Since its discovery as an antirachitic agent, vitamin D has been recognized for its importance to health, most namely bone health, prompting food fortification practices that are still in place today. The two forms of vitamin D, ergocalciferol (D2) and cholecalciferol (D3), are obtained through the diet or synthesized in the skin via ultraviolet-B radiation. Vitamin D is activated by enzymes mainly found in hepatic and renal tissues, to exert downstream effects via the nuclear vitamin D receptor (VDR). VDR is expressed nearly in all tissues, allowing activated vitamin D to have pleiotropic functions. This review focuses on the gastrointestinal tract, with high VDR content and known associations between vitamin D deficiency and disease states. For example, VDR expression within esophageal submucosal glands may influence fibrosis in eosinophilic esophagitis, while in the stomach VDR is associated with malignancy and Heliocobacter pylori infection. Intestinal diseases like inflammatory bowel disease, intestinal failure, and irritable bowel syndrome have also been linked to vitamin D deficiency and VDR expression. Although there are studies focused on the impact of genetic polymorphisms in VDR and vitamin D supplementation on intestinal diseases, they remain largely inconclusive at this time. Interest in the gut-lung axis has further prompted the investigation of vitamin D in respiratory conditions like chronic pulmonary obstructive disease, asthma, and Mycobacterium tuberculosis infection. While it is clear that vitamin D is important to both the gut and the lungs, there is still a need for further research on the overall role of this important vitamin.

Leiomyomas are rare benign esophageal tumors and represent less than 1% of all esophageal neoplasms. Those located at the esophagogastric junction (EGJ) are uncommon and challenging due to their proximity to the lower esophageal sphincter. Most cases are asymptomatic and discovered incidentally, though symptomatic patients may present with dysphagia, heartburn, regurgitation, or chest pain. Diagnosis typically involves barium swallow studies, upper endoscopy, endoscopic ultrasonography, and computed tomography. Surgical treatment is recommended for symptomatic patients or those with tumors larger than 3 cm or showing rapid growth. Traditionally, open enucleation or visceral resection has been used, but recent advances include endoscopic, laparoscopic, and hybrid methods to achieve tumor enucleation. This report demonstrates a laparoscopic transgastric and endoscopically assisted enucleation of a large, horse-shoe shaped EGJ leiomyoma. The patient complained epigastric pain, occasional solid food dysphagia and mild regurgitation. The upper endoscopy revealed a large horseshoe-shaped subcardial mass at the anterior, left-lateral, and posterior aspects of the subcardial junction. Abdominal computed tomography (CT) showed a large hypointense subcardial mass and endoscopic ultrasound identified a 5 cm submucosal hypoechoic lesion from the muscular layer with diagnosis of leiomyoma at fine needle biopsy. A minimally invasive transgastric enucleation was planned and successfully performed. The technique involved a vertical anterior gastrotomy, incision of the overlying mucosa, blunt tumor dissection with enucleation, and mucosal closure with intraoperative endoscopic assistance. The postoperative course was uneventful with no postoperative complication and patient hospital discharge on postoperative day four. Histological examination confirmed the diagnosis of esophageal leiomyoma. This minimally invasive approach offers a safe, effective alternative to EGJ resection, especially for "plongeant" endoluminal leiomyomas involving the posterior aspect of the EGJ.

The underlying relationship between pyroptosis and tumorigenesis has garnered increasing attention recently. It has been demonstrated that the transcription factor MYB proto-oncogene-like 2 (MYBL2) is elevated in various solid tumors, thereby promoting cell proliferation. However, the role of MYBL2 gene in lung adenocarcinoma (LUAD), especially its potential connection with pyroptosis, is still unclear. Here, by combining ATAC seq and RNA seq methods, we initially identified MYBL2 gene as the main regulatory transcription factor (MR-TF) driving LUAD phenotype plasticity. An in-depth analysis of the sequencing results revealed that the expression of the MYBL2 gene was significantly higher in LUAD tissues than in normal tissues. Further experiments confirmed that MYBL2 promoted the proliferation of LUAD and attenuated tumor cell pyroptosis. Mechanistically, MYBL2 negatively regulated GSDME expression by binding to its promoter, thereby diminishing cisplatin-induced pyroptosis and ultimately leading to reduced chemosensitivity. Moreover, MYBL2 interacted with YAP1 to co-regulate GSDME transcription. The results of this research could be used to inform new strategies for screening effective populations and overcoming treatment resistance, making them potentially clinically valuable.

Combined resection for tracheal invasion in esophageal cancer is extremely challenging. Tracheal resection with cervical or mediastinal tracheostomy is often performed; however, this procedure has high morbidity rates and results in loss of voice. We present our experience performing a partial-layer tracheal resection, "tracheal shaving," for esophageal cancer with tracheal invasion. We successfully performed tracheal adventitia and tracheal muscle resection in a patient with adventitial invasion, and the shaving area was reinforced by omental covering along with a gastric tube reconstructed through the posterior mediastinum. We believe that our "tracheal shaving" technique may potentially allow curative resection in selected T4 cases while preserving laryngeal function. It may serve as a minimally invasive alternative to conventional tracheal resection, although further evaluation is required.