Search Results (559)

Gastric cancer is a globally prevalent malignancy, with early detection being pivotal for improving patient survival. While endoscopy remains the diagnostic gold standard, it frequently faces challenges such as missed lesions and operator dependency. Artificial intelligence (AI) has emerged as a powerful tool to address these limitations. This narrative review synthesizes recent evidence from PubMed and Web of Science, focusing on four core functional domains of AI-assisted gastric endoscopy: lesion detection and characterization, margin delineation, invasion depth prediction, and blind-spot monitoring. Furthermore, we summarize current limitations, including single-center data biases and algorithmic “black-box” issues, and discuss future directions such as multimodal data integration and real-time video analysis systems. Ultimately, carefully validated AI represents a vital clinical adjunct that holds great potential to significantly enhance diagnostic accuracy and patient outcomes. Full article

The anisakid nematode Sulcascaris (S.) sulcata is one of the most frequently reported pathogenic parasites of the gastrointestinal tract of sea turtles, with a wide distribution in warm marine ecosystems of the Pacific, Atlantic, and Mediterranean basins. Sea turtles, including the Mediterranean loggerhead turtle (Caretta caretta), act as definitive hosts by ingesting infected bivalve and gastropod mollusks containing fourth-stage larvae. Infected sea turtles typically develop ulcerative gastritis and chronic mucosal inflammation. We molecularly characterized 19 anisakid nematodes collected from the gastric tract of stranded C. caretta (n = 19) along the Adriatic and Ionian coasts and examined them at local Zooprophylactic Institutes. Stomach samples from five severely infested turtles were also submitted to histological analysis. Species identification was performed through two conventional PCRs targeting MT-CO1 and MT-CO2, and sequencing of 35 amplicons confirmed their identity as S. sulcata, revealing high genetic homogeneity. Phylogenetic analyses showed no clustering by geographic origin or host. Pathological examination revealed mucocatarrhal gastritis with ulcerative lesions, while histological analysis showed chronic gastritis characterized by lymphocytic infiltration. These findings refine current knowledge on S. sulcata distribution and host–parasite dynamics, with implications for marine turtle health and intermediate-host ecology. Full article

Introduction: Gastric ulcer perforation is a life-threatening surgical emergency in which delay is poorly tolerated. In this setting a specimen is taken from ulcer margin to detect possible malignancy risk. The purpose of the present systematic review is to evaluate the need of intraoperative biopsy in gastric ulcer perforations using current biopsy-proven malignancy rates and its effect on complications. Methods: The review was carried out in line with the PRISMA guidelines and was registered (INPLASY202650135). Reports describing adults who operated on for a perforated gastric ulcer were considered. The principal endpoint was detection of malignancy. Malignancy proportions were combined within a random-effects model after Freeman–Tukey double-arcsine transformation, and statistical heterogeneity was quantified with the I² statistic. Results: Twelve reports were eligible for the review, amounting to 1122 patients. Of these, 953 individuals (64% men; average age 52 years) underwent sampling of the ulcer at operation. Twenty-seven patients had biopsy-proven malignancy on intraoperative histology; one additional patient had a false-negative intraoperative biopsy that was confirmed as malignant on postoperative endoscopy, so the biopsy-proven outcome was based on 27 events. The random-effects pooled proportion of biopsy-proven malignancy among patients with no previous gastric cancer diagnosis was 3.1% (95% CI 1.4–5.7%). There was substantial statistical heterogeneity between studies (I² = 72%; Cochran Q = 39.8, df = 11, p < 0.001). Sampling was omitted in 169 patients, and complications in patients with and without biopsy were contrasted in a single report only. In that single retrospective study, both total complications (46.4% vs. 11.8%, p = 0.007) and Clavien–Dindo grade ≥ III complications (34.5% vs. 5.9%, p = 0.017) occurred more often after biopsy since this signal derives from one single-centre comparison and may be confounded by ulcer complexity, so it ought to be treated as a hypothesis to be tested rather than as an established effect. Conclusions: The available evidence does not support the routine biopsy of all perforated gastric ulcers during surgery. However, as the evidence base is almost entirely retrospective and the included studies did not categorize lesions by size or appearance, a selective biopsy or intraoperative frozen section strategy may still be justified for large, chronic, mass-like, or otherwise suspicious ulcers, particularly in elderly patients. Full article

Selenite bioreduction by food-grade lactic acid bacteria enables mild production of selenium nanoparticles (SeNPs) together with selenium-enriched biomass. Here, a highly Se(IV)-tolerant isolate from Enshi soil was identified as Pediococcus acidilactici JD-21, which efficiently reduced 5 mmol/L Se(IV) and accumulated SeNPs with an average diameter of 46.4 ± 7.7 nm, potentially associated with protein- and polysaccharide-related biomolecules. Selenium enrichment markedly enhanced the antibacterial activity of JD-21 against Escherichia coli, Staphylococcus aureus and Salmonella enteritidis and improved survival in simulated gastric juice, indicating probiotic potential. In a mouse Streptococcus suis infection model, oral-gavage SeNPs alleviated infection-associated weight loss, restored antioxidant enzyme activities and reduced liver and spleen lesions. RNA-seq revealed 537 Se(IV)-responsive genes, with up-regulated redox, lipid/exopolysaccharide and transport pathways and down-regulated growth-related functions. These findings demonstrate that JD-21 is a promising food-grade chassis for producing biogenic SeNPs and selenium-enriched probiotics for selenium fortification and foodborne pathogen control. Full article

Background/Objectives: Hydrochloric acid (HCl)/ethanol-induced gastric mucosal injury is closely associated with oxidative stress and inflammatory responses. Probiotics are promising therapeutic agents for gastrointestinal disorders. Therefore, this study evaluated the preventive effects of Cheonggukjang-derived Bacillus strains on HCl/ethanol-induced gastric mucosal injury in a rat model (n = 5 per group), with emphasis on inflammatory mechanisms. Methods: Eight-week-old male Sprague–Dawley rats were orally administered Bacillus amyloliquefaciens C393 1.0 × 10⁹ CFU (B393), Bacillus subtilis C439 1.0 × 10⁹ CFU (B439), or B. subtilis C512 1.0 × 10⁹ CFU (C512). Gastric injury was induced by oral administration of HCl/ethanol (150 mM HCl in 60% ethanol). Results: HCl/ethanol exposure significantly increased symptom scores, gastric mucosal lesion area, and histopathological damage. Pretreatment with B393 and B439 significantly attenuated these alterations. Moreover, HCl/ethanol administration increased gastric secretion volume and decreased gastric pH, both of which were significantly normalized by B393 and B439. Serum levels of pro-inflammatory cytokines, including tumor necrosis factor-α and interleukin-6, were significantly elevated following HCl/ethanol exposure but were markedly reduced by B393 and B439. Immunohistochemical analysis demonstrated that nuclear factor-kappa B activation in gastric tissues was significantly suppressed in these groups. Conclusions: These findings indicate that Cheonggukjang-derived Bacillus strains exert strain-specific gastroprotective effects possibly by suppressing NF-κB-mediated inflammatory signaling. Full article

Background/Aim: Rifaximin is a gut-selective antibiotic with minimal systemic absorption that exerts its effects primarily within the gastrointestinal tract. Beyond its antimicrobial activity, rifaximin has been shown to possess anti-inflammatory and immunomodulatory properties. Gastric intestinal metaplasia (GIM) is a premalignant lesion associated with chronic gastric inflammation and Helicobacter pylori infection and is considered an important step in gastric carcinogenesis. Given the regulatory effects of rifaximin on the gut microbiota and mucosal inflammation, its potential impact on gastric histopathological alterations remains poorly understood. This study aimed to evaluate the effects of rifaximin therapy on gastric histopathological findings, particularly gastric intestinal metaplasia. Methods: In this retrospective single-center study, patients who received rifaximin therapy for various gastrointestinal indications and underwent upper gastrointestinal endoscopy with gastric biopsies both before and after treatment were included. Demographic characteristics, rifaximin treatment data, and histopathological findings were obtained from hospital records. Pre- and post-treatment biopsy findings were compared with respect to gastric intestinal metaplasia, dysplasia, and Helicobacter pylori positivity. Results: A total of 80 patients (mean age: 62.4 ± 11.9 years; 58.8% male) were included. Following rifaximin therapy, gastric intestinal metaplasia demonstrated significant regression (p < 0.001). Complete regression was observed in 45 patients (56.2%), partial regression in 12 patients (15.0%), stable disease in 14 patients (17.5%), and progression in 9 patients (11.3%). Helicobacter pylori positivity decreased from 42.5% to 31.2% (p = 0.041), whereas no significant change was observed in dysplasia rates (p = 0.564). No significant correlation was found between biopsy interval and the degree of intestinal metaplasia regression (Spearman’s r = −0.057, p = 0.617). Conclusions: Rifaximin therapy was associated with regression in both the presence and severity of gastric intestinal metaplasia. These findings provide preliminary evidence supporting further investigation of rifaximin in gastric intestinal metaplasia. However, the results should be considered hypothesis-generating, and larger prospective controlled studies are required to establish a causal relationship and further elucidate the underlying mechanisms. Full article

Background: Chronic atrophic gastritis (CAG) is a prevalent precancerous gastric disorder characterized by persistent inflammation, glandular atrophy, and progressive mucosal damage, for which effective multi-target therapeutic strategies remain insufficient. The Lian-Huo-Hua-Zhuo formula (LHHZ), a traditional Chinese herbal prescription, has demonstrated potential anti-inflammatory and gastrointestinal protective effects in clinical practice; however, its active constituents and mechanisms of action against CAG remain undefined. This study aimed to clarify the absorbed bioactive components of LHHZ and explore its therapeutic mechanism for CAG. Methods: Ultra-high-performance liquid chromatography coupled with quadrupole Orbitrap high-resolution mass spectrometry was employed to identify the absorbed components of LHHZ in the gastric and intestinal tissues of mice. The therapeutic effects of LHHZ on CAG were assessed through histopathological staining, ultrastructural observation, and evaluation of serum and gastric functional indicators. Network pharmacology, molecular docking, and molecular dynamics simulations were integrated to predict the core targets and key signaling pathways, while the regulatory effects on the interleukin-17 (IL-17) signaling pathway were further validated by immunofluorescence staining, real-time quantitative polymerase chain reaction, and Western blotting. Additionally, 16S ribosomal RNA gene sequencing and targeted metabolomics were applied to investigate the effects of LHHZ on gut microbiota composition and short-chain fatty acid (SCFA) metabolism. Results: The results revealed that 55 and 48 absorbed components were identified in the gastric and intestinal tissues, respectively, predominantly derived from Coptis chinensis Franch. and Pogostemon cablin (Blanco) Benth. LHHZ significantly alleviated gastric mucosal lesions, reduced intestinal metaplasia, restored the ultrastructure of gastric mucosal cells, improved gastric functional indicators including pepsinogen I (PG I), pepsinogen II (PG II), and gastrin-17 (GAS-17), and decreased the levels of pro-inflammatory cytokines. Network pharmacology combined with in vitro and in vivo experiments demonstrated that the core bioactive components of LHHZ can target and regulate interleukin-1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α), attenuate activation of the IL-17 signaling pathway, and suppress the secretion of downstream pro-inflammatory factors. Furthermore, LHHZ enhanced the alpha diversity of gut microbiota, reduced the Firmicutes to Bacteroidetes (F/B) ratio, restored the abundance of SCFA-producing bacteria such as Bacteroidales and Oscillospirales, and normalized the aberrant levels of eight SCFAs. Significant correlations were also observed between gut microbiota composition and SCFA metabolism. Conclusions: These findings suggest that LHHZ alleviates CAG by inhibiting inflammation via the IL-17 signaling pathway and by modulating the gut microbiota–SCFA axis, thereby providing preclinical evidence supporting its further investigation and development for multi-target therapeutic strategies against CAG. Full article

Chronic atrophic gastritis (CAG) is a pivotal precancerous condition in gastric carcinogenesis, with progression typically following the classic Correa cascade. Although Helicobacter pylori (H. pylori) infection is widely recognized as the principal etiological factor, the persistence of gastric cancer (GC) risk in a subset of patients after successful eradication suggests that gastric microbiota dysbiosis may also contribute to CAG progression. In recent years, high-throughput sequencing technologies have revealed distinct microbial restructuring in patients with CAG, characterized by decreased microbial diversity, depletion of commensal taxa, and enrichment of opportunistic pathogens. These compositional changes are accompanied by metabolic dysfunction, activation of inflammatory signaling pathways, and disruption of immune homeostasis, which may contribute to a microenvironment permissive for precancerous transformation of the gastric mucosa. Probiotics and related microbiome-based therapeutics, including prebiotics, synbiotics, and postbiotics, have emerged as promising adjunctive strategies for H. pylori eradication and disease management. Their beneficial effects are mediated through multiple mechanisms, including remodeling of the microbial community, inhibition of pathogen colonization, modulation of host immune responses, and restoration of mucosal barrier integrity. However, whether these interventions can reverse established atrophic or metaplastic lesions remains unclear. In addition, how strain specificity, dose dependency, and interindividual heterogeneity influence clinical efficacy has yet to be fully elucidated. In this review, we summarize the compositional and functional features of gastric microbiota dysbiosis in patients with CAG, as well as the mechanisms and clinical applications of microbiome-based interventions. We further highlight current limitations in the field and discuss future directions for precision microecological therapies integrating multi-omics approaches, engineered probiotics, and artificial intelligence. These advances may provide a theoretical framework and practical guidance for the diagnosis and management of CAG and the prevention of GC. Full article

Background/Objectives: Breast cancer is the most commonly diagnosed malignancy among women, with hormone receptor-positive tumors representing the majority of cases. Increasing survival rates have shifted attention toward long-term complications, including the risk of secondary malignancies. Emerging evidence suggests a potential association between breast cancer and gastrointestinal (GI) neoplasia. This study aimed to evaluate the role of colonoscopic and upper gastrointestinal endoscopic monitoring in patients with ER/PR-positive breast cancer and to assess its potential value in the early detection of digestive lesions. Methods: We conducted a prospective observational study including 186 female patients with histologically confirmed ER/PR-positive breast cancer. A total of 95 patients underwent colonoscopy, and 91 patients underwent upper gastrointestinal endoscopy. Clinical, demographic, and risk factor data were collected. A structured questionnaire was used to assess gastrointestinal symptoms. Endoscopic findings, lesion characteristics, and histopathological results were recorded. Bowel preparation quality was assessed using the Boston Bowel Preparation Scale. Results: Colonoscopy identified polyps and other lesions, with the majority located in the rectum and descending colon. A total of 12 biopsies were performed, revealing 1 malignant lesion, 2 borderline lesions, and the remainder benign. Upper gastrointestinal endoscopy showed gastritis as the most frequent finding, followed by gastric ulcers and polyps, while most patients had normal endoscopic results. Overall, 72% of patients presented at least one risk factor for digestive malignancy. Following treatment, most patients reported improvement in gastrointestinal symptoms. Conclusions: Patients with ER/PR-positive breast cancer may present a higher prevalence of gastrointestinal lesions, potentially related to shared risk factors and the systemic effects of endocrine therapy. Targeted, symptom-oriented endoscopic evaluation may facilitate early detection of premalignant and malignant digestive conditions. A multidisciplinary, risk-adapted surveillance approach should be considered to improve patient outcomes. Further large-scale studies are required to establish evidence-based screening strategies in this population. Full article

Inflammatory fibroid polyp (IFP) or Vanek’s tumor is a rare benign submucosal lesion of the gastrointestinal tract that may radiologically mimic mesenchymal gastric tumors, particularly gastrointestinal stromal tumors. We present the case of a 65-year-old patient with a contrast-enhancing gastric submucosal mass detected on computed tomography, initially interpreted as a suspected mesenchymal neoplasm. CT imaging demonstrated a well-defined enhancing lesion arising from the gastric wall without evidence of metastatic disease. Surgical resection was performed because imaging findings were considered highly suggestive of GIST. Gross intraoperative appearance and pathological examination, however, established the final diagnosis of gastric inflammatory fibroid polyp (Vanek’s tumor). Histopathological analysis demonstrated characteristic spindle-cell proliferation with inflammatory eosinophil-rich infiltrates, while immunohistochemistry excluded GIST. This case highlights the diagnostic challenge in differentiating IFP from other gastric submucosal neoplasms based solely on imaging findings and emphasizes the importance of histopathological confirmation for definitive diagnosis. Full article

Background/Objectives: Spinosin, a flavone glycoside derived from medicinal plants, has been widely studied for its neuroactive properties; however, its effects on gastric injury remain unclear. Therefore, this study investigated the potential protective role of spinosin against HCl/ethanol-induced gastric lesions and its association with Nrf2/HO-1-related antioxidant responses. Methods: Gastric ulceration was experimentally induced in male Swiss albino mice by intragastric administration of 0.3 M HCl in 70% ethanol. Spinosin was administered orally at doses of 10 and 20 mg/kg, while omeprazole (20 mg/kg) was used as a reference treatment. Results: HCl/ethanol exposure led to pronounced oxidative stress and inflammatory responses, as reflected by increased levels of MDA, NFκB, IL-6, TNF-α, Cox-2, iNOS, IL-1β, Bax, and Cas-3, along with reduced antioxidant enzyme activities (GSH, SOD, CAT), decreased PGE2 and NO levels, and downregulation of Nrf2, HO-1, and Bcl-2 expression. Spinosin administration significantly attenuated gastric injury, suppressed pro-inflammatory mediators, reduced markers of lipid peroxidation and apoptosis, and enhanced antioxidant defenses. In parallel, spinosin treatment was associated with increased expression of Nrf2, HO-1, and Bcl-2. Conclusions: These findings suggest that spinosin mitigates gastric damage and is associated with attenuation of oxidative stress, inflammatory responses, and apoptosis, suggesting a possible contribution of Nrf2/HO-1-related antioxidant responses. Full article

The accurate segmentation of gastric cancer cells is important in pathology for diagnosing and detecting diseases early. However, current approaches still suffer from limitations such as expensive annotation, fuzzy lesion boundaries, and weak feature expression. In order to solve these problems, we present MSAF-Net, a novel U-Net framework optimized both architecturally and in terms of the loss function. In particular, we incorporate a Multi-scale Dilated Pooling Fusion Block into the encoder stage to achieve enhanced interaction of multi-paths and thus improve features’ diversity and boundary sensitivity. We also introduce a Dual-Channel Attention Block in place of traditional convolution block in the decoder stage to restore better details and reconstruct the fuzzy boundaries. Meanwhile, a Diagonal Mahalanobis Consistency Loss is incorporated into our framework to facilitate class compactness. Experiments performed on the SEED-Gastric Carcinoma Stage 1 dataset show that the designed algorithm can reach 0.776 in Dice score and 0.821 in Accuracy, which outperforms the baseline method U-Net. It is clear that these results have shown the effectiveness and robustness of our proposed approach. The introduced algorithm allows for more precise quantification of gastric cancer cell morphology. Full article

The gastric endocrine population comprises functionally distinct cell types that exhibit both neuronal and endocrine characteristics; however, their molecular markers remain incompletely defined. Here, we identify growth differentiation factor 9 (GDF9), nephrin (NPHS1), and rearranged during transfection (RET) as novel markers of gastric endocrine cells. A co-immunofluorescence (IF) analysis demonstrated that GDF9, NPHS1, and RET are co-expressed with chromogranin A (CHGA), a well-known marker of gastrointestinal endocrine cells. Further Co-IF analysis revealed that GDF9-expressing cells were negative for ghrelin and somatostatin, whereas NPHS1 was co-expressed with both hormones. A subpopulation of RET-positive cells co-expressed ghrelin but not somatostatin. Notably, GDF9- and RET-positive cells co-expressed dopamine decarboxylase (DDC), consistent with enrichment in enterochromaffin-like (ECL) cells. Revisitation of our previous mRNA-sequencing data revealed reduced transcript levels of Gdf9, Nphs1, and Ret in CA-PKA mice, which express constitutively active protein kinase A (PKA) and develop gastric preneoplastic lesions. Co-IF and cellular quantification showed a localized reduction in the density of GDF9 and CHGA-positive endocrine cells, together with altered abundance of NPHS1- and RET-expressing cells in CA-PKA stomachs. These changes occurred in the context of extensive hyperplasia of the surrounding epithelium, indicating that the observed alterations reflect localized reduction and non-cell-autonomous effects of epithelial expansion. Notably, we observed RET misexpression outside the endocrine compartment in CA-PKA mice, suggesting that aberrant RET signaling may contribute to lesions by promoting abnormal glandular branching. Together, these findings identify GDF9, NPHS1, and RET as novel markers of gastric endocrine cells and their potential role in gastric homeostasis. Full article

Background/Objectives: Tordylium trachycarpum Boiss. (Apiaceae) is traditionally used in Kurdish ethnomedicine for the management of gastrointestinal disorders; however, its pharmacological efficacy and safety profile remain insufficiently investigated. This study evaluated, for the first time, the gastroprotective activity and associated antioxidant, inflammatory, and apoptotic responses of the methanolic extract of T. trachycarpum using an ethanol-induced gastric ulcer model in Sprague–Dawley rats. Methods: Preliminary phytochemical screening revealed the presence of phenolics, flavonoids, terpenoids, tannins, coumarins, and glycosides. Acute oral toxicity testing demonstrated no signs of toxicity at doses up to 5 g/kg. Gastric ulceration was induced by absolute ethanol, and animals were pretreated with the extract (250 and 500 mg/kg) or omeprazole (20 mg/kg). Results: The extract significantly decreased the gastric lesion area from 258.50 ± 6.38 mm² in the ulcer control group to 143.70 ± 0.76 mm² and 115.50 ± 0.76 mm², corresponding to ulcer inhibition rates of 44.41% and 55.31%. Additionally, the extract increased mucus production, maintained mucosal structure, and raised stomach pH. Biochemical analysis showed a significant increase in antioxidant enzymes [superoxide dismutase (SOD) and catalase (CAT)] and a reduction in malondialdehyde (MDA) levels, indicating attenuation of oxidative stress. In addition, the extract modulated pro-inflammatory cytokines (TNF-α, IL-1β, IL-6, and IL-10). Blood-based ELISA analysis demonstrated increased expression of heat shock protein 70 (HSP70) and reduced Bax levels, suggesting anti-apoptotic activity. Conclusions: These findings indicate that T. trachycarpum exerts significant gastroprotective activity through antioxidant, anti-inflammatory, and anti-apoptotic mechanisms, supporting its traditional use and highlighting its potential as a natural therapeutic candidate for the management of gastric ulcers. Full article

Gastric adenomas are epithelial premalignant neoplasms which may appear similar on endoscopic examination; however, histologically, they are classified into four distinct subtypes according to the World Health Organization (WHO) Classification of Tumors of the Digestive System: intestinal adenoma, foveolar-type adenoma, oxyntic gland adenoma, and pyloric gland adenoma. Each subtype has characteristic histologic features that are essential for accurate diagnosis, although distinction can be challenging due to overlapping morphologic patterns. Moreover, these entities differ in their potential for malignant transformation and in their associations with hereditary or syndromic conditions. The objective of this review is to provide a practical guide for the histopathologic diagnosis of gastric adenomas, summarize the evidence regarding their risk of associated malignancy or malignant transformation, and review current recommendations for clinical follow-up and management. Given that various lesions may present endoscopically as gastric polyps, this manuscript also reviews both epithelial and non-epithelial mimickers of gastric adenomas. Full article