Publication Name	World Journal of Gastroenterology
Manuscript ID	119646
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Observational Study
Article Title	Development and validation of a tongue image-clinical nomogram for detection of advanced colorectal adenoma
Manuscript Source	Unsolicited Manuscript
All Author List	Jing Zhang, Mei-Li Zhu, Yu-Xuan Xie, Ya-Qin Fan, Wei Zhang, Shi-Shi Liu, Xiang-Mei Yu, Wei Wang and Xiao-Yan Fu
Funding Agency and Grant Number	Funding Agency Grant Number Fujian Provincial Financial Subsidy Special Program No. X2023010 Natural Science Foundation of Fujian Province No. 2024Y0020
Corresponding Author	Xiao-Yan Fu, Chief Physician, MD, Department of Gastroenterology and Hepatology, The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, No. 282 Wusi Road, Fuzhou 350003, Fujian Province, China. fxy001@sohu.com
Key Words	Advanced adenoma; Colorectal cancer screening; Tongue imaging; Predictive model; Nomogram; Opportunistic screening
Core Tip	This study developed and internally validated a noninvasive nomogram integrating quantitative tongue phenotypes with clinical factors for advanced adenoma detection. In the validation cohort, the nomogram showed higher discrimination than the Asia-Pacific colorectal screening (APCS) and modified APCS scores. In the high-risk subgroup (APCS ≥ 4), where conventional scores had limited discriminative value, the nomogram maintained moderate performance and detected 2-3 times as many advanced adenomas as the conventional scores did at approximately 80% specificity, suggesting potential as a noninvasive risk-refinement tool for opportunistic screening.
Citation	Zhang J, Zhu ML, Xie YX, Fan YQ, Zhang W, Liu SS, Yu XM, Wang W, Fu XY. Development and validation of a tongue image-clinical nomogram for detection of advanced colorectal adenoma. World J Gastroenterol 2026; In press

Received	2026-02-03 02:43
Peer-Review Started	2026-02-03 02:43
First Decision by Editorial Office Director	2026-03-27 12:38
Return for Revision	2026-03-27 12:38
Revised	2026-04-09 04:08
Publication Fee Transferred	2026-04-15 03:16
Second Decision by Editor	2026-04-28 02:42
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-04-28 09:29
Articles in Press	2026-04-28 09:29
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
Open Access	This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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