR-142-5p, as well as the interplay between IFITM3 and miR-142-5p, were confirmed through dual-luciferase assays. To assess the effects of CKMT2-AS1 transfection, alongside the cotransfection of CKMT2-AS1 and miR-142-5p interference plasmids, a series of experiments were conducted utilizing CCK-8 and transwell assays to evaluate changes in proliferation, migration, and invasion of HCC cells. Additionally, qPCR was employed to elucidate the influence of miR-142-5p on the expression of IFITM3 in HCC cells.

Results: The study elucidated that CKMT2-AS1 was significantly upregulated in HCC tissues and cells, while miR-142-5p exhibited a marked downregulation, revealing a noteworthy negative correlation. Notably, the downregulation of CKMT2-AS1 hindered the function of HCC cells. Conversely, the downregulation of miR-142-5p effectively mitigated the inhibitory effects of CKMT2-AS1 on cellular activities. Furthermore, the upregulation of miR-142-5p resulted in a substantial decrease in the levels of IFITM3 in HCC cells. This investigation established a potential regulatory network, identifying IFITM3 as the downstream target mRNA.

Conclusion: The sponging effect of CKMT2-AS1 on miR-142-5p resulted in altered expression levels of IFITM3, subsequently influencing the progression of HCC.