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"DIGESTIVE SYSTEM"
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The science of the digestive system
Explores the human digestive system using simple flowcharts to break down difficult concepts into accessible chunks.
Book
Integrating inflammation, nutrition, and immunity: the CALLY index as a prognostic tool in digestive system cancers - a systematic review and meta-analysis
Background
Digestive system cancers remain a leading cause of cancer-related mortality globally, underscoring the need for reliable prognostic tools. The C-reactive protein-Albumin-Lymphocyte (CALLY) index, which reflects inflammation, nutrition, and immunity, has shown potential in predicting survival. However, comprehensive evaluations of its role in digestive system cancers are still limited.
Methods
A meta-analysis of English-language studies from online databases was performed to assess the prognostic value of the CALLY index. Pooled hazard ratios (HRs) were calculated for overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and cancer-specific survival (CSS).
Results
A total of eighteen articles (19 studies, encompassing 7,951 patients) were included. A lower CALLY index was significantly associated with poorer outcomes across all survival endpoints. The pooled HR for OS was 1.973 (95% CI: 1.734–2.244), with HRs for DFS, RFS, and CSS being 2.093 (95% CI: 1.682–2.604), 1.462 (95% CI: 1.292–1.654), and 2.456 (95% CI: 1.887–3.221), respectively (all
P
< 0.001). Subgroup analyses for OS demonstrated consistent prognostic significance across various treatment strategies, cancer types, cutoff values, sample sizes, and regions. Notably, the CALLY index was a strong predictor of OS in surgical patients (HR = 2.014, 95% CI: 1.794–2.260,
P
< 0.001). Sensitivity analyses validated the robustness of these findings, with minimal publication bias (Egger’s test
P
= 0.053).
Conclusions
The CALLY index serves as a cost-effective and reliable biomarker for predicting prognosis in digestive system cancers. Its utility as a pre-treatment risk stratification tool, which integrates key factors of inflammation, nutrition, and immunity, renders it valuable for guiding clinical decision-making.
Journal Article
Your digestive system
Presents information about the digestive system, looking at the tongue, esophagus, stomach, and intestines that compose it, as well as how they work together to keep the body healthy.
Book
Immune cell infiltration as a biomarker for the diagnosis and prognosis of digestive system cancer
The digestive system cancers are aggressive cancers with the highest mortality worldwide. In this study, we undertook a systematic investigation of the tumor immune microenvironment to identify diagnostic and prognostic biomarkers. The fraction of 22 immune cell types of patients were estimated using CIBERSORT. The least absolute shrinkage and selection operator (LASSO) analysis was carried out to identify important immune predictors. By comparing immune cell compositions in 801 tumor samples and 46 normal samples, we constructed the diagnostic immune score (DIS), showing high specificity and sensitivity in the training (area under the receiver operating characteristic curve [AUC] = 0.929), validation (AUC = 0.935), and different cancer type cohorts (AUC > 0.70 for all). We also established the prognostic immune score (PIS), which was an effective prognostic factor for relapse‐free survival in training, validation, and entire cohorts (P < .05). In addition, PIS provided a higher net benefit than TNM stage. A composite nomogram was built based on PIS and patients' clinical information with well‐fitted calibration curves (c‐index = 0.84). We further used other cohorts from Gene Expression Omnibus databases and obtained similar results, confirming the reliability and validity of the DIS and PIS. In addition, the unsupervised clustering analysis using immune cell proportions revealed 6 immune subtypes, suggesting that the immune types defined as having relatively high levels of M0 or/and M1 macrophages were the high‐risk subtypes of relapse. In conclusion, this study comprehensively analyzed the tumor immune microenvironment and identified DIS and PIS for digestive system cancers. Our study comprehensively analyzed the utility of consideration of immune cells in the diagnosis and prognosis of digestive system cancers. The diagnostic immune score and prognostic immune score signature might serve as biomarkers for early diagnosis and predicting survival.
Journal Article
Understanding food and digestion
Explains how the human body digests, utilizes and eliminates the food it ingests.
Book
Bile acid-microbiota crosstalk in gastrointestinal inflammation and carcinogenesis
Emerging evidence points to a strong association between the gut microbiota and the risk, development and progression of gastrointestinal cancers such as colorectal cancer (CRC) and hepatocellular carcinoma (HCC). Bile acids, produced in the liver, are metabolized by enzymes derived from intestinal bacteria and are critically important for maintaining a healthy gut microbiota, balanced lipid and carbohydrate metabolism, insulin sensitivity and innate immunity. Given the complexity of bile acid signalling and the direct biochemical interactions between the gut microbiota and the host, a systems biology perspective is required to understand the liver-bile acid-microbiota axis and its role in gastrointestinal carcinogenesis to reverse the microbiota-mediated alterations in bile acid metabolism that occur in disease states. An examination of recent research progress in this area is urgently needed. In this Review, we discuss the mechanistic links between bile acids and gastrointestinal carcinogenesis in CRC and HCC, which involve two major bile acid-sensing receptors, farnesoid X receptor (FXR) and G protein-coupled bile acid receptor 1 (TGR5). We also highlight the strategies and cutting-edge technologies to target gut-microbiota-dependent alterations in bile acid metabolism in the context of cancer therapy.
Journal Article
20 fun facts about the digestive system
\"From the mouth and esophagus to the small and large intestine, re aders take a journey through the human body via the digestive tract, and enjoy learning about processes the digestive system does without us even knowing\"-- Provided by publisher.
Book
Prognostic value of nutritional risk assessment indices in patients with digestive system tumors
Background
Nutritional risk assessment indices impact disease prognosis, yet their prognostic roles in preoperative digestive system tumor (DST) patients remain unclear.
Methods
In this study, the Controlling Nutritional Status (CONUT) score, the Nutritional Risk Index (NRI) and the Prognostic Nutritional Index (PNI) before surgery were applied to 17, 338 patients with 10 kinds of newly diagnosed DSTs. The distribution of nutritional risk and its correlation with mortality were examined in this study through the utilization of three nutritional risk assessment indices.
Results
The study encompassed 17,338 cases of DSTs, comprising 7,644 cases of gastric cancer, 5,542 cases of esophageal cancer, 2,826 cases of pancreatic cancer, 570 cases of gastroesophageal junction cancer, 185 cases of liver cancer, and minimal instances of five other tumor types, each numbering approximately 100. According to the 3 nutritional risk assessment indices, CONUT, NRI and PNI, nutrition risk was common in patients with DSTs (79.24% with CONUT, 38.91% with NRI, 3.13% with PNI), and even in patients with normal or high BMI. In gastric cancer, in addition to age, stage, presence of metastasis, and tumor tissue type, three nutritional risk assessment indices could effectively stratify the prognosis based on nutritional status. CONUT was valuable for predicting the prognosis of intrahepatic cholangiocarcinoma, whereas NRI was significant in Esophageal Cancer and Pancreatic Cancer.
Conclusions
Nutritional risk was common among DSTs patients and was strongly associated with increased mortality in GC according to CONUT, NRI and PNI Stratification. More attention should be paid to nutritional risk assessment indices to improve prognosis, and prospective clinical trials were needed to evaluate the efficacy of nutritional interventions in GC patients. However, the utility of these three nutritional risk assessment indices in other DSTs was limited.
Journal Article
AKR1B10 and digestive tumors development: a review
Aldo-keto reductase family 1 member B10 (AKR1B10) is a member of the AKR1B subfamily. It is mainly found in cytoplasm, and it is typically expressed in the stomach and intestines. Given that its expression is low or absent in other tissues, AKR1B10 is a potential diagnostic and therapeutic biomarker for various digestive system diseases. Here, we review recent research progress on AKR1B10 in digestive system tumors such as hepatocellular carcinoma, gastric carcinoma, colorectal carcinoma, pancreatic carcinoma, oral squamous cell carcinoma, laryngeal squamous cell carcinoma, cholangiocarcinoma, and nasopharyngeal carcinoma, over the last 5 years. We also discuss the current trends and future research directions for AKR1B10 in both oncological and non-oncological diseases to provide a scientific reference for further exploration of this gene.
Journal Article