World Journal of Gastroenterology

BACKGROUND Gastric cancer (GC) poses significant treatment challenges due to late-stage diagnosis and the limited efficacy of conventional therapies. Immunotherapy, particularly immune checkpoint inhibitors such as pembrolizumab and nivolumab targeting the programmed death-ligand 1 (PD-L1) pathway, has shown promising results. Pembrolizumab is effective in PD-L1-positive tumors, while nivolumab i…

Inflammation-based indices such as the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, and nutritional metrics like the prognostic nutritional index or controlling nutritional status, offer pragmatic risk stratification in hepatocellular carcinoma treated with lenvatinib, these scores being not immutable. Nutrition and physical activity can influe…

BACKGROUND Tropomyosin 3 (TPM3) has been implicated in the progression of several cancers; however, its specific role and underlying molecular mechanisms in gastric cancer (GC) remain unclear. The current research aimed to investigate the role of TPM3 in the onset and advancement of GC, along with the related molecular pathways. AIM To investigate TPM3’s role in enhancing GC malignancy and elucid…

Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, is a group of chronic relapsing disorders caused by dysregulated mucosal immunity, altered gut microbiota, and impaired epithelial barrier function. There is increasing evidence linking circadian disruptions, such as shift work, jet lag, sleep loss, light misalignment, and irregular eating patterns, to the ri…

BACKGROUND Myeloid sarcoma is a rare extramedullary tumor of immature myeloid cells, often associated with acute myeloid leukemia. Primary intestinal myeloid sarcoma without hematologic disease is uncommon and can mimic gastrointestinal stromal tumor (GIST). CASE SUMMARY A 52-year-old man presented with upper abdominal pain, distension, and nausea. Computed tomography revealed a small intestinal …

BACKGROUND Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction and is characterized by chronic abdominal pain and altered bowel habits. Current evidence indicates that immune activation and autoantibody production contribute to IBS pathogenesis. However, the mechanisms by which autoantibodies affect the enteric nervous system and contribute to IBS-related symptoms are poo…

Split liver transplantation (SLT) has always existed in a delicate tension between expanding access and accepting complexity. By converting one deceased donor liver into two grafts, SLT directly addresses the persistent organ shortage, but at the cost of extended transection planes, altered hemodynamics, and a consistently higher rate of early postoperative complications (EPC) compared with whole…

BACKGROUND Despite emerging evidence supporting circulating tumor DNA (ctDNA) as a potential biomarker for pancreatic ductal adenocarcinoma (PDAC), its clinical efficacy for serial monitoring has not been thoroughly explored. We hypothesized that serial monitoring of ctDNA provides clinically relevant information on treatment response and prognosis in patients with PDAC. AIM To investigate the fe…

BACKGROUND The worldwide prevalence of inflammatory bowel disease (IBD) continues to rise, motivating extensive exploration into possible contributing factors. Proton pump inhibitors (PPIs) are frequently prescribed medications for managing various gastrointestinal disorders. However, uncertainties persist regarding the implications of chronic PPI therapy and its potential association with the on…

BACKGROUND Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare primary liver cancer with poor prognosis and a lack of reliable markers for prognostic assessment or tailored postoperative therapy. The expression of human epidermal growth factor receptor 2 (HER2) in cHCC-CCA and its potential role in predicting prognosis remain unclear. Therefore, investigating the clinical significance…

BACKGROUND Despite 5-aminosalicylic acid (5-ASA) being the first-line therapy for ulcerative colitis (UC), there is limited real-world evidence concerning sex-specific differences in the efficacy of 5-ASA therapy and patient prognosis. AIM To investigate sex-disparities in 5-ASA treatment responses and long-term outcomes in a Chinese large-scale UC cohort. METHODS A retrospective study was conduc…

BACKGROUND Nucleoside/nucleotide analogs are currently the core drugs for antiviral treatment of chronic hepatitis B (CHB). Among them, entecavir (ETV) and tenofovir alafenamide fumarate (TAF) exhibit potent antiviral effects with low resistance rates and are recommended as first-line treatment regimens in domestic and international guidelines. AIM To evaluate bone and renal safety in patients wi…

BACKGROUND The rising detection of branch-duct intraductal papillary mucinous neoplasms (BD-IPMN) has led to updated surveillance guidelines, yet the true malignant transformation rate and the cost-effectiveness of these strategies remain uncertain. Current protocols are based on expert opinion rather than validated data, leading to conflicting recommendations and significant healthcare costs. Th…

BACKGROUND Portal hypertension (PHT) is a complication of chronic liver disease. PHT was observed from the early stage of cholestatic liver disease (CLD). Growth arrest specific 6 (Gas6)-mediated macrophage efferocytosis was an essential process clearing apoptotic cells and facilitating liver injury repair. AIM To investigate the effects of recombinant Gas6 (rGas6) on efferocytosis in PHT based o…

BACKGROUND Although immune checkpoint inhibitors have shown remarkable efficacy in multiple malignancies, their clinical benefit remains limited in the majority of colorectal cancers (CRC). This resistance is attributed to CD8+ T cell exhaustion. The extracellular signal-regulated kinase (ERK)/p38 mitogen-activated protein kinase (p38 MAPK) pathway plays a pivotal role in both tumor progression a…

Immune contexture increasingly shapes colorectal cancer (CRC) prognosis, yet most profiling is tumor-centric. The study interrogated adjacent nontumor mucosa (NM) and tumor center (TC) in 99 CRC patients with liver metastases (LM). Using immunohistochemistry for CD68 (M0), CD80 (M1), and CD206/CD163 (M2), they observed a consistent density gradient (CD163 > CD206 > CD68 > CD80) and marke…

BACKGROUND Acute pancreatitis (AP) is a common disease in the intensive care unit. Although the clinical management of AP has improved, over mortality has not declined significantly. Rhubarb, an anthraquinone glycoside derivative, has been reported to improve intestinal blood perfusion, inhibit excessive inflammatory responses, regulate inflammatory mediator cascades, and enhance intestinal motil…

BACKGROUND Liver inflammatory lesions and malignancies often have overlapping manifestations and contrast-enhanced ultrasound (CEUS) enhancement modes, particularly in hepatitis or cirrhosis settings. Conventional biomarkers, such as alpha-fetoprotein (AFP) and the Model for End-Stage Liver Disease (MELD) score, have limited diagnostic accuracy in this setting. Therefore, an interpretable, multi-…

BACKGROUND While numerous studies have examined the associations between dietary polyphenol subclasses (i.e. , flavonoids, phenolic acids, lignans, and stilbenes) and the risk of gastric cancer (GC), evidence regarding their relationships with gastric precancerous lesions (GPL) and their subtypes [i.e. , chronic atrophic gastritis, intestinal metaplasia (IM), and low-grade dysplasia (LGD)] remain…

BACKGROUND Gastric variceal hemorrhage (GVH) is among the most life-threatening complications of portal hypertension. Endoscopic variceal ligation (EVL) and cyanoacrylate injection (endoscopic variceal obturation) are the main endoscopic options for hemostasis, but their comparative efficacy and safety remain debated due to variable evidence. AIM To investigate the safety and efficacy of endoscop…