Study of newly diagnosed Gastroenterology tumors and associated risk factors at Tishreen University Hospital in Lattakia – Syria: دراسة لأورام الجهاز الهضمي المشخصة حديثاً في مشفى تشرين الجامعي في اللاذقية - سوريا وعوامل الخطر المرتبطة بها

Objective: The study was conducted in order to determine the epidemiological characteristics of referred patients at Tishreen University Hospital in Lattakia and who have been diagnosed with one of the types of malignant Gastrointestinal tumors and study the distribution of risk factors in these patients. Patients and Methods: An Observational Descriptive study (Cross- Sectional) conducted for the period from January 2020 to January 2021 at Tishreen University Hospital in Lattakia- Syria (in Gastrointerolog Department). The variables analyzed were age, gender, tumor location and risk factors Results: The research sample included 223 patients (127 males and 96 females). Esophageal tumors are relatively rare and most of them are of the squamous cell carcinoma type (72.8%). Stomach tumors are the second most common tumor with a percentage of (23.8%), and adenocarcinoma constituted 89% of the cases. Colon and rectal cancer represented the largest percentage (35%) of gastrointestinal tumors, and half of these tumors were in the rectum. Pancreatic cancer ranked third with 11.2% of cases. Tumors of the small intestine and gallbladder and hepatocellular carcinoma are relatively rare. Our most frequently seen risk factors were smoking in most tumors, positivity for H. pylori in 70% of gastric adenocarcinoma patients, and family history and inflammatory bowel disease in Colon tumor patients. Conclusion: Although the incidence of some gastrointestinal cancers has decreased, these cancers continue to pose major challenges to public health, especially colorectal tumors.

Genotype-based chemotherapy for patients with gastrointestinal tumors: focus on oxaliplatin, irinotecan, and fluoropyrimidines

This review aimed to summarize the pharmacogenetic studies of the most commonly used drugs in the chemotherapy of gastrointestinal (GI) tumors: oxaliplatin, irinotecan, and fluoropyrimidines. So far, it has not been possible to develop an effective genotype-based approach for oxaliplatin. More and more evidence is emerging in favor of the fact that the choice of a dose of fluorouracil based on pharmacogenetic testing according to DPYD*2A, can be not only effective but also cost-effective. Additional, well-planned trials of the UGT1A1 genotype-based approach to irinotecan therapy are predicted to reduce adverse drug events in people with the UGT1A1*28/*28 genotypes and improve treatment efficacy in the rest of the patients, which might be cost-effective.

Correlations between P2RX1 Expression and Gastrointestinal Cancers Prognosis and Immune Infiltration Based on Bioinformatics Analysis

This study was conducted to explore the correlations between the expression, methylation, and various clinicopathological factors of purinergic P2X1 receptor (P2RX1) and the prognosis of patients with gastrointestinal tumors. The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) databases were used to analyze the expression of P2RX1 in different types of gastrointestinal cancers. Kaplan-Meier analysis and univariate Cox regression analysis were used to analyze the correlations between P2RX1 expression and the prognosis of various gastrointestinal tumors. Correlations between P2RX1 expression and N6 methyladenine (m6A)-related genes as well as immune checkpoint genes were analyzed by R packages (R version: 4.0.3) based on TCGA database. The association between P2RX1 methylation level and the prognosis of patients with gastrointestinal cancers was analyzed using the MethSurv database. In order to explore the biological functions of P2RX1 in hepatocellular carcinoma, the Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analysis were carried out using R software. In order to evaluate the correlations between P2RX1 and tumor immune infiltration, Spearman correlation test was performed. The correlations between P2RX1 expression and immune score as well as immune checkpoint genes were analyzed based on TCGA and Tumor Immune Estimation Resource (TIMER) databases. The expression of P2RX1 was found to be significantly downregulated in gastrointestinal tumors except in cholangiocarcinoma (P < 0.05). High expression of P2RX1 tended to present better prognosis in hepatocellular carcinoma (P < 0.05). It was noted that cg06475633 of P2RX1 presented a higher methylation level compared with other CpG sites in hepatocellular carcinoma. Overall, six CpGs of P2RX1 were associated with significant prognosis in patients with hepatocellular carcinoma (P < 0.05). Among all the 20 m6A-related genes, Wilms’ tumor 1-associating protein (WTAP) was the most strongly correlated with P2RX1 in hepatocellular carcinoma. Gene enrichment analysis showed that P2RX1 is widely involved in the proliferation, activation, organization, and differentiation of various immune cells. After investigating the TIMER database, P2RX1 was found to be tightly correlated with immune infiltrating cells in gastrointestinal tumors, especially with dendritic cells. Moreover, P2RX1 was found to be strongly positively associated with programmed cell death 1 (PD1), programmed death-ligand 1 (PD-L1), and cytotoxic T-lymphocyte-associated protein 4 (CTLA4) in hepatocellular carcinoma (P < 0.05). In conclusion, the dual role of P2RX1 in cancers and its involvement in the recruitment as well as regulation of tumor infiltrating cells in gastrointestinal cancers may be appreciated through this study.

Meta-Analysis on the Improvement of Symptoms and Prognosis of Gastrointestinal Tumors Based on Medical Care and Exercise Intervention

Gastric cancer is a malignant tumor that originates from the epithelium of the gastric mucosa. It is the result of a combination of multiple factors, but the current research has not yet clarified its pathogenesis, so further research and exploration are needed. This article is mainly based on the meta-analysis of the improvement of gastrointestinal tumor-related symptoms and prognosis based on medical care and exercise intervention. The control group followed routine care after enrollment. In addition to routine care, patients in the intervention group exercised through assessment, formulation of exercise prescriptions, implementation of supervision, and adjustment. By viewing the subjects' physical examination reports, determine their blood routine, urine routine, blood lipids, blood sugar, liver and kidney function, and electrocardiogram examination. In this experiment, dual-contrast ultrasound in each T staging was greater than 0.8, indicating that the diagnostic method is very accurate in the preoperative diagnosis of gastric cancer T staging. The results show that exercise intervention can improve the pain of patients with gastrointestinal tumors after chemotherapy, relieve cancer-induced fatigue, and improve the quality of life.