Molecular Characterization of Gastrointestinal Stromal Tumors (Gist) and Contribution of Immunohistochemistry in Congolese from Kinshasa

Introduction: The differentiation of digestive tumors very often requires the use of techniques currently not widely in use in the Democratic Republic of Congo (DRC), such as immunohistochemistry. This is perfectly verified for GISTs whose precise, or at least highly certain, diagnosis can only be made using immunohistochemical markers. This underuse of these techniques due to lack of equipment and human skills explains the limited epidemiological data available to date, thus leading to untargeted and too often late treatment of patients. Research question: What contribution can immunohistochemical markers make to the diagnosis of digestive tract tumours? Objective: Discuss the contribution of immunohistochemical markers in the diagnosis of GIST and provide basic data on the epidemiology of these nosological entities in Kinshasa. Methodology: This was a retrospective study carried out at the LEBOMA private anatomy and pathological cytology centre. The main inclusion criterion was any digestive tract block or slide whose diagnosis of GIST had been requalified after review by at least 2 pathologists. An immuhistochemical study was performed using an automated technique (with a Ventana XT machine) using a panel of antibodies: CD-117 and DOG-1 which are listed in the literature as strongly correlated with the occurrence of GIST, all slides were made at Hj Hospital using an OLYMPUS BX41 co-observation microscope. Results: Of 601 cases of digestive tumors recorded during the concerned period, 32 (5.32%) concerned GIST. This prevalence was confirmed by our immunohistochemical results where the expression of CD117 and that of DOG-1 were positive in 90.6% and 100% of cases which prevalence is high compared with the worldwide prevalence according to the literature, respectively. The distribution of the patients concerned was made with a sex ratio of 1.6 women/men with a median age of 53 years. Most cases (81%) had a gastric location and were fusiform GISTs. Conclusion: Gastrointestinal stromal tumours, although rare and underestimated, account for 5.32% of cases in the DRC. This is a considerable and high prevalence compared with the world average. To the best of our knowledge, no studies have been carried out on these aspects in the DRC, which explains the importance of this study. The results of this research demonstrated the contribution of these 2 markers as specific and effective biomarkers for optimal and differential diagnosis in GIST. In view of the above, it is therefore more than necessary to popularise the use of these biomarkers in order to contribute effectively to improving the overall management of gastrointestinal tumours by improving their identification.

Role of tumor-associated macrophages in common digestive system malignant tumors

Many digestive system malignant tumors are characterized by high incidence and mortality rate.Increasing evidence has revealed that the tumor microenvironment(TME)is involved in cancer initiation and tumor progression.Tumor-associated macrophages(TAMs)are a predominant constituent of the TME,and participate in the regulation of various biological behaviors and influence the prognosis of digestive system cancer.TAMs can be mainly classified into the antitumor M1 phenotype and protumor M2 phenotype.The latter especially are crucial drivers of tumor invasion,growth,angiogenesis,metastasis,immunosuppression,and resistance to therapy.TAMs are of importance in the occurrence,development,diagnosis,prognosis,and treatment of common digestive system malignant tumors.In this review,we summarize the role of TAMs in common digestive system malignant tumors,including esophageal,gastric,colorectal,pancreatic and liver cancers.How TAMs promote the development of tumors,and how they act as potential therapeutic targets and their clinical applications are also described.

Prevention of malignant digestive system tumors should focus on the control of chronic inflammation

Chronic inflammation,through a variety of mechanisms,plays a key role in the occurrence and development of digestive system malignant tumors(DSMTs).In this study,we feature and provide a comprehensive understanding of DSMT prevention strategies based on preventing or controlling chronic inflammation.The development and evaluation of cancer prevention strategies is a longstanding process.Cancer prevention,especially in the early stage of life,should be emphasized throughout the whole life course.Issues such as the time interval for colon cancer screening,the development of direct-acting antiviral drugs for liver cancer,and the Helicobacter pylori vaccine all need to be explored in long-term,large-scale experiments in the future.

Role of inositol polyphosphate-4-phosphatase type II in oncogenesis of digestive system tumors

Inositol polyphosphate-4-phosphatase type II(INPP4B)is a newly discovered PI(3,4,5)P3 phosphatase.Many studies have revealed that INPP4B is upregulated or downregulated in tumors of the digestive system,and the abnormal expression of INPP4B may be attributed to the occurrence,development,and prognosis of tumors of the digestive system.This paper reviews studies on the correlations between INPP4B and digestive system tumors and the roles of INPP4B in the development of different tumors to provide a theoretical basis for further research on its molecular mechanism and clinical application."INPP4B"and"tumor"were searched as key words in PubMed and in the CNKI series full text database retrieval system from January 2000 to August 2023.A total of 153 Englishlanguage studies and 30 Chinese-language studies were retrieved.The following enrollment criteria were applied:(1)Studies contained information on the biological structure and functions of INPP4B;(2)studies covered the influence of abnormal expression of INPP4B in digestive system tumors;and(3)studies covered the role of INPP4B in the diagnosis,treatment,and prognosis of digestive system tumors.After excluding the literature irrelevant to this study,61 papers were finally included in the analysis.INPP4B expression is low in gastric cancer,colon cancer,pancreatic cancer,and liver cancer but it has high expression in esophageal cancer,colon cancer,pancreatic cancer,and gallbladder cancer.INPP4B is involved in the occurrence and development of digestive system tumors through the regulation of gene expression and signal transduction.The abnormal expression of INPP4B plays an important role in the development of digestive system tumors.Studies on INPP4B provide new molecular insights for the diagnosis,treatment,and prognosis evaluation of digestive system tumors.

IGF2BPs: a family as diagnostic and prognostic biomarkers in digestive system tumors

The highest morbidity and mortality in the world are attributed to digestive system tumors,such as stomach cancer,liver cancer,and pancreatic cancer.Exploring potential biomarkers is a crucial direction of tumor research.We use bioinformatics methods to explore potential biomarkers of the digestive system.Mining and analyzing data from Gene Expression Profiling Interactive Analysis(GEPIA),Kaplan-Meier,cBioPortal,and Metabolic gEne RApid Visualizer(MERAV)to explore the correlation between IGF2BP(insulin-like growth factor-2 mRNA-binding protein)family expression and immune infiltration in digestive system tumors,and further probe the prognostic value of IGF2BP family in digestive system tumors.Esophageal cancer tissues showed a significantly higher expression of IGF2BP2 than normal tissues,while IGF2BP3 was notably more expressed in esophageal cancer,pancreatic cancer,and stomach cancer.In the prognosis evaluation,the IGF2BP1 gene in patients with liver cancer and the IGF2BP2 and IGF2BP3 genes in patients with stomach cancer and liver cancer of the low gene expression level groups were better.Multivariate COX regression analysis further suggested that tumor stage,CD8 positive T cells,macrophages,dendritic cell infiltration,and IGF2BP3 expression were independent risk factors affecting the prognosis of patients with stem cell liver cancer.The IGF2BP family may be a potential marker for immunotherapy and the prognosis of digestive system tumors.

Analysis of sleep quality,disease uncertainty,and psychological tolerance in patients undergoing chemotherapy for digestive tract malignancies

BACKGROUND Colorectal cancer is the second leading cause of cancer-related deaths among digestive tract malignancies,following gastric cancer.Sleep is of great significance for maintaining human health.The incidence of sleep disorders in patients with cancer is approximately twice that observed in the general population.Lack of sleep can prolong hospital stays,increase the likelihood of infection,and increase mortality rates.Therefore,studying the factors related to sleep quality is significant for improving the quality of life of patients with malignant tumors of the digestive tract.AIM To investigate the relationships among sleep quality,disease uncertainty,and psychological resilience in patients undergoing chemotherapy for digestive tract malignancies.METHODS A total of 131 patients with malignant digestive tract tumors who were treated at Hefei BOE Hospital between April 2021 and September 2022 were selected as research participants.Based on their Pittsburgh Sleep Quality Index(PSQI)scores,participants were divided into either the sleep disorder group(PSQI score>7)or the normal sleep group(PSQI score≤7).The clinical data—together with the Mishel Uncertainty in Illness Scale for Adults(MUIS-A)and Connor-Davidson Resilience Scale(CD-RISC)scores—were compared.RESULTS In this study,78(59.54%)patients with digestive tract malignancies developed sleep disorders after chemotherapy.Sleep disorder incidence was higher in patients with colorectal cancer than in those with gastric and esophageal cancers(P<0.05).The total MUIS-A score and those for each item in the sleep disorder group were higher than those in the normal sleep group.The total CD-RISC score and those for each item in the sleep disorder group were lower than those in the normal sleep group(P<0.05).The PSQI scores of patients with malignant digestive tract tumors were positively correlated with the scores for lack of disease information,disease uncertainty,and unpredictability in the MUIS-A and negatively correlated with the scores for tenacity,self-improvement,and optimism in the CD-RISC(P<0.05).CONCLUSION Patients undergoing chemotherapy for digestive tract malignancies are prone to sleep problems related to disease uncertainty and psychological resilience.Therefore,interventions can be implemented to improve their sleep quality.

Two-photon excitation fuorescence lifetime imaging microscopy:A promising diagnostic tool for digestive tract tumors

Digestive tract tumors acount for 15%and 19.3%of the cancer incidence and deaths,respec-tively.Early detection of digestive tract tumors is crucial to the reduction of global cancer burden.Two-photon excitation fuorescence lifetime imaging microscopy(TP-FLIM)allows non-invasive,label free,three-dimensional,high-resolution imaging of living tisues with not only histological but also biochemical characterization ability in both qualitative and quantitative way.Benefiting from these advantages,this technology is protmising for clinical diagnosis of digestive tract tumors.In recent years,many efforts have'been made in this field and some remarkable progress has been achieved.In this paper,we overview the recent progress of TP-FLIM-based researches on digestive tract tumor detection.Among them,our latest results on the gastric cancer and esophageal cancer are elaborately depicted.Finally,we outlook and discuss the potential advantages and challenges of TP-FLIM in future clinical applications.

Associations between the Serum Zinc Levels and Digestive Tract Tumors:A Meta-Analysis

Background The incidence and mortality rates of digestive tract tumors are among the top ten worldwide.Notably,studies have shown that zinc may be significantly related to digestive tract tumors.This meta analysis was conducted to explore whether the serum zinc level of patients is associated with gastrointestinal cancer.Methods We systematically searched PUBMED,the Cochrane Library,the Web of Science and EMBASE from their start dates up to October 2022 for studies on the association between the serum zinc concentration and digestive tract tumors.The I^(2)statistic was used to assess the heterogeneity.A sensitivity analysis,subgroup analysis and meta-regression analysis were also used to analyze heterogeneity.Moreover,Begg’s and Egger’s tests were adopted to assess potential publication bias.Results In total,we identified 24 eligible studies with 1,499 total participants with digestive tract tumors and 6,039 participants without tumors.The average serum zinc concentration in patients with digestive tract tumors was lower than that in the control group(SMD=-0.98,95%CI:-1.29~-0.66,I^(2):94.1%,P<0.001).Specifically,the serum zinc concentration of patients with esophageal cancer(SMD=-2.08,95%CI:-2.89~-1.26,I^(2):92.9%,P<0.001),gastric cancer(SMD=-0.74,95%CI:-1.16~-0.33,I^(2):92.1%,P<0.001),and colorectal cancer(SMD=-0.85,95%CI:-1.51~-0.19,I^(2):95.9%P<0.05)were significantly different from the controls.Conclusion Our review showed that the serum zinc concentration in patients with digestive tract tumors was lower than that in patients without tumors,and further studies are needed to explore how zinc affects the occurrence and development of digestive tract tumors.

Research progress on drug delivery systems for curcumin in the treatment of gastrointestinal tumors

Curcumin is a natural compound with a diketone structure,which can control the growth,metastasis,recurrence,neovascularization,invasion,and drug resistance of gastrointestinal tumors by inhibiting nuclear factorκB,overexpression of tumor cells,vascular endothelial growth factor,etc.However,due to the low bioavailability of curcumin formulation,it did not fully exert its pharmacological effects,and its application and development in the treatment of various malignant tumors are still limited.This review summarizes the research on drug delivery systems of curcumin combating digestive tract tumors in order to further reduce the toxic side effects of curcumin-containing drugs and fully exert their pharmacological activities,and improve their bioavailability and clinical value.

Analysis of the rule of medication of compound Chinese traditional patent medicine for digestive system tumors based on data mining

Objective:Based on the data mining method,explore the medication rules of Chinese patent medicines for the treatment of digestive system tumors.Method:Based on the"Chinese Traditional Medicine Prescription Database"in https://db.yaozh.com/,collect Chinese patent medicines for the treatment of digestive system tumors,establish an Excel table,and use the ancient and modern medical case cloud platform(V2.2.1)to perform frequency statistics,association rules,and drugs on the data Clustering and complex network analysis.Results:A total of 36 Chinese patent medicines for the treatment of digestive system tumors were screened.The medicinal properties were mainly warm and cold,the taste was bitter and sweet,and the meridians were mainly liver and spleen meridians.High frequency Chinese medicine include Astragalus,Scutellaria-barbata,Ginseng,Curcuma,Triangle,Atractylodes,Hedyotis diffusa,etc.Correlation analysis obtained 17 drug combinations,High-frequency drug pairs include Scutellaria-barbata-Astragalus,Ginseng-Astragalus,Curcuma-Astragalus,Scutellaria-barbata-Curcuma,etc.Cluster analysis found 3 types of drugs.The core drug network is composed of 27 drugs,and the core compatibility network consists of 3 groups of drugs.Conclusion:The Chinese patent compound medicine for the treatment of digestive system tumors has the characteristics of combining cold and warming,replenishing and reducing treatment,and treating the liver and spleen at the same time.The medicine is mainly used to replenish qi and invigorate the spleen,promote blood circulation and remove blood stasis,and clear away heat and detoxification.Replenish qi,nourish yin,invigorate blood,and detoxify are mainly compatible with each other,reflecting the pathogenesis characteristics of"deficiency,stasis,and toxin"in digestive system tumors.Data mining can provide references for the prescription and compatibility of Chinese patent medicines.

Clinicopathological significance and prognostic value of claudin10 expression in primary malignant tumors of digestive system:A metaanalysis

Objective:To investigate the correlation between claudin10 expression and clinicopathological characteristics and prognosis of primary malignant tumors of digestive system.Methods:We searched the PubMed,Web of Science,Ovid MEDLINE,CNKI,CQVIP,and WanFang Data databases.The data between claudin10 expression and clinical characteristics as well as survival outcome were extracted.RevMan 5.3 and Stata 15.1 software were employed for metaanalysis.Results:A total of 6 studies containing 512 patients with primary malignant tumors of digestive system were analyzed.The analysis showed that high expression of claudin10 was more common in cancer tissue than in normal tissue[OR=3.22,95%CI(2.26,4.60),P<0.01],and was associated with increasing tumor size[OR=6.21,95%CI(2.44,15.83),P<0.01],high differentiation[OR=0.56,95%CI(0.32,0.99),P=0.05],positive lymph node metastasis[OR=3.41,95%CI(1.09,10.65),P=0.03].The expression of claudin10 was not associated with sex[OR=1.62,95%CI(0.91,2.90),P=0.10],age[OR=1.72,95%CI(0.97,3.07),P=0.06],distant metastasis[OR=4.51,95%CI(0.55,36.70),P=0.16],or prognosis[HR=1.99,95%CI(0.93,4.23),P=0.08].Conclusion:The expression of claudin10 is correlated with the clinicopathological features of primary malignant tumors of digestive system and is a potential tumor marker.

New insights into digestive tract tumors

Digestive tract tumors,ranging from esophageal to colorectal cancers(CRCs),pose a substantial challenge in oncology because of their high global incidence and mortality.1,2 The heterogeneity of these malignancies underscores the complexity of their etiology,which is influenced by a combination of genetic,epigenetic,and environmental factors.3 Unraveling the molecular complexities and clinical implications of these tumors is of growing importance,as they provide insights that can inform the development of more effective diagnostic,therapeutic,and preventative approaches.The Special Issue,titled“Basic research and clinical practice on gastrointestinal cancer”,aims to highlight the recent advances in molecular mechanisms and clinical research in the field of digestive tract oncology.We hope that by presenting these findings we can foster collaboration and dialog among experts in the field,ultimately leading to innovative perspectives on the diagnosis and treatment of these cancers.

Chinese expert consensus and practice guideline of totally implantable access port for digestive tract carcinomas

Totally implantable access port is a fully implantable drug delivery system that is implanted subcutaneously and can be retained for a long time.Advantages of ports include a simple nursing process,low risk of infection and embolism,and high patient comfort.In order to promote the standardized application of ports in the treatment of digestive tract tumors and reduce port-related complications,the Chinese Research Hospital Association Digestive Tumor Committee,the Chinese Association of Upper Gastrointestinal Surgeons,the Chinese Gastric Cancer Association,and the Gastrointestinal Surgical Group of Chinese Surgical Society Affiliated to Chinese Medical Association have organized multidisciplinary expert discussions at the General Hospital of the People’s Liberation Army and nationwide expert letter reviews and on-site seminars,and formulated an expert consensus of the operation guidelines.

Nanomaterials modulate tumor-associated macrophages for the treatment of digestive system tumors

The treatment of digestive system tumors presents challenges,particularly in immunotherapy,owing to the advanced immune tolerance of the digestive system.Nanomaterials have emerged as a promising approach for addressing these challenges.They provide targeted drug delivery,enhanced permeability,high bioavailability,and low toxicity.Additionally,nanomaterials target immunosuppressive cells and reshape the tumor immune microenvironment(TIME).Among the various cells in the TIME,tumor-associated macrophages(TAMs)are the most abundant and play a crucial role in tumor progression.Therefore,investigating the modulation of TAMs by nanomaterials for the treatment of digestive system tumors is of great significance.Here,we present a comprehensive review of the utilization of nanomaterials to modulate TAMs for the treatment of gastric cancer,colorectal cancer,hepatocellular carcinoma,and pancreatic cancer.We also investigated the underlying mechanisms by which nanomaterials modulate TAMs to treat tumors in the digestive system.Furthermore,this review summarizes the role of macrophage-derived nanomaterials in the treatment of digestive system tumors.Overall,this research offers valuable insights into the development of nanomaterials tailored for the treatment of digestive system tumors.

Expression of hMSH2 gene and mutant p53 in sporadic digestive tract tumors

Objective To investigate the role of mutated mismatch repair gene hMSH2 and mutant p53 gene in the carcinogenesis and development of sporadic digestive tract tumors. Methods hMSH2 gene in normal and tumor tissue of 30 digestive tract tumor specimens was examined using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) silver staining. The PCR product with an abnormal strand was sequenced directly. Mutant p53 protein in the tumor tissue was analyzed immunohistochemically. Results Six patients were identified as having mutated strands, three on hMSH2 exon 1 and three on hMSH2 exon 5. DNA sequencing revealed that all 6 patients had mutated basic groups that led to decrease in function of the hMSH2 protein. Forty percent (12/30) of patients were p53 positive. The frequency of mutated hMSH2 in p53 positive patients (41.7%) was significantly higher than in p53 negative patients (5.6%, P<0.05). Conclusion The mutation of hMSH2 plays an important role in the carcinogenesis and development of digestive tract tumors through stimulating p53 mutation.

Progress in Research on Applying Sijunzi Decoction (四君子汤) in Treating Digestive Malignant Tumor

Patients with digestive malignant tumor always have their immune function, especially the cellular immunity, suppressed to a certain extent. Traditional Chinese medicine （TCM） holds that Pi （脾 ）-Wei （胃） is the essence of postnatal life, and the genesis and development of digestive tumor are chiefly due to the insufficiency of vital-qi, which makes the body open to the invasion of evil pathogens. Starting from regulating the immune function of organisms, researchers recently obtained some therapeutic effects by applying the Chinese recipe, Sijunzi Decoction （四君子汤）, in the treatment of digestive malignant tumors. In this paper, the related studies on the concerned basic theory and clinical application were reviewed.