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1
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"This is such an important topic and issue in upper GI and Pancreatobiliary surgery seen by General Surgeons, Surgical Oncologist, Hepatopancreatobiliary surgeons on a daily basis. Invasive operation is shifting toward minimally invasive endoscopic management, even beyond percutaneous intervention. Moving forward, endoscopic management will play more significant role in these situations and will be the way to go. Many surgeons are not aware of these new technologies and new capabilities of advanced endoscopic treatments.
I would like to write a letter to editor regarding this issue. I am seeing patients with these issues everyday and clearly new technology is changing the standard of care even in the USA. "
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Lesmana CRA, Paramitha MS, Gani RA. Therapeutic interventional endoscopic ultrasound in pancreato-biliary disorders: Does it really replace the surgical/percutaneous approach? World J Gastrointest Surg 2021; 13(6): 537-547 [DOI: 10.4240/wjgs.v13.i6.537]
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2
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"This is an interesting systematic review by Becker et al. that analyzes DILI publications in Brazil. The authors carried out a thorough search of the main sources over a long period of time including several decades.
One of the limitations concerning several of the published studies reporting DILI is that the cut-off points taken by many of the analyzed papers are not based on the current definition of DILI, which takes as a cut-off point ALT/AST higher than 5 times the upper limit of normal and stated during an expert meeting report in 2011 (Aithal et al. Case definition and phenotype standardization in drug-induced liver injury.Clin Pharmacol Ther 2011;89:806–15, ).
This issue casts doubt on many diagnoses of hepatotoxicity because most of these biochemical episodes could have been an adaptive phenomenon, very frequent in clinical practice and observed at the beginning of drug intake, which after some time of drug consuming, liver tests become normal despite continued consumption of the drug.
Another DILI confounding factor is hepatitis E (HEV), which is endemic in several countries of latin america and in most liver toxicity reports is not properly ruled out. Latin America and Brazil in particular, also have several tropical diseases that can be confused with liver adverse reactions and they were not properly ruled out in most DILI reports
The authors very clearly presents the selected articles, however, the results are not presented in detail and had been insufficiently developed in order for the reader to understand the true magnitude of the deficiencies in DILI's reporting in Brazil.
The discussion is too extensive and does not focus on the value of the DILI registries, where Latin America already has its own (LATINDILI), which is working since 2011 and has several publications (none of which are cited), showing a DILI recruitment higher than 300 cases.
These DILI registries, besides helping to know which are the regional prevalence of liver toxicity induced by drugs and herbs, also represent an important help to the regulatory authorities of each country.
The joint work between researchers and the corresponding Ministries of Health should be stimulated due to the high impact that hepatotoxicity represent for public health.
Finally, it is worth mentioning that a DILI management guide based on Latin American data has already been published.
It it is very comprehensive review and orients the reader on how to base the diagnosis, management and where to look for appropriate information of each drug suspected of hepatotoxicity (Bessone F. et al. Annals of Hepatology 24 (2021) 1003-21)
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Becker MW, Schwambach KH, Lunardelli M, Blatt CR. Overview of drug induced liver injury in Brazil: What is the role of public health policy on the evidence? World J Gastrointest Pharmacol Ther 2021; 12(3): 40-55 [PMID: 34046243 DOI: 10.4292/wjgpt.v12.i3.40]
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3
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"Very nicely conducted review. Very comprehensive. Kudos to authors"
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Ng ZQ, Han M, Beh HN, Keelan S. Chylous ascites in colorectal surgery: A systematic review. World J Gastrointest Surg 2021; 13(6): 585-596 [DOI: 10.4240/wjgs.v13.i6.585]
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4
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"Gastrointestinal motility disorders in diabetes remain an unattended borderline between diabetology and gastroenterology. I thank Concepción Zavaleta et al. for choosing this topic and providing an updated review on the pathophysiology,
symptoms, diagnosis, and treatment of gastointestinal complications of diabetes. Authors have addressed all aspects of diabetic enteropathy in this review in sufficient details. I feel, this article can be a call to action for health care providers involved in the management of patients with diabetes. Both endocrinologists and gastroenterologists working together will make it possible to optimize the outcomes and avoid consequences of impaired gastrointestinal function in these patients. "
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Concepción Zavaleta MJ, Gonzáles Yovera JG, Moreno Marreros DM, Rafael Robles LDP, Palomino Taype KR, Soto Gálvez KN, Arriola Torres LF, Coronado Arroyo JC, Concepción Urteaga LA. Diabetic gastroenteropathy: An underdiagnosed complication . World J Diabetes 2021; 12(6): 794-809 [DOI: 10.4239/wjd.v12.i6.794]
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"TO THE EDITOR,
We read the recent publication by Jang HR and Lee HY (World J Diabetes 2021 June 15; 12(6): 685-915) on the relationship of mechanisms linking intestinal microbial metabolites to insulin resistance published in this journal with great interest.
Notably, based on compelling evidences of the host-microbiota and metabolic derangement crosstalk, substantial body of literature, either in preclinical models or in clinical studies (1-3), has linked intestinal microbiota in the pathophysiology of insulin resistance and type 2 diabetes.
This present article elegantly highlights the potential role of specific microbiota-derived compounds in insulin-responsive tissues, acting as risk factors or protectors for the development of insulin resistance and the importance of the muscle-liver-adipose tissue axis interaction.
Although so well demonstrated by the authors the potential role of some bacterial metabolites as regulators of metabolic functions in the body, such as short chain fatty acids propionate, butyrate, acetate, microbial products derived from phenolic acids and fatty-acids, in upregulating glucose homeostasis, the role of some bacterial metabolites in the host metabolism still need to be better understood.
Despite mentioned the importance of succinate, a metabolite of the tricarboxylic acid cycle produced by both microbiota and the host (4), in the improvement of glucose homeostasis through activation of intestinal gluconeogenesis (5), Serena et al demonstrated that obese individuals exhibit high levels of this circulating metabolite (4). Furthermore, the imbalance of higher relative abundance of succinate-producing bacteria (Prevotellaceae and Veillonellaceae) and lower relative abundance of succinate-consuming bacteria Odoribacteraceae and Clostridaceae) may promote an increase in succinate levels and, ultimately, an impaired glucose metabolism. These authors also point out succinate as a potencial role in obesity and metabolic-associated cardiovascular disorder. Importantly, succinate acts as an immunogenic molecule, named damage associated molecular patterns (DAMPs). That molecular is recognized by immune cells and through its G-protein coupled receptor (succinate receptor 1/SUCNR1 or GPR19) stabilizes hypoxia-inducible factor-1α (HIF-1α), which promotes the pro-inflammatory differentiation of T lymphocytes, and synergizes the effects with Toll-like receptor ligands in dendritic cells for the production of cytokines (6,7). Collectively, these findings may promote an enhancement of insulin resistance and DM burden.
In addition, broader investigations on the physiological implications of hydrogen sulfide (H2S) and the role of sulfur-reducing bacteria from the intestinal microbiota in better host glycemic control would be relevant (8). H2S metabolite may protect from oxidative stress by restoring reduced glutathione (GSH) and scavenging of mitochondrial reactive oxygen species, inducing pro-survival/angiogenesis signaling pathway (STAT3), and promoting immunomodulation (NF-κB) and vasodilation (KATP ion channel) (9).
In conclusion, the modulation of the intestinal microbiota has emerged as a promising strategy in metabolic diseases, such as insulin resistance and diabetes. The intestinal microbiota is affected by several environmental aspects, and its response to these different stimuli must also be considered when studying the host-gut microbiota interactions (10). The interest in expanding the knowledge and understanding of the intestinal microbiota and compounds derived from this microbiota in human metabolism offers future perspectives for therapeutic purposes and opportunity for mitigating the impact of metabolic insults associated with those pathologies. Although there are many open questions to be explored in this growing field.
Rosana M. C. Bastos1, Érika B. Rangel1,2
1Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
2Nephrology Division, Federal University of São Paulo, São Paulo, SP, Brazil
REFERENCES
1. Wang H, Lu Y, Yan Y, Tian S, Zheng D, Leng D, et al. Promising Treatment for Type 2 Diabetes: Fecal Microbiota Transplantation Reverses Insulin Resistance and Impaired Islets. Frontiers in cellular and infection microbiology. 2019;9:455.
2. Qin J, Li Y, Cai Z, Li S, Zhu J, Zhang F, et al. A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature. 2012;490(7418):55-60.
3. Karlsson FH, Tremaroli V, Nookaew I, Bergstrom G, Behre CJ, Fagerberg B, et al. Gut metagenome in European women with normal, impaired and diabetic glucose control. Nature. 2013;498(7452):99-103.
4. Serena C, Ceperuelo-Mallafré V, Keiran N, Queipo-Ortuño MI, Bernal R, Gomez-Huelgas R, et al. Elevated circulating levels of succinate in human obesity are linked to specific gut microbiota. The ISME journal. 2018;12(7):1642-57.
5. De Vadder F, Kovatcheva-Datchary P, Zitoun C, Duchampt A, Bäckhed F, Mithieux G. Microbiota-Produced Succinate Improves Glucose Homeostasis via Intestinal Gluconeogenesis. Cell metabolism. 2016;24(1):151-7.
6. Garcia-Martinez I, Shaker ME, Mehal WZ. Therapeutic Opportunities in Damage-Associated Molecular Pattern-Driven Metabolic Diseases. Antioxid Redox Signal. 2015; 23(17): 1305-1315.
7. Rodriguez-Nuevo A, Zorzano A. The sensing of mitochondrial DAMPs by non-immune cells. Cell stress. 2019; 3(6): 195-207.
8. Pichette J, Fynn-Sackey N, Gagnon J. Hydrogen Sulfide and Sulfate Prebiotic Stimulates the Secretion of GLP-1 and Improves Glycemia in Male Mice. Endocrinology. 2017;158(10):3416-25.
9. Pal VR, Bandyopadhyay P, Singh A. Hydrogen Sulfide in Phsysiology and Pathogenesis of Bacteria and Viruses. IUBMB Life. 2018; 70(5): 392-410.
10. Fan Y, Pedersen O. Gut microbiota in human metabolic health and disease. Nature reviews Microbiology. 2021;19(1):55-71.
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Jang HR, Lee HY. Mechanisms linking gut microbial metabolites to insulin resistance. World J Diabetes 2021; 12(6): 730-744 [DOI: 10.4239/wjd.v12.i6.730]
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"The authors have submitted an interesting and well-written review on the mechanisms linking gut microbial metabolites to insulin resistance. In future reviews, the authors could also explore the contribution of oxidative stress to the microbiome-insulin resistance crosstalk. In addition, the potential benefits of prebiotics and probiotics in the management of insulin resistance could be discussed."
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Jang HR, Lee HY. Mechanisms linking gut microbial metabolites to insulin resistance. World J Diabetes 2021; 12(6): 730-744 [DOI: 10.4239/wjd.v12.i6.730]
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7
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"This is a very short review article in a relative new filed. It provides helpful knowledge in stem cell therapy in organ injury field. I would recommend to my student and colleagues to read it."
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Matta A, Nader V, Galinier M, Roncalli J. Transplantation of CD34+ cells for myocardial ischemia. World J Transplant 2021; 11(5): 138-146 [PMID: 34046316 DOI: 10.5500/wjt.v11.i5.138]
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8
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"Very good article, analyzing the interference of Alzheimer Disease and Type Two diabetes, condition often appearing in the elderly.
The authors analyze the molecular picture of the two conditions, as well as the points of interference of the two incurable condition. "
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Rojas M, Chávez-Castillo M, Bautista J, Ortega Á, Nava M, Salazar J, Díaz-Camargo E, Medina O, Rojas-Quintero J, Bermúdez V. Alzheimer’s disease and type 2 diabetes mellitus: Pathophysiologic and pharmacotherapeutics links. World J Diabetes 2021; 12(6): 745-766 [DOI: 10.4239/wjd.v12.i6.745]
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"Han et al have carried out a network meta-analysis of randomized controlled trials studies to review and compare response rates, survival outcomes, and safety of first-line systemic therapies for advanced hepatocellular carcinoma [1]. We praise and applaud their imperative research, but several important issues should be noted.
First, in the “eligibility criteria” subheading of the paper, the author stated the inclusion and exclusion criteria but these are not based on PICO and PRISMA statement (PRISMA 2009 checklist, item 6) [2-4]. In this section, readers cannot properly understand what intervention (s) have been examined and what the comparison (s) are and what the outcome (s) have been examined.
Second, in the “Information sources, search strategy, and study selection” subheading of the paper, the author stated that “Studies were identified by searching the following electronic databases: PubMed, Science Direct, and the Cochrane Database, and etc”. It is very clear that “Science Direct” is not a database, and is a website which provides access to a large bibliographic database of scientific and medical publications of the Dutch publisher Elsevier. The authors of the article did not mention any reason why they did not search important databases such as Scopus, Web of Science and Embase. This issue is also not mentioned in the study limitations section. However, authors in Figure 1 stated that the Embase database is searched, which is not in line with the text. Also, based on the PRISMA statement 2009, items 7 and 8, authors should indicate the databases with dates of coverage, and any limits used in search. There is a possibility of publication bias in this case. In addition, the authors did not give us any information about the “study selection” (PRISMA statement 2009, item 9). The quality assessment stage is also interestingly stated in this section. According to PRISMA, this is a major step and should be taken in a separate section (PRISMA statement 2009, items 12 and 15).
Third, in the “Studies included in the analysis” subheading of the paper, the author stated that of 86 articles, 27 met the inclusion criteria. Based on the PRISMA statement, item 17, the reason for exclusion at each stage must be stated. These reasons can be in the text or in the flow chart. In this study, the reasons for exclusions are not mentioned in any section.
Forth, in the “Quality assessment” subheading of the paper, the author stated that “study design characteristics are summarized in Supplementary Figure 1”, however, only “Risk of bias across studies” is given in the supplement and the results related to “Risk of bias in individual studies” are not mentioned. In addition, there is no information about the emission bias in this section. (PRISMA statement, items 19 and 22).
References
1 Han Y, Zhi W-H, Xu F, Zhang C-B, Huang X-Q, Luo J-F. Selection of first-line systemic therapies for advanced hepatocellular carcinoma: A network meta-analysis of randomized controlled trials. World journal of gastroenterology 2021; 27(19): 2415
2 Arab-Zozani M, Hassanipour S. Following PRISMA in a Systematic Review: Obligation or Authority? Int J Prev Med 2020; 11: 70-70 [PMID: 32742614 DOI: 10.4103/ijpvm.IJPVM_400_19]
3 Arab-Zozani M, Ghoddoosi-Nejad D, Dehghani M. Tips on Reporting a Systematic Review. Bulletin of emergency and trauma 2018; 6(1): 71-72 [PMID: 29379813 PMCID: PMC5787367 DOI: 10.29252/beat-060111]
4 Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Annals of internal medicine 2009; 151(4): 264-269, w264 [PMID: 19622511 DOI: 10.7326/0003-4819-151-4-200908180-00135]
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Han Y, Zhi WH, Xu F, Zhang CB, Huang XQ, Luo JF. Selection of first-line systemic therapies for advanced hepatocellular carcinoma: A network meta-analysis of randomized controlled trials. World J Gastroenterol 2021; 27(19): 2415-2433 [PMID: 34040331 DOI: 10.3748/wjg.v27.i19.2415]
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10
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"Very interesting study that open new ways to the use of bone marrow cells"
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Matta A, Nader V, Galinier M, Roncalli J. Transplantation of CD34+ cells for myocardial ischemia. World J Transplant 2021; 11(5): 138-146 [PMID: 34046316 DOI: 10.5500/wjt.v11.i5.138]
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11
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"It is a good explanation about how ACEi works in the liver, but this article explain about the missing ling is about the explanation the metformin as a common medication. The interesting things is post mortem examination how the microvascular steatosis and mild inflammation infiltrates in liver does meaningful for next research.
The drawback for this article are not stated that about the gender, ages, the cause of liver disease and the possibility using the drug. What kind of drug use, the interaction. The article discuss about the relationship between how the ACEi expression not in the human. Overall it is a good article to read. "
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Leowattana W. Angiotensin-converting enzyme 2 receptors, chronic liver diseases, common medications, and clinical outcomes in coronavirus disease 2019 patients. World J Virol 2021; 10(3): 86-96 [PMID: 34079691 DOI: 10.5501/wjv.v10.i3.86]
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12
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"Interesting topic, generally well written, enough accurate the method and statistical section.
Highly valuable "
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Yang XJ, Liu D, Ren HY, Zhang XY, Zhang J, Yang XJ. Effects of sepsis and its treatment measures on intestinal flora structure in critical care patients. World J Gastroenterol 2021; 27(19): 2376-2393 [PMID: 34040329 DOI: 10.3748/wjg.v27.i19.2376]
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"Poddighe and Abdukhakimova [1] have carried out the prevalence of celiac disease (CD) in Asian countries. In this study, researchers examined the prevalence of the disease in several selected countries such as China, Japan, Southeast Asia, Russia, and Central Asia. The conclusion of the researchers of this study was the underestimation of CD in Asian countries, especially in Russia and Central Asia.
Outside the Indian subcontinent and the Middle East, the epidemiological burden of celiac disease is underestimated in Asia, especially in Russia and Central Asia, where wheat is a staple food and its genetic potential is comparable to that of European countries. The reason for this finding is insufficient knowledge of physicians, limited access to diagnostic resources, inadequate interpretation of existing serological tests, and lack of diagnostic standards [2].
The results of this study are valuable, but mentioning a few points can improve the quality of this report.
First, there is no mention of a comprehensive study by Sing et al [3]. On the global epidemiology of CD. In this study, the global prevalence of the disease was estimated to be 1.4% based on anti-tissue transglutaminase and/or anti-endomysial antibodies and 0.7% based on biopsy-confirmed celiac disease. The prevalence of celiac disease was 0.4% in South America, 0.5% in Africa and North America, 0.6% in Asia, and 0.8% in Europe and Oceania. The prevalence was higher in women than in men (0.6 vs. 0.4; P <0.001). The prevalence of celiac disease in children was significantly higher than in adults (0.9 vs. 0.5; P <0.001).
The second point is that to estimate the burden of the disease in different countries, all the researches should be included, for example, in China and Japan, are the articles that are not written in English mentioned?
Given that the authors of this study are from Kazakhstan and that they correctly referred to studies published in Russia and Central Asia in languages other than English, the authors' conclusion of the CD in the Central Asian region can be trusted.
References
1 D P, D A. Celiac Disease in Asia beyond the Middle East and Indian subcontinent: Epidemiological burden and diagnostic barriers. World journal of gastroenterology 2021; 27(19): 2251-2256
2 Agarwal A, Chauhan A, Ahuja V, Makharia GK. Opportunities and challenges in the management of celiac disease in Asia. JGH Open 2020; 4(5): 795-799 [PMID: 33102747 DOI: 10.1002/jgh3.12381]
3 Singh P, Arora A, Strand TA, Leffler DA, Catassi C, Green PH, Kelly CP, Ahuja V, Makharia GK. Global Prevalence of Celiac Disease: Systematic Review and Meta-analysis. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 2018; 16(6): 823-836.e822 [PMID: 29551598 DOI: 10.1016/j.cgh.2017.06.037]
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Poddighe D, Abdukhakimova D. Celiac Disease in Asia beyond the Middle East and Indian subcontinent: Epidemiological burden and diagnostic barriers. World J Gastroenterol 2021; 27(19): 2251-2256 [PMID: 34040319 DOI: 10.3748/wjg.v27.i19.2251]
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14
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"The authors used populational data on Vitamin D levels and severity/moratality data on COVID-19 in Europe. The data is interesting, but the COVID-19 outcome may be affected by many aspects. The topic remains controversial, due to the conflicting results with a few reports regarding the relation between Vitamin D deficiency and COVID-19."
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Papadimitriou DT, Vassaras AK, Holick MF. Association between population vitamin D status and SARS-CoV-2 related serious-critical illness and deaths: An ecological integrative approach. World J Virol 2021; 10(3): 111-129 [PMID: 34079693 DOI: 10.5501/wjv.v10.i3.111]
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15
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"very interesting topic ... I would be curious to evaluate the same results in terms of bridge and downstaging to extend the milan criteria. thank you"
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Conticchio M, Inchingolo R, Delvecchio A, Laera L, Ratti F, Gelli M, Anelli F, Laurent A, Vitali G, Magistri P, Assirati G, Felli E, Wakabayashi T, Pessaux P, Piardi T, di Benedetto F, de'Angelis N, Briceño J, Rampoldi A, Adam R, Cherqui D, Aldrighetti LA, Memeo R. Radiofrequency ablation vs surgical resection in elderly patients with hepatocellular carcinoma in Milan criteria. World J Gastroenterol 2021; 27(18): 2205-2218 [PMID: 34025074 DOI: 10.3748/wjg.v27.i18.2205]
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"I am not a virologist nor a doctor in medicine. I am a nuclear physicist using statistics. Statistics is carefully treated although (probably) more statistical parameters should be quoted to support conclusions. Consequently, i am not able to answer honestly about reported references(11): my answer 11 is only approximate. "
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Papadimitriou DT, Vassaras AK, Holick MF. Association between population vitamin D status and SARS-CoV-2 related serious-critical illness and deaths: An ecological integrative approach. World J Virol 2021; 10(3): 111-129 [PMID: 34079693 DOI: 10.5501/wjv.v10.i3.111]
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"Invited Comment/ Editorial
“Hepatitis E – It is not always about the liver”
Sandy, Natascha Silva1, Vieira Neto, Ronan José 2
1. Division of Gastroenterology, Hepatology and Nutrition and the Transplant and Regenerative Medicine Center, SickKids Hospital. Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
2. Division of Neurology and Stroke Program, Toronto Western Hospital. University Health Network, Toronto, On, Canada.
Address correspondence to Natascha Silva Sandy, MD, Division of Gastroenterology, Hepatology and Nutrition, SickKids Hospital, 555 University Ave, M5G 1X8, Toronto, ON, Canada (e-mail: natascha.silvasandy@sickkids.ca)
See “Neurological manifestations of hepatitis E virus infection: An overview”. by Jha et al - World J Gastroenterol 2021; 27(18): 2090-2104 [DOI: 10.3748/wjg.v27.i18.2090]
Initially called "non-A, non-B hepatitis", the Hepatitis E Virus (HEV) was first described in the 1980s, in a hepatitis epidemic in India, transmitted via the fecal-oral route.(1) Since then, we have consolidated good knowledge about the biological behavior of this virus, and a few well-established facts about HEV have been described. Molecular characterization of HEV revealed several genotypes, and four (HEV genotypes 1 to 4) were recognized as responsible for or most infections in humans(2). Epidemiological and clinical data have documented that the majority of individuals who acquire HEV will be either asymptomatic or will present with a "flu-like" illness, but the most well-known facet of this infection is the presentation with “icteric hepatitis”, reported in 5%–40% of affected individuals.(2, 3) Another widespread observation about HEV infection is that there is a mortality rate among pregnant females, as well as in individuals with underlying chronic liver disease.(2) Nevertheless recently, what we know about this virus has been challenged by recent studies reporting emerging new data on the epidemiology as well as on the epidemiology and clinical presentation of HEV. Notably, an important concept that was changed was the initial belief that this virus could not cause chronic infection, as chronic hepatitis was consistently reported in immunosuppressed patients, including patients who have received a solid-organ transplant, patients with hematological patients and HIV-positive patients.(4)
The majority of studies on Hepatitis E Virus (HEV) Infection have been conducted in Asia, as HEV is reported to be highly endemic in several parts of Asia the Middle East, Africa, and Central America.(5) But recently, many studies have recognized the impact of HEV infection in other countries.(6) Over the past decades, in regions like in different countries in Europe – which were not the traditionally recognized areas of HEV outbreaks, the number of cases of HEV infection is steadily increasing.(2, 6-8)
On the clinical side, extrahepatic Manifestations of HEV, including a range of neurological, renal, pancreatic, and haematological disorders are also becoming increasingly recognized, particularly neurological injury.(9, 10) In this issue of the journal, Jha et al. (11) summarize evidence of neurological manifestations of HEV infection in a mini-review that provides a comprehensive overview of the involvement of both the peripheral nervous system and central nervous system secondary to the infection. As reported by the authors, manifestations may include Neuralgic amyotrophy, Guillain-Barré syndrome, Meningoencephalitis, Cerebral ischemia, Seizures, Transverse myelitis, Mononeuritis multiplex, Peripheral neuropathy, Cranial nerve neuropathy, Myositis, Myasthenia gravis and Meningoradiculitis. Each of these manifestations being relative rare, with a total number of cases reported varying from 1 to 64. The increasing interest in this facet of the disease may reveal that the extent of neurological finings secondary to HEV may go beyond these descriptions, as many of these neurological manifestations are often described as idiopathic but testing for HEV infection is not routine. Unfortunately, the evidence to fully understand the neurologic impact of HEV is still scarce. Until we can fully understand the importance of HEV in neurologic syndromes, prospective multicenter studies – like the one by Dalton et al., even if they are to find a small number of cases (11 out of 464 patients presenting with acute non-traumatic neurological injury in that study)(10) and reviews grouping theses cases together, like the one present in this current edition of the Word Journal of Gastroenterology by Jha et al. (11) are of great importance.
REFERENCES
1. Balayan MS, Andjaparidze AG, Savinskaya SS, Ketiladze ES, Braginsky DM, Savinov AP, et al. Evidence for a virus in non-A, non-B hepatitis transmitted via the fecal-oral route. Intervirology. 1983;20(1):23-31.
2. Kamar N, Dalton HR, Abravanel F, Izopet J. Hepatitis E virus infection. Clin Microbiol Rev. 2014;27(1):116-38.
3. Kamar N, Izopet J, Pavio N, Aggarwal R, Labrique A, Wedemeyer H, et al. Hepatitis E virus infection. Nat Rev Dis Primers. 2017;3:17086.
4. Kamar N, Bendall R, Legrand-Abravanel F, Xia N-S, Ijaz S, Izopet J, et al. Hepatitis E. The Lancet. 2012;379(9835):2477-88.
5. Aggarwal R. Hepatitis E: Historical, contemporary and future perspectives. J Gastroenterol Hepatol. 2011;26 Suppl 1:72-82.
6. Frias M, López-López P, Rivero A, Rivero-Juarez A. Role of Hepatitis E Virus Infection in Acute-on-Chronic Liver Failure. Biomed Res Int. 2018;2018:9098535.
7. Ijaz S, Arnold E, Banks M, Bendall RP, Cramp ME, Cunningham R, et al. Non-travel-associated hepatitis E in England and Wales: demographic, clinical, and molecular epidemiological characteristics. J Infect Dis. 2005;192(7):1166-72.
8. Nijskens CM, Pas SD, Cornelissen J, Caliskan K, Hoek RA, Hesselink DA, et al. Hepatitis E virus genotype 3 infection in a tertiary referral center in the Netherlands: Clinical relevance and impact on patient morbidity. J Clin Virol. 2016;74:82-7.
9. Dalton HR, Kamar N, van Eijk JJ, McLean BN, Cintas P, Bendall RP, et al. Hepatitis E virus and neurological injury. Nat Rev Neurol. 2016;12(2):77-85.
10. Dalton HR, van Eijk JJJ, Cintas P, Madden RG, Jones C, Webb GW, et al. Hepatitis E virus infection and acute non-traumatic neurological injury: A prospective multicentre study. J Hepatol. 2017;67(5):925-32.
11. Jha AK, Kumar G, Dayal VM, Ranjan A, Suchismita A. Neurological manifestations of hepatitis E virus infection: An overview. World J Gastroenterol 2021; 27(18): 2090-2104 [DOI: 10.3748/wjg.v27.i18.2090]
Author contributions:
Sandy NS and Vieira Neto reviewed the original manuscript, wrote and revised the letter.
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Jha AK, Kumar G, Dayal VM, Ranjan A, Suchismita A. Neurological manifestations of hepatitis E virus infection: An overview. World J Gastroenterol 2021; 27(18): 2090-2104 [PMID: 34025066 DOI: 10.3748/wjg.v27.i18.2090]
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18
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"This review manuscript deals with wearable devices related to heath care and presents up-to-date wearable technology to monitor many parameters associated with physical activity and health care. The topic of this manuscript is very interesting and straightforward, and contributes to more effective treatment using wearable devices. If the authors added in detail comparisons the results of new wearable devices to those of normal devices or modalities which are commonly used in hospitals, the manuscript would be more intriguing and convincing."
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Chong KP, Woo BK. Emerging wearable technology applications in gastroenterology: A review of the literature. World J Gastroenterol 2021; 27(12): 1149-1160 [PMID: 33828391 DOI: 10.3748/wjg.v27.i12.1149]
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19
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"Under the special background of pandemic, the diagnosis and treatment of abdominal diseases are fraught with difficulties and challenges. Novel coronavirus infection may overlap abdominal symptoms with other abdominal inflammation, which is a wake-up call for clinicians. In particular, novel coronavirus may constitute the direct cause of cholecystitis and hepatitis, thus giving clinicians more thought. It is hoped that the diagnosis and treatment of hepatic and gall diseases by clinicians can be more accurate and the etiology can be explored, instead of just making diagnosis and treatment in this special period.
The purpose of this article is to analyze the molecular level risk of gastrointestinal organ novel coronavirus inflammation. We read with great interest of this article in your journal about the high expression of ACE-2 in the liver and gall of COVID-infected patients. In other words, it's time to think about the molecular mechanisms by which viruses infect organs. Combined with the inter-action between ACE2 and novel coronavirus, we further considered the potential pathological and molecular characteristics of novel coronavirus, and antiviral measures of digestive organs. This is particularly important as the pandemic intensifies."
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Leowattana W. Angiotensin-converting enzyme 2 receptors, chronic liver diseases, common medications, and clinical outcomes in coronavirus disease 2019 patients. World J Virol 2021; 10(3): 86-96 [PMID: 34079691 DOI: 10.5501/wjv.v10.i3.86]
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"This minireview is on the gastrointestinal effects of radiation.
As a whole, the details were written in an easy-to-understand manner.
My only comment is that I wondered why small bowel was next to esophagus instead of stomach.
Radiation-induced gastritis occurs in about 30–50% of patients undergoing radiation therapy whenever the stomach is included in radiation fields as the main target or an organ at risk. (Ainaz Sourati et al. Radiation Gastritis in Acute Side Effects of Radiation Therapy pp 133-136, 2017)
I wish there were a section on radiation gastritis.
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McCaughan H, Boyle S, McGoran JJ. Update on the management of the gastrointestinal effects of radiation. World J Gastrointest Oncol 2021; 13(5): 400-408 [PMID: 34040701 DOI: 10.4251/wjgo.v13.i5.400]
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"Comment on “Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis”
Xiao-Long Tang, Yan-Dong Miao, Deng-Hai Mi
Xiao-Long Tang, The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, PR China
The Second Department of Gastrointestinal Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong City, Sichuan Province, China
Yan-Dong Miao, The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, PR China
Deng-Hai Mi, The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, PR China
Gansu Academy of Traditional Chinese Medicine, Lanzhou City, Gansu Province, China
Author contributions: Xiao-Long Tang and Yan-Dong Miao designed research; Xiao-Long Tang and Yan-Dong Miao performed research; Xiao-Long Tang and Yan-Dong Miao analyzed data; Xiao-Long Tang wrote the comment; and Deng-Hai Mi revised the comment.
Supported by: the Special Plan for Condition Construction of Gansu Provincial Scientific Research Institutes (Grants No. 20JR10RA432)
Corresponding author: Deng-Hai Mi, MD, Gansu Academy of Traditional Chinese Medicine, Lanzhou City, Gansu Province, China. mi.dh@outlook.com
Abstract
The present comment to the editor is related to Omar Elshaarawy et al. Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis. World J Gastroenterol 2021;13(5):424-439. Preoperative evaluation of liver reserve function in hepatocellular carcinoma (HCC) patients with cirrhosis is critical, and there is no global consensus on how to evaluate it. Through retrospective analysis, Omar Elshaarawy et al. evaluated the influence of various traditional clinical indicators on liver failure and prognosis after hepatectomy in HCC patients with cirrhosis. We suggest that we should make an effort to look for new evaluation indicators such as indocyanine green retention rate at 15 min (ICG-R15).
Keywords: ICG-R15, hepatectomy, Cirrhosis, Hepatocellular carcinoma
Core tip: Improper hepatectomy can lead to liver failure and even death for HCC patients with cirrhosis. The major highlight of this comment is to stress the urgency of searching and validating new predictors before hepatectomy in HCC patients with cirrhosis.
TO THE EDITOR
In “Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis”, Omar Elshaarawy et al. assessed many traditional predictors for liver failure and prognosis in cirrhosis patients undergoing radical resection of HCC via univariate and multivariate analyses[1]. They found that the preoperative MELD score, tumor diameter, length of stay after radical resection of liver cancer, and hospital stay length are significant independent predictors of liver decompensation. Preoperative MELD score, different levels of PHLF, and postoperative HCC recurrence resection are significant independent predictors of prognosis. This research is valuable information and is helpful for doctors to improve the preoperative evaluation of HCC patients with cirrhosis. Although we appreciate this work very much, we consider that the article would have been far more interesting if the author had adopted the indocyanine green retention rate at 15 min (ICG-R15). For more details about this opinion, we are looking forward to evaluation and discussion with the authors.
With the remarkable progress of surgical techniques, the methods of hepatectomy are becoming more and more radical. Improper surgery can lead to liver failure and even death. It is valuable for the surgeon to focus on verifying significant predictors of postoperative liver decompensation and prognosis. As we all know, The ICG-R15 is superior to many biochemical measures as a single assessment and has been widely used for the preoperative evaluation of hepatic functional reserve. However, the ICG-R15, a sensitive predictor of liver function reserve, was not mentioned in this study.
ICG is selectively ingested by liver cells after injection, secreted by liver cells into bile, and rapidly excreted by the biliary tract[2]. ICG does not have any chemical reaction in the body and is only excreted from the liver, so that it can be a good assessment of liver function reserve. ICG-R15 can respond to the current liver function injury when there are no abnormalities in many conventional biochemical indicators. Thus it provides the necessary means for clinical prevention of surgical trauma, liver loss of blood, and other blows caused by acute liver failure. Recently, Kokudo, Takashi et al. noted that ICG R15 might enhance physicians' ability to stratify patients at risk for postoperative liver failure[3]. Furthermore, Wang, Yan-Yan et al. based on a comparative study of 185 patients, demonstrated that ICG-R15 is more reliable than the MELD score and Child-Pugh score in predicting hepatic functional reserve before hepatectomy[4].
Accurate evaluation of liver function reserve is very important for the correct treatment of HCC patients with cirrhosis. Correct preoperative evaluation is vital to patient recovery. Although no global consensus on the evaluation tool for the liver functional reserve is currently available, we feel that we should actively explore more novel and valuable predictors to adapt to the development of surgical techniques.
ACKNOWLEDGEMENTS
This work was supported by the Special Plan for Condition Construction of Gansu Provincial Scientific Research Institutes (Grants No. 20JR10RA432).
REFERENCES
1 Elshaarawy O, Aman A, Zakaria HM, Zakareya T, Gomaa A, Elshimi E, Abdelsameea E. Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis. WJGO 2021; 13: 424–439. [DOI: 10.4251/wjgo.v13.i5.424]
2 Inagaki Y, Kokudo T, Kamiya M, Uno S-N, Sato M, Kaneko J, Kokudo N, Urano Y, Hasegawa K. A novel liver-specific fluorescent anti-cancer drug delivery system using indocyanine green. Sci Rep 2019; 9: 3044. [PMID: 30816163 DOI: 10.1038/s41598-019-39269-0]
3 Kokudo T, Hasegawa K, Shirata C, Tanimoto M, Ishizawa T, Kaneko J, Akamatsu N, Arita J, Demartines N, Uldry E, Kokudo N, Halkic N. Assessment of Preoperative Liver Function for Surgical Decision Making in Patients with Hepatocellular Carcinoma. Liver Cancer 2019; 8: 447–456. [PMID: 31799202 DOI: 10.1159/000501368]
4 Wang Y-Y, Zhao X-H, Ma L, Ye J-Z, Wu F-X, Tang J, You X-M, Xiang B-D, Li L-Q. Comparison of the ability of Child-Pugh score, MELD score, and ICG-R15 to assess preoperative hepatic functional reserve in patients with hepatocellular carcinoma. J Surg Oncol 2018; 118: 440–445. [PMID: 30259515 DOI: 10.1002/jso.25184]
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Elshaarawy O, Aman A, Zakaria HM, Zakareya T, Gomaa A, Elshimi E, Abdelsameea E. Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis. World J Gastrointest Oncol 2021; 13(5): 424-439 [PMID: 34040703 DOI: 10.4251/wjgo.v13.i5.424]
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"Type 1 diabetes mellitus (T1D) is an autoimmune disease characterized by the destruction of insulin producing cells in islets by autoreactive T cells β Cells, leading to high blood sugar levels and serious long-term complications. Dendritic cells (DCs) are professional antigen-presenting cells (APCs) specialized in the initiation of both immunogenic and tolerogenic response. DC antigen presentation is in the early stage of immune response，so it has a great effect on the control of disease development. The use of tolDC as alternative immunotherapy arises as a promising approach for T1D therapy. In this paper, the author makes a full and detailed review of tolDC induction and application in preclinical and clinical."
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Ríos-Ríos WJ, Sosa-Luis SA, Torres-Aguilar H. Current advances in using tolerogenic dendritic cells as a therapeutic alternative in the treatment of type 1 diabetes. World J Diabetes 2021; 12(5): 603-615 [PMID: 33995848 DOI: 10.4239/wjd.v12.i5.603]
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"Fecal incontinence (FI) causes severe psychological and financial burden, and extremely reduced the patients’ quality of life. The true incidence of FI may be underestimated. The present review gave a brief introduction of the etiology of FI in adults, and described several commonly used methods for the evaluation of FI. However, based on our clinical experience, we believe that some related information were not sufficiently discussed in this article.
1. Causes and risk factors
FI is a multifactorial disease. In this section, the authors listed the main causes and risk factors of FI. We noticed that fecal impaction and impaired rectal compliance were not mentioned, yet they are also common causes of FI. It would be better to categorize the causes of FI according to the main mechanisms instead of simply make a list of all the related diseases. The header of Table 1 was missing, and the first row of content was incorrectly bolded. Besides, there were some language mistakes or typo's in Table 1. ‘Congenital/ Acquired neurological’ should be ‘Congenital/ Acquired neurological disease’, and ‘Ana cancer’ was probably a misspelling of “Anal cancer”.
2. History taking & physical examination
In this part, the authors summarized the key informations that should be collected during history taking. In our perspective, there is still one thing to add. Since the stool form is an influencing factor of the continence mechanism that cannot be neglected, it would be better to assess the stool form with varified universal scales, e.g. Bristol stool form scale. What’s more, the severity of FI should also be quantified with patient reported scales.
The content in this section was too general to be used as a ‘practical tool box’. A checklist which covers the main points of history taking will be more helpful in clinical practise. Japanese Practice Guidelines for Fecal Incontinence has given a great example in this aspect.
3. Diagnostic tools
The authors gave a very comprehensive introduction of commonly used clinical diagnostic and assessment tools of FI, including HRAM, EAUS & MRI, as well as electromyography. As far as we know, defecography is an important method in assessing the morphological movement of rectum and the pelvic floor muscles. Unfortunately, in this section, the introduction of MRI defecography was too brief, and failed to reveal its role in disease diagnosis and surgical intervention sufficiently. Nevertheless, barium defecography was not mentioned.
The last figure of this review showed a stepwise approach of faecal incontinence investigation, which may contribute to better clinical decision making.
In conclusion, this review provided an comprehensive overview of FI, but the main weakness of it was the missing of some significant information and the lack of novelty. Space limitation may be responsible for this disadvantage. We sincerely looking forward to the authors’ future work.
Xiyue Hu, M.D., Zheng Liu, M.D.
Dept. of Colorectal Surgery
National Cancer Center/ Cancer Hospital, Chinese Academy of Medical Science
17 Panjiayuan Nanli, Chaoyang District, Beijing, China, 100021"
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Sbeit W, Khoury T, Mari A. Diagnostic approach to faecal incontinence: What test and when to perform? World J Gastroenterol 2021; 27(15): 1553-1562 [PMID: 33958842 DOI: 10.3748/wjg.v27.i15.1553]
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"This is a sound mini-review of an important topic in general. However, it would have been a more robust reveiw if it had discerned crucial differences between binary vs. multinomial classfications of tumors in terms of methods, results and implications. "
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Shao Y, Zhang YX, Chen HH, Lu SS, Zhang SC, Zhang JX. Advances in the application of artificial intelligence in solid tumor imaging. Artif Intell Cancer 2021; 2(2): 12-24 [DOI: 10.35713/aic.v2.i2.12]
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"The review summarizes recent data on gastrointestinal manifestations in patients with COVID-19 infection in a ways, similar to previous several reviews devoted to the same topic.
The scope of review is mostly concentrated on functional disorders, while severe gastrointestinal complications were almost uncovered. This is related to intestinal microbiota as well - issues related to Cl.difficile infection, pseudomembranous colitis were not discussed.
Functional disorders lack description of psychological changes in COVID-19 patients."
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Jin B, Singh R, Ha SE, Zogg H, Park PJ, Ro S. Pathophysiological mechanisms underlying gastrointestinal symptoms in patients with COVID-19. World J Gastroenterol 2021; 27(19): 2341-2352 [PMID: 34040326 DOI: 10.3748/wjg.v27.i19.2341]
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"The topic is very actual - both from diagnostic and management points of view.
Review summarizes different studies with different severity and stage of pancreatic cancer. However article is a bit overloaded with statistical information while lacking practical outcomes."
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Frere C. Burden of venous thromboembolism in patients with pancreatic cancer. World J Gastroenterol 2021; 27(19): 2325-2340 [PMID: 34040325 DOI: 10.3748/wjg.v27.i19.2325]
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"The article represents good-quality review representing both pathogenesis and diagnostic approach in IgG4-related disease that describes the new horizons of research in the field. "
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Hara A, Watanabe T, Minaga K, Yoshikawa T, Kamata K, Kudo M. Biomarkers in autoimmune pancreatitis and immunoglobulin G4-related disease. World J Gastroenterol 2021; 27(19): 2257-2269 [PMID: 34040320 DOI: 10.3748/wjg.v27.i19.2257]
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"This review gives an overall view of the importance of the identification of the potential biomarkers from body fluids and feces, which could helps to early diagnosis of hepatocellular carcinom and also its therapeutic targetts for the better clinical understanding and out comes of the individuals. "
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Guan MC, Ouyang W, Wang MD, Liang L, Li N, Fu TT, Shen F, Lau WY, Xu QR, Huang DS, Zhu H, Yang T. Biomarkers for hepatocellular carcinoma based on body fluids and feces. World J Gastrointest Oncol 2021; 13(5): 351-365 [PMID: 34040698 DOI: 10.4251/wjgo.v13.i5.351]
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"Very interesting case report that highlights the impact of vaccine-preventable diseases on the overall wellbeing of children."
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Yang QH, Ma XP, Dai DL, Bai DM, Zou Y, Liu SX, Song JM. Gastrointestinal cytomegalovirus disease secondary to measles in an immunocompetent infant: A case report. World J Gastroenterol 2021; 27(15): 1655-1663 [PMID: 33958850 DOI: 10.3748/wjg.v27.i15.1655]
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"A comprehensive retrospective study with great results and valid conclusions."
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Liang XY, Jia TX, Zhang M. Intestinal bacterial overgrowth in the early stage of severe acute pancreatitis is associated with acute respiratory distress syndrome. World J Gastroenterol 2021; 27(15): 1643-1654 [PMID: 33958849 DOI: 10.3748/wjg.v27.i15.1643]
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"Valid, useful and with practical meaning."
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Muniraj T, Aslanian HR, Laine L, Jamidar PA, Farrell JF, Mitchell KA, Salem RR. Resection of pancreatic cystic neoplasms in recurrent acute pancreatitis prevents recurrent pancreatitis but does not identify more malignancies. World J Gastroenterol 2021; 27(15): 1630-1642 [PMID: 33958848 DOI: 10.3748/wjg.v27.i15.1630]
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"Novel and interesting results."
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Cecati M, Giulietti M, Righetti A, Sabanovic B, Piva F. Effects of CXCL12 isoforms in a pancreatic pre-tumour cellular model: Microarray analysis. World J Gastroenterol 2021; 27(15): 1616-1629 [PMID: 33958847 DOI: 10.3748/wjg.v27.i15.1616]
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"Interesting paper, revealing a new oncogenic mechanism."
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Li K, Peng YF, Guo JZ, Li M, Zhang Y, Chen JY, Lin TR, Yu X, Yu WD. Abelson interactor 1 splice isoform-L plays an anti-oncogenic role in colorectal carcinoma through interactions with WAVE2 and full-length Abelson interactor 1. World J Gastroenterol 2021; 27(15): 1595-1615 [PMID: 33958846 DOI: 10.3748/wjg.v27.i15.1595]
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"Great design and methods used to achieve the aim of the study."
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Alharbi SA, Ovchinnikov DA, Wolvetang E. Leucine-rich repeat-containing G protein-coupled receptor 5 marks different cancer stem cell compartments in human Caco-2 and LoVo colon cancer lines. World J Gastroenterol 2021; 27(15): 1578-1594 [PMID: 33958845 DOI: 10.3748/wjg.v27.i15.1578]
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"Very well-written and extensive review on the topic."
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Sakai Y, Ohtsuka M, Sugiyama H, Mikata R, Yasui S, Ohno I, Iino Y, Kato J, Tsuyuguchi T, Kato N. Current status of diagnosis and therapy for intraductal papillary neoplasm of the bile duct. World J Gastroenterol 2021; 27(15): 1569-1577 [PMID: 33958844 DOI: 10.3748/wjg.v27.i15.1569]
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"Useful clinical pearls for the clinical practice."
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Lorenzo-Zúñiga V, Bustamante-Balén M, Pons-Beltrán V. Prevention of late complications with coverage agents in endoscopic resection of colorectal lesions: Current landscape in gastrointestinal endoscopy. World J Gastroenterol 2021; 27(15): 1563-1568 [PMID: 33958843 DOI: 10.3748/wjg.v27.i15.1563]
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"Concise and comprehensive paper. Valid conclusions that are beneficial for the clinical practice."
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Sbeit W, Khoury T, Mari A. Diagnostic approach to faecal incontinence: What test and when to perform? World J Gastroenterol 2021; 27(15): 1553-1562 [PMID: 33958842 DOI: 10.3748/wjg.v27.i15.1553]
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"The paper presented all the new insights regarding the cytokine storm, including therapeutic options."
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Ali FEM, Mohammedsaleh ZM, Ali MM, Ghogar OM. Impact of cytokine storm and systemic inflammation on liver impairment patients infected by SARS-CoV-2: Prospective therapeutic challenges. World J Gastroenterol 2021; 27(15): 1531-1552 [PMID: 33958841 DOI: 10.3748/wjg.v27.i15.1531]
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"The paper is concise. It comprehensively covers the main aspects of the topic."
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Tsilimigras DI, Pawlik TM, Moris D. Textbook outcomes in hepatobiliary and pancreatic surgery. World J Gastroenterol 2021; 27(15): 1524-1530 [PMID: 33958840 DOI: 10.3748/wjg.v27.i15.1524]
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"I agree with the authors that AI will play more significant role in the future of cancer management, including diagnosis, treatment and follow-up. Additionally, helping interpreting the images could have a tremendous effect on reducing the time and pressure on medical specialists, along with improving the quality of diagnosing process."
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Shao Y, Zhang YX, Chen HH, Lu SS, Zhang SC, Zhang JX. Advances in the application of artificial intelligence in solid tumor imaging. Artif Intell Cancer 2021; 2(2): 12-24 [DOI: 10.35713/aic.v2.i2.12]
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"Although short in form, the paper covers all the critical points in the AI regarding CRC. The authors present their thesis accurately, comprehensively and concisely. "
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Alloro R, Sinagra E. Artificial intelligence and colorectal cancer: How far can you go? Artif Intell Cancer 2021; 2(2): 7-11 [DOI: 10.35713/aic.v2.i2.7]
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"The authors provide a comprehensive review of the value of artificial intelligence in various oncology applications and explain how it will change the medical workflow.AI is the trend of the future and we should actively learn from it and take advantage of it."
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Shao Y, Zhang YX, Chen HH, Lu SS, Zhang SC, Zhang JX. Advances in the application of artificial intelligence in solid tumor imaging. Artif Intell Cancer 2021; 2(2): 12-24 [DOI: 10.35713/aic.v2.i2.12]
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"I agree with the author that AI is the development trend of the future and we should actively learn from it and make use of it."
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Alloro R, Sinagra E. Artificial intelligence and colorectal cancer: How far can you go? Artif Intell Cancer 2021; 2(2): 7-11 [DOI: 10.35713/aic.v2.i2.7]
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"Alcohol intake is a risk factor for the development of gastric cancer, and the authors further demonstrated through meta-analysis that alcohol consumption increases the risk of gastric cancer in men."
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Bae JM. Sex as an effect modifier in the association between alcohol intake and gastric cancer risk. World J Gastrointest Oncol 2021; 13(5): 453-461 [PMID: 34040705 DOI: 10.4251/wjgo.v13.i5.453]
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"This is a paper on image, which has broadened my knowledge."
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Elsayed M, Loya M, Galt J, Schuster DM, Bercu ZL, Newsome J, Brandon D, Benenati S, Behbahani K, Duszak R, Sethi I, Kokabi N. Same day yttrium-90 radioembolization with single photon emission computed tomography/computed tomography: An opportunity to improve care during the COVID-19 pandemic and beyond. World J Gastrointest Oncol 2021; 13(5): 440-452 [PMID: 34040704 DOI: 10.4251/wjgo.v13.i5.440]
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"It is difficult for doctors to accurately evaluate the prognostic factors of decompensation and productivity in clinical work due to the great differences in clinical characteristics of HCC patients.By univariate and multivariate COX analysis, the authors calculated the factors affecting postoperative liver decompensation and prognosis of patients, which provided a reference for clinicians to choose the appropriate treatment time."
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Elshaarawy O, Aman A, Zakaria HM, Zakareya T, Gomaa A, Elshimi E, Abdelsameea E. Outcomes of curative liver resection for hepatocellular carcinoma in patients with cirrhosis. World J Gastrointest Oncol 2021; 13(5): 424-439 [PMID: 34040703 DOI: 10.4251/wjgo.v13.i5.424]
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"Based on a large number of literature, the authors describe the cases, clinical manifestations, tests and examination indicators of Plexiform fibromyxoma, and the differential diagnosis, which provide help for clinicians to select appropriate treatment measures."
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Arslan ME, Li H, Fu Z, Jennings TA, Lee H. Plexiform fibromyxoma: Review of rare mesenchymal gastric neoplasm and its differential diagnosis. World J Gastrointest Oncol 2021; 13(5): 409-423 [PMID: 34040702 DOI: 10.4251/wjgo.v13.i5.409]
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"By reviewing a large number of literatures, the author elaborated the complications of chemotherapy in different parts of the tumor, and put forward the corresponding mitigation measures, which provided help for clinicians to choose the appropriate treatment measures."
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McCaughan H, Boyle S, McGoran JJ. Update on the management of the gastrointestinal effects of radiation. World J Gastrointest Oncol 2021; 13(5): 400-408 [PMID: 34040701 DOI: 10.4251/wjgo.v13.i5.400]
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"The authors demonstrate that laparoscopic or robotic transverse colon resection based on the CME concept is suitable for TCC patients through evidence, providing some reference for the selection of clinical treatment plan."
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Li C, Wang Q, Jiang KW. What is the best surgical procedure of transverse colon cancer? An evidence map and minireview. World J Gastrointest Oncol 2021; 13(5): 391-399 [PMID: 34040700 DOI: 10.4251/wjgo.v13.i5.391]
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"By reviewing a large number of literatures, the authors described the current therapeutic targets and related targeted drugs for gastric cancer, as well as the progress of immunotherapy, and summarized the development status of precision medicine in the field of gastric cancer."
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Matsuoka T, Yashiro M. Molecular-targeted therapy toward precision medicine for gastrointestinal cancer: Current progress and challenges. World J Gastrointest Oncol 2021; 13(5): 366-390 [PMID: 34040699 DOI: 10.4251/wjgo.v13.i5.366]
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