Assessment of the relationship between resilience and quality of life in patients with digestive cancer

AIM: To study the relationship between resilience and quality of life (QOL) in patients with digestive cancer.

Digestive cancer incidence and mortality among young adults worldwide in 2020:A population-based study

BACKGROUND Digestive cancer has traditionally been thought of as a disease that mainly occurs in elderly individuals,and it has been ignored in young adults by both patients and physicians.AIM To describe the worldwide profile of digestive cancer incidence,mortality and corresponding trends among 20–39-year-olds,with major patterns highlighted by age,sex,development level,and geographical region.METHODS I performed a population-based study to quantify the burden of young adult digestive cancers worldwide.Global,regional,sex,and country-specific data estimates of the number of new cancer cases and cancer-associated deaths that occurred in 2020 were extracted from the GLOBOCAN Cancer Today database.To assess long-term trends in young adult digestive cancer,cancer incidence data and mortality data were obtained from the Cancer in Five Continents Plus database and the World Health Organization mortality database,respectively.The associations between the human development index(HDI)and digestive cancer burden in young adults were evaluated by linear regression analyses.RESULTS In 2020,there were an estimated 19292789 new cancer cases,resulting in 9958133 deaths worldwide,which equated to an age-standardized incidence rate(ASIR)of 5.16 and age-standardized mortality rate(ASMR)of 3.04,accounting for 12.24%of all new cancer cases and 25.26%of all cancer deaths occurring in young adults.The burden was disproportionally greater among males,with male:female ratios of 1.34 for incidence and 1.58 for mortality.The ASIRs were 2.1,1.4,and 1.0 per 100000 people per year,whereas the ASMRs were 0.83,1.1,and 0.62 per 100000 people per year for colorectal,liver,and gastric cancer,respectively.When assessed by geographical region and HDI levels,the cancer profile varied substantially,and a strong positive correlation between the mortality-to-incidence ratio of digestive cancer and HDI ranking was found(R^(2)=0.7388,P<0.001).CONCLUSION The most common digestive cancer types are colorectal,liver and gastric cancer.The global digestive cancer burden among young adults is greater among males and exhibits a positive association with socioeconomic status.The digestive cancer burden is heavy in young adults,reinforcing the need for primary and secondary prevention strategies.

A meta-analysis of the effects of energy intake on risk of digestive cancers

AIM:To quantitatively assess the relationship between energy intake and the incidence of digestive cancers in a meta-analysis of cohort studies.METHODS:We searched MEDLINE,EMBASE,Science Citation Index Expanded,and the bibliographies of retrieved articles.Studies were included if they reported relative risks(RRs) and corresponding 95% CIs of digestive cancers with respect to total energy intake.When RRs were not available in the published article,they were computed from the exposure distributions.Data were extracted independently by two investigators and discrepancies were resolved by discussion with a third investigator.We performed fixed-effects meta-analyses and meta-regressions to compute the summary RR for highest versus lowest category of energy intake and for per unit energy intake and digestive cancer incidence by giving each study-specific RR a weight that was proportional to its precision.RESULTS:Nineteen studies consisting of 13 independent cohorts met the inclusion criteria.The studiesincluded 995 577 participants and 5620 incident cases of digestive cancer with an average follow-up of 11.1 years.A significant inverse association was observed between energy intake and the incidence of digestive cancers.The RR of digestive cancers for the highest compared to the lowest caloric intake category was 0.90(95% CI 0.81-0.98,P < 0.05).The RR for an increment of 239 kcal/d energy intake was 0.97(95% CI 0.95-0.99,P < 0.05) in the fixed model.In subgroup analyses,we noted that energy intake was associated with a reduced risk of colorectal cancer(RR 0.90,95% CI 0.81-0.99,P < 0.05) and an increased risk of gastric cancer(RR 1.19,95% CI 1.08-1.31,P < 0.01).There appeared to be no association with esophageal(RR 0.96,95% CI 0.86-1.07,P > 0.05) or pancreatic(RR 0.79,95% CI 0.49-1.09,P > 0.05) cancer.Associations were also similar in studies from North America and Europe.The RR was 1.02(95% CI 0.79-1.25,P > 0.05) when considering the six studies conducted in North America and 0.87(95% CI 0.77-0.98,P < 0.05) for the five studies from Europe.CONCLUSION:Our findings suggest that high energy intake may reduce the total digestive cancer incidence and has a preventive effect on colorectal cancer.

Imaging techniques used for the real-time assessment of angiogenesis in digestive cancers

Angiogenesis has a critical role in primary tumor growth and the development of metastases.Several angiogenesis inhibitors were recently developed,being a very attractive target for digestive tumor therapy.However,individualized therapy should not only be based on the pre-treatment imaging evaluation,but also on sensitive monitoring of microvascular changes during treatment.State-of-theart imaging techniques have the potential to visualize and characterize angiogenesis,although the technology and methodologies employed are recent and need further validation.The aim of this series of reviews was to analyze and enhance current knowledge and future perspectives about the real-time assessment of angiogenesis in digestive cancers,used for the longitudinal monitoring of the effects of chemo-radiotherapy(including anti-angiogenic therapies),as well as for the precise targeting of drugs through molecular-based drug-delivery systems.

Survival Study over 5 Years of Digestive Cancers in Tlemcen Province during 2011-2017

In the world,digestive cancers represent a major public health problem by their frequency and severity.Digestive tract cancers are very common malignant tumors worldwide and are an important cause of cancer-related death.The objective of our study was to determinate the survival of digestive cancers in the province of Tlemcen over a period of 5 years.This is a prognostic historical-prospective study with an exhaustive collection data,which consists of studying the 5-year survival of digestive cancers in the province of Tlemcen,of all patients with digestive cancers whatever the stage,diagnosed between 2011 and 2012 and histologically confirmed in subjects residing in the province of Tlemcen at the moment of diagnosis.The subjects of our study were identified from the cancer registry of Tlemcen.In total,408 cases of digestive cancers were diagnosed over 2 years in Tlemcen province.Most digestive cancers were characterized by a predominance of men except for cancer of the liver,gallbladder and bile ducts but whatever the sex,these cancers occur mainly in subjects whose age is greater than or equal to 45 years.Topographically,for both sexes combined,the colorectum followed by the stomach were the organs most affected by digestive cancers.Histopathologically,a predominance of adenocarcinoma has been noted.The 5-year global survival rate of all digestive cancers was 55.4%,depending on the localization;colorectal cancer,small bowel cancer,gallbladder and bile ducts cancer,stomach and esophagus cancers are cancers of intermediate prognosis whose survival in 5 years is between 40%and 80%.Liver cancer and pancreatic cancer remain poor prognosis cancers with 5-year survival rates of 23.08%and 33.3%respectively.The survival of digestive cancers must be improved by adequate care and surveillance of patients.The prevention of colorectal cancers which occupy the first place among the digestive cancers is based essentially on the knowledge of the risk factors and the screening allowing the improvement of the survival rate.The registry of cancer remains a fundamental tool of any cancer control program;it constitutes a starting source for the analysis of survival.

The Epidemiological Profil of Digestive Cancers in Secondary and Tertiary Health Care Facilities in Cameroon

Background: Cancers have been a major public health problem in developing countries in recent years. The aim of this study was to determine the epidemiological profile of digestive cancers in secondary and tertiary health care facilities in Cameroon. Methodology: This was a cross sectional and descriptive study conducted over a period of 12 months in 14 health structures over the national territory. Included in our study were patients aged 15 and above with a histologically proven digestive cancer, patients with a clinical, biological and morphologic evidence of a digestive cancer. Socio-demographic (age, gender, region of origin, profession), clinical (symptoms on diagnosis, personal and family past history, consumption habits, tumour location) and paraclinical data were recorded on a pretested questionnaire. Data was analysed using SPSS version 20.0. Quantitative data was expressed as means with their corresponding standard deviations. Chi square was used for correlation between variables. A P value 0.05 was considered statistically significant. Results: Five hundred and eighty-two cases of digestive cancers were recorded out of 37,780 consultations/admissions during the study period giving a prevalence of 1.5% with a male predominance (58.1%). The mean age was 53.11 ± 17.26 years (15 - 99) with 33.8% of them below 45 years of age. Tumours were predominantly localized in the liver (43.5%) and colon (24.9%). Adenocarcinoma was the most common histological type in 44.5% of all cases. Alcohol consumption was found to be associated with colorectal cancer (p = 0.028) while tobacco consumption was found to be significantly associated with oesophageal cancer (p ≤ 0.001) and gastric cancer (p = 0.0047). Conclusion: A third of patients with digestive cancers were aged less than 45 years suggesting an early onset of these cancers in our setting. Relatively low prevalence with the liver being the most common site of localisation in our setting.

A Comprehensive Study of the Association between LEPR Gene rs1137101 Variant and Risk of Digestive System Cancers

Objective The leptin receptor,encoded by the LEPR gene,is involved in tumorigenesis.A potential functional variant of LEPR,rs1137101(Gln223Arg),has been extensively investigated for its contribution to the risk of digestive system(DS)cancers,but results remain conflicting rather than conclusive.Here,we performed a case–control study and subsequent meta-analysis to examine the association between rs1137101 and DS cancer risk.Methods A total of 1,727 patients with cancer(gastric/liver/colorectal:460/480/787)and 800 healthy controls were recruited.Genotyping of rs1137101 was conducted using a polymerase chain reactionrestriction fragment length polymorphism(PCR-RFLP)assay and confirmed using Sanger sequencing.Twenty-four eligible studies were included in the meta-analysis.Results After Bonferroni correction,the case–control study revealed that rs1137101 was significantly associated with the risk of liver cancer in the Hubei Chinese population.The meta-analysis suggested that rs1137101 is significantly associated with the risk of overall DS,gastric,and liver cancer in the Chinese population.Conclusion The LEPR rs1137101 variant may be a genetic biomarker for susceptibility to DS cancers(especially liver and gastric cancer)in the Chinese population.

Immunomodulatory and chemopreventive effects of resveratrol on the digestive system cancers

Resveratrol(RSV),the primary polyphenol found in grapes,has been revealed to have anti-inflammatory properties by reducing the capacity of the peripheral blood mononuclear cells to produce pro-inflammatory cytokines,including IL-1β,IL-6,IL-1ra and TNFα.Considering the close association between chronic inflammation and cancer development,RSV’s immunomodulatory properties are one way by which the polyphenol may inhibit cancer initiation,proliferation,neovascularization,and migration.Resveratrol influences the generation of microtumor environment which is one of the key factors in cancer progress.In addition to immunomodulation,RSV inhibits cancer development by expressing anti-oxidant effects,causing cell cycle arrest,stimulating the function of certain enzymes,and activating cell signaling pathways.The end outcome is one of the various forms of cell death,including apoptosis,pyroptosis,necroptosis,and more,as it has been observed in vitro.RSV has been shown to act against cancer in practically every organ,while its effects on colon cancer have been documented more frequently.It is remarkable that longer-term clinical studies that may have established the potential for this natural substance to serve as a therapeutic adjuvant to traditional anti-cancer medications were not prompted by the encouraging outcomes seen with cancer cells treated with non-toxic doses of resveratrol.The current review aims to assess the recent findings about the immunological and anti-cancer characteristics of RSV,with a particular emphasis on cancers of the digestive tract,as a challenge for future clinical research that may contribute to the better prognosis of cancer.

Effects of exercise by type and duration on quality of life in patients with digestive system cancers:A systematic review and network meta-analysis

Background:There is scant evidence regarding the effects of exercise type and duration on quality of life(QoL)in digestive system cancer(DSC)survivors.We aim to investigate the optimal type and duration of exercise to improve QoL for DSC survivors through a systematic review and network meta-analysis.Methods:A systematic literature search of PubMed,Embase,and Web of Science was performed.Eligibility for study inclusion was limited to studies that were randomized controlled trials involving all kinds of exercise in adult patients with DSCs,and the comparator was in standard care or other types of exercise.The primary outcome was QoL,including general health,physical health,mental health,and role function.Secondary outcomes included cancer-related symptoms such as fatigue,insomnia,depression,anxiety,and duration of hospital stay.The network meta-analyses were performed using a random-effect model.Results:The analysis included 32 eligible articles and a total of 2558 participants.Our primary outcome indicated that short-term aerobic exercise significantly enhanced general health(standardized mean difference(SMD)=0.66,95%credible intervals(Crls):0.05 to 1.30),and also contributed to a better mental health(SMD=0.38,95%CrI:-0.05 to 0.81)and role function(SMD=0.48,95%CrI:-0.27 to 1.20).Although without significant changes,short-term resistance exercise tended to increase the physical health of patients with DSCs(SM=0.69,95%CrI:-0.07 to 1.50)and effective in alleviating fatigue(SMD=-0.77,95%CrI:-1.50 to 0.01).Short-term aerobic exercise was related to a lower score of insomnia(SMD=-1.20,95%CrI:-2.40 to 0.06),depression(SMD=-0.51,95%CrI:-1.50 to 0.45),and anxiety(SMD=-0.45,95%CrI:-1.30 to 0.34).All types of exercise related to a trend of declined hospital stays(-0.87 to-5.00 day).Long-term resistance exercise,however,was negatively associated with general health(SMD=-0.33,95%CrI:-1.70 to 1.00),physical health(SMD=-0.18,95%CrI:-1.30to 0.90),and role function(SMD=-1.20,95%CrI:-2.50 to 0.11).Conclusion:This study suggests that short-term aerobic exercise,with or without resistance exercise programs,enhances QoL(especially for general health)as well as relieves cancer-related symptoms for DSC survivors,while long-term resistance exercise may have negative effects,and thus should be adopted cautiously.These results provide important evidence for the management of DSCs.

Suicide in Digestive System Cancers: A Scoping Review

Digestive system cancers are important causes of morbidity and mortality worldwide.Cancer patients are more likely to commit suicide.The objective of this scoping review is to provide a comprehensive and updated summary of the existing literature on suicide among patients with digestive system cancers to identify the incidence and risk factors relevant to suicide in these populations.The PRISMA-Scr(Preferred Reporting Items for Systematic reviews and Meta-Analyses extension protocol for scoping reviews)protocol was used.The review was based on relevant articles published prior to January 2022 in databases of Web of Science and PubMed.The authors identified 21 records that met the criteria for inclusion.Among the 21 articles,18(n=85.7%)reported suicide risk factors,21(n=100%)evaluated the incidence of suicide and 16(n=76.2%)involved the variation in suicide rates.Only one study comprehensively reported that the suicide rate for this population was 32.8 per 100,000 years and the standardized mortality ratio(SMR)was 1.91.Most suicides occurred in patients with pancreatic,esophageal,and gastric cancers.The factors associated with suicide in digestive system cancers included male gender,older age,the white race,single status,advanced stage of disease,and cancer metastasis.The most critical time for suicide was in the early post-diagnostic period.It is indispensable to identify suicide in these cancer patients,especially those with high-risk factors.In the future,more prospective research may be needed to provide more reliable support and care to prevent suicide.

Impact of comorbid anxiety and depression on quality of life and cellular immunity changes in patients with digestive tract cancers

AIM:A study was performed to investigate the impact of comorbid anxiety and depression (CAD) on quality of life (QOL) and cellular immunity changes in patients with digestive tract cancers. METHODS: One hundred and fifty-six cases of both sexes with cancers of the digestive tract admitted between March 2001 and February 2004 in the Department of Medical Oncology, First Affiliated Hospital of Xi'an Jiaotong University were randomly enrolled in the study. Depressive and anxiety disorder diagnoses were assessed by using the Structured Clinical Interview for DSM-IV. All adult patients were evaluated with the Hamilton depressive scale (HAMD, the 24-item version), the Hamilton anxiety scale (HAMA, a modified 14-item version), quality of life questionnaire-core 30 (QLQ-C30), social support rating scale (SSRS), simple coping style questionnaire (SCSQ), and other questionnaires, respectively. In terms of HAMD ≥ 20 and HAMA ≥ 14, the patients were categorized, including CAD (n = 31) in group A, anxiety disorder (n = 23) in group B, depressive disorder (n = 37) in group C, and non-disorder (n = 65) in group D. Immunological parameters such as T-lymphocyte subsets and natural killer (NK) cell activities in peripheral blood were determined and compared among the four groups. RESULTS: The incidence of CAD was 21.15% in patients with digestive tract cancers. The average scores of social support was 43.67±7.05 for 156 cases, active coping 20.34±7.33, and passive coping 9.55±5.51. Compared with group D, subjective support was enhanced slightly in group A, but social support, objective support, and utilization of support reduced, especially utilization of support with significance (6.16 vs7.80, P<0.05); total scores of active coping decreased, while passive coping reversed; granulocytes proliferated, monocytes declined, and lymphocytes declined significantly (32.87 vs 34.00, P<0.05); moreover, the percentage of CD3, CD4, CD8 and CD56 in T lymphocyte subsets was in lower level, respectively, and CD56 showed a significant decline in group A (26.02 vs 32.20, P<0.05), however, CD4/CD8 ratio increased. Physical function, role function, fatigue, sleeplessness and constipation had significant changes among different groups by one-way ANOVA, and group A was in poor QOL. It revealed that global health-related quality of life (QL) were positively correlated with active coping and CD56; CAD was negatively correlated with QL, active coping and CD56. Furthermore, the step-wise regression analysis suggested that utilization of support, CD56, active coping, fatigue, sleeplessness and depression were significant factors contributing to QOL. CONCLUSION: CAD, which can impair QOL and cellular immunity, occurs with a higher incidence in patients with digestive tract cancers. Hence, it is essential to improve mental health for them with specifically tailored interventions.

Organoid Technology and Clinical Applications in Digestive System Cancer

Cancers of the digestive system(DS),including esophageal,gastric,colorectal,liver,and pancreatic can-cers,have a high incidence and mortality worldwide.Current cancer models cannot faithfully recapitu-late the critical features of the original tumor,resulting in the failure of translation from basic research into clinical practice.More advanced cancer models are in urgent need of pathogenesis exploration and anticancer medicine development.Organoids are in vitro cultured three dimensional(3D)self-organizing organotypic structures derived from tissues and pluripotent stem cells,which faithfully mimic the histological features and preserve the genetic heterogeneity of the original tissues.Both normal and malignant organoids can now be efficiently established from the DS tissues of patients.In this review,we summarize the general methods to generate human DS organoids and their applications as a novel model in basic cancer research,preclinical medical practice,and precision medicine.

XPC Polymorphism Increases Risk of Digestive System Cancers:Current Evidence from A Meta-Analysis

Objective： Xeroderma pigmentosum complementation group C （XPC） participates in the initial recognition of DNA damage during nucleotide excision repair process in global genomic repair. Our meta-analysis was performed to evaluate the association between three polymorphisms （Lys939Gln, PAT＋/- and Ala499Val） of XPC gene and risk of digestive system cancers. Methods： All the relevant case-control studies published to April 2011 were identified through searching PubMed. Digestive system cancer risk with the three polymorphisms was estimated for each study by odds ratio （OR） with its 95% confidence interval （95% CI）. Results： We found an increased overall risk for digestive system cancers in all three models of Lys939Gln AC （AC/CC vs. AA： OR, 1.20; 95% CI, 1.11-1.30; CC vs. AC/AA： OR, 1.24; 95% CI, 1.11-1.39; CC vs. AA： OR, 1.36; 95% CI, 1.21-1.53）. When strati？ed by ethnicity, results remained significant in Asian population （AC/CC vs. AA： OR, 1.18; 95% CI, 1.02-1.37; CC vs. AC/AA： OR, 1.32; 95% CI, 1.1-1.51; CC vs. AA： OR, 1.35; 95% CI, 1.08-1.70）, but not for Caucasians. However for Ala499Val CT, a significant protective effect of T allele was only observed in the dominant model. Otherwise, no significant results were observed for PAT＋/-. Conclusion： XPC Lys939Gln AC polymorphism may play an important role in digestive system cancer susceptibility.

Prognostic Value of Sox2 Expression in Digestive Tract Cancers: A Meta-analysis

The aim of the present study was to accurately evaluate the association of Sox2 expression with the survival of patients with digestive tract cancers. Relevant literatures were identified by comprehensively searching databases including the Pubmed, Embase, CBMdisc, and Wanfang（up to October 2014）. A meta-analysis was performed to clarify the association between Sox2 expression and overall survival or clinicopathological parameters of patients with digestive tract cancers（esophageal, gastric, and colorectal cancers）. The results showed a significant association between high Sox2 expression and poor overall survival in patients with digestive tract carcinomas（HR=1.55, 95% CI=1.04–2.31）, especially for patients with esophageal cancer（HR=2.04, 95%CI=1.30–3.22）, colorectal cancer（HR=1.40, 95% CI=1.04–1.89）, and digestive tract adenocarcinoma（HR=1.80, 95% CI=1.12–2.89）, for Europeans（HR=1.98, 95% CI=1.44–2.71） or patients who did not receive neoadjuvant treatment（HR=1.73, 95% CI=1.10–2.72）. Furthermore, Sox2 over-expression was highly correlated with vascular invasion（OR=1.86, 95% CI=1.25–2.77） and poor differentiation（OR=1.88, 95% CI=1.14–3.08）, especially in esophageal and colorectal cancers. In conclusion, Sox2 expression may serve as a novel prognostic factor for patients with digestive tract cancers. Over-expression of Sox2 that is correlated with vascular invasion and poor differentiation suggests poor outcomes of patients with digestive tract cancers.

Tumor circulome in the liquid biopsies for digestive tract cancer diagnosis and prognosis

Digestive tract cancer is one of the main diseases that endanger human health.At present,the early diagnosis of digestive tract tumors mainly depends on serology,imaging,endoscopy,and so on.Although tissue specimens are the gold standard for cancer diagnosis,with the rapid development of precision medicine in cancer,the demand for dynamic monitoring of tumor molecular characteristics has increased.Liquid biopsy involves the collection of body fluids via noninvasive approaches,and analyzes biological markers such as circulating tumor cells,circulating tumor DNA,circulating cell-free DNA,microRNAs,and exosomes.In recent years,liquid biopsy has become more and more important in the diagnosis and prognosis of cancer in clinical practice due to its convenience,non-invasiveness,high specificity and it overcomes temporal-spatial heterogeneity.Therefore,this review summarizes the current evidence on liquid biopsies in digestive tract cancers in relation to diagnosis and prognosis.

RELATIONSHIP BETWEEN DRINKING WATER,VEGETABLES AND CANCER DEATH IN THE HIGH INCIDENCE AREA OF DIGESTIVE TRACT CANCER

The Paper analyzed of investigation datas on thedeath causes of digestive tract cancer in high-incidencearea between 70s and 80s. The results showed that thecancer-adjusted mortalities were 224.14/100000 and226.66/100000: it was 7 times as high as low-incidence(31.19/100000 and 29.82/100000). In 70s, the cancer deathof esophagus, stomach and liver (87.41/100000,73.93/100000 and 8.59/100000) were 28 times, 10 timesand 4 times as high as low-incidence area (3.70/100000,10.57/100000 and 1.94/100000), respectively (P<0.001). In80s, the cancer death of esophagus, stomach and liver(68.26/100000, 109.39/100000 and 23.89/100000) were 17times, 10 times and 4 times as high as low-incidence area(4.54/100000, 10.84/100000 and 6.35/100000), respectively(P<0.001). In high-incidence area, the cancer death ofesophagus was lower, of stomach and liver were higherin 80s than 70s, respectively (P<0.01)- The result alsoshowed that the nitrate content of drinking water andvegetables were 21.45mg/1 and 1185.27mg/kg in high-incidence area; it were significant higher than that in low-incidence area (2.14mg/1 and 41.6omg/kg), the nitritecontent (0.01mg/l) of drinking water in high-incidencearea was significant higher than that in low-incidencearea (0.004mg/l), but the nitrite content among vegetableswas no significant difference between the two regions(N0.05). Our results suggest that the nitrate and nitritecontents increase in drinking water and vegetables maybe an important risk factor of upper alimentary cancer inhigh-incidence area.

A study of the clinical characteristics in patients with digestive tract cancer related cognitive impairment

Objective:The aims of this study was to explore the clinical characteristics of patients with digestive tract cancer-related cognitive impairment(CRCI),and provide reference for the comprehensive clinical understanding,early prevention and treatment.Methods:164 patients with digestive tract cancer were divided into CRCI group and non-CRCI impairment group based on the Montreal Cognitive Assessment Scale(MOCA)and the Minimal Mental State Scale(MMSE).Baseline features,blood biochemical indexes,anxiety and depression were compared.Statistical analysis were carried out by SPSS software(version 20.0).Results:Among all the patients with CRCI,males were more common.Also,there were statistically differences in marital status,liver metastasis,hypertension,ferritin(FER),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),NK cells,anxiety and depression(P<0.05).Conclusion:Part of patients with digestive tract cancer have varied degrees of cognitive dysfunction.Marital status,hypertension,immune function,liver metastasis and serum lipid metabolism were the risk factors for patients with digestive tract CRCI.Early identification of CRCI is of great significance to ensure the integrity of treatment,improve the quality of life and prognosis for patients with digestive tract CRCI.

The Association between miR-196a2 rs11614913 Polymorphism and Digestive System Cancer Risk: A Meta-Analysis of 34 Studies

Background: MicroRNAs (miRNAs) negatively regulate the gene expression and act as tumor suppressors or oncogenes in carcinogenesis. The association between single nucleotide polymorphism (SNP) in miR-196a2 rs11614913 and the susceptibility of digestive system cancers was inconsistent in previous studies. Methods: A standardized search of PubMed, Embase, and Cochrane library databases for publications on miR-196a2 rs11614913 polymorphism and digestive system cancer risk was performed. Then the genotype data were analyzed in a meta-analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to evaluate the association. Test of heterogeneity, sensitivity analysis and assessment of publication bias were conducted in the present meta-analysis by STATA software 12.0. Results: An updated meta-analysis based on 34 independent case-control studies consisting of 13,013 cases and 16,046 controls was performed to address this association. There was a remarkable association between miR-196a2 rs11614913 polymorphism and overall digestive system cancer risk, especially in Asian populations. Moreover, subgroup analysis revealed that variant C allele increased risk of colorectal carcinoma, gastric cancer and hepatocellular carcinoma (HCC), compared with wild T allele. Conclusions: There was a remarkable association between miR-196a2 rs11614913 polymorphism and overall digestive system cancer risk, especially in Asian populations.

Esophageal Cancer: Epidemiological, Clinical and Histopathological Aspects over a 24-Years Period at Kamenge University Hospital, Bujumbura, Burundi

Aim: There were no data about esophageal cancer in Burundi. The aim of the study was to highlight the epidemiological, clinical and histopathological aspects of the esophageal cancer. Method: A retrospective study over a 24-years period (from January 1988 to December 2011) was carried out at Kamenge university hospital, including patients with esophageal cancer. The cases were selected on basis of the histological evidence of the cancer. Results: A total of 34 cases were retrieved and included for analysis. Among them, 24 patients (70.5%) were males. The esophageal cancer constituted 8.6% of digestive cancers over the period of the study. The average age was 50.9 years. It was revealed by dysphagia in 32 patients (94.1%) and was concomitantly metastatic in 12 patients. The squamous cell carcinoma was 30 cases (88.2%). 27 patients underwent a curative resection, but the outcome and prognosis were poor. In-hospital mortality and morbidity rates were respectively 8.8% and 17.7%. Conclusion: The present study showed evidence that the esophageal cancer in our country had the same characteristics and distribution as well as in developing countries. It had a poor prognosis and efforts had to be done in the early cancer detection.

Emergency Digestive Oncological Surgery in Yaounde (Cameroon): Indications and Short-Term Results

Background: Data on emergency digestive oncology surgery are limited in Cameroon. The aim of this work was to give the short-term results of emergency digestive carcinological surgery in our context. Patients and Methods: We conducted a descriptive and analytical observational study with retrospective data collection in four reference hospitals in the city of Yaoundé. Files of patients who had emergency digestive oncological surgery, for an acute complication, from January 1, 2016 to December 31, 2020, were included. The outcomes of the patients in the 30 days following the surgery had to be known. Results: We collected 41 patients, representing 20% of the digestive oncological surgery activity. Their average age was 51.76 ± 16.59 years with a male predominance (63.4%). The cancer complication was inaugural in 27 patients. The main tumor sites were colic (56.1%), rectal (19.5%), and gastric (9.7%). The indications for surgery were: acute bowel obstruction (60.9%), acute generalized peritonitis (29.3%), and gastrointestinal bleeding (4.9%). The tumor was diagnosed intraoperatively in 10 patients (24.4%). The main operative procedures were left colectomy (21.9%) and Hartmann’s intervention (19.5%). The morbidity and mortality rates were 60.9% and 43.9%, respectively. Preoperative anemia (p = 0.019), peritonitis as indication for surgery (p = 0.039) and TNM stage 4 (p = 0.015) were identified as associated with an increased risk of death. Conclusion: In our context, one-fifth of digestive oncological surgery is done urgently in front of an acute complication which is inaugural for cancer in nearly two-thirds of patients. Postoperative morbidity and mortality are significant.