[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-356967-105":59,"doc-detail-356967-en":134},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":127,"head_meta":129,"extra_data":131,"updated_unix":133},105,"en","the-association-between-tongue-features-and-tongue-coating-microbiota-and-gastrointestinal-cancer-a-systematic-review-and-meta-analysis","The association between tongue features and tongue coating microbiota and gastrointestinal cancer - a systematic review and meta-analysis","","Gastrointestinal (GI) cancers create a major clinical and socioeconomic burden, motivating non-invasive biomarkers that can support earlier detection and ongoing surveillance. Tongue inspection, widely used in traditional Chinese medicine, can be quantified through imaging-derived tongue features and microbiome analyses. This systematic review and meta-analysis synthesized case–control and cohort evidence comparing tongue characteristics and tongue-coating microbiota between GI cancer patients and healthy controls, pooling data across databases up to July 2025.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-association-between-tongue-features-and-tongue-coating-microbiota-and-gastrointestinal-cancer-a-systematic-review-and-meta-analysis/356967/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-association-between-tongue-features-and-tongue-coating-microbiota-and-gastrointestinal-cancer-a-systematic-review-and-meta-analysis/356967.png","ImageObject",300,407,{"name":92,"@type":93},"eBook King","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-28","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main objective of the systematic review and meta-analysis?","Question",{"text":112,"@type":113},"To synthesize evidence on how tongue features and tongue-coating microbiota relate to GI cancer detection.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were studies selected and how were results combined?",{"text":117,"@type":113},"The review systematically searched PubMed, EMBASE, Cochrane, and Chinese databases until July 2025 and pooled data using fixed- or random-effects models.",{"name":119,"@type":110,"acceptedAnswer":120},"Which tongue features showed significant differences between GI cancer patients and controls?",{"text":121,"@type":113},"GI cancer patients had higher rates of abnormal tongue body morphology, tongue body color, abnormal tongue coating texture, and abnormal tongue coating color compared with controls.",{"name":123,"@type":110,"acceptedAnswer":124},"What limitation and need for further research did the authors emphasize?",{"text":125,"@type":113},"Heterogeneity and methodological limitations indicated the need for larger-scale prospective studies to validate the findings.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},356967,1790527807,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":143,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":149},962088006270,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","JOURNAL OF ORAL MICROBIOLOGY 2026, VOL. 18, NO. 1, 2681268  \n[https://doi.org/10.1080/20002297.2026.2681268](https://doi.org/10.1080/20002297.2026.2681268)  \nREVIEW ARTICLE     \nThe association between tongue features and tongue coating microbiota and gastrointestinal cancer: a systematic review and meta-analysis  \nXin Gaoa, b, Yuan Zoua, Jianming Fanga, Xiaqiu Wua,c, Weifang Zhenga, Yongsheng Zhangb and Wen Haoa,c  \naDepartment of Gastroenterology, Lanxi Hospital of Traditional Chinese Medicine, Jinhua, China; bSchool of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China; cSchool of Public Health, Zhejiang Chinese Medical University, Hangzhou, China  \nABSTRACT  \nBackground: Gastrointestinal (GI) cancers pose a significant health burden, highlighting the need for non-invasive biomarkers. Tongue inspection, a traditional diagnostic method in Chinese medicine, has been increasingly quantified via imaging and microbiome analysis.  \nObjective: This review synthesizes evidence on tongue features and coating microbiota in GI cancer detection.  \nDesign: We systematically searched PubMed, EMBASE, Cochrane and Chinese databases until July 2025 for case–control or cohort studies comparing tongue characteristics or microbiota between GI cancer patients and healthy controls. Data were pooled using fixed- or random-effects models.  \nResults: Sixteen studies (n = 4,994) were included. GI cancer patients showed significantly higher rates of abnormal tongue body morphology (OR = 5.33, 95% CI 3.26–8.72), abnormal tongue body color (OR = 17.85, 95% CI 7.01–45.54), abnormal tongue coating texture (OR = 5.98, 95% CI 4.02–8.91) and abnormal tongue coating color (OR = 3.24, 95% CI 2.00–5.26) versus controls. Although α-diversity did not differ, certain taxa (e.g. Actinobacteria, Prevotella_ 7) were reduced in cancer patients. Subgroup analyses by cancer type showed generally consistent directions of association for abnormal tongue manifestations in gastric, colorectal and esophageal cancers, despite significant heterogeneity. Conclusion: Abnormal tongue features and specific microbial shifts are associated with GI cancers, suggesting potential non-invasive tools for early detection. However, due to heterogeneity and methodological limitations, further large-scale prospective studies are needed for validation.  \nARTICLE HISTORY  \nReceived 23 October 2025 Revised 13 February 2026 Accepted 25 May 2026  \nKEYWORDS  \nGastrointestinal cancer; tongue features; tongue coating; microbiota; metaanalysis; non-invasive biomarker  \nIntroduction  \nGastrointestinal (GI) cancers remain a major global health challenge, with substantial morbidity, mortality and economic burden despite advances in screening and treatment. Recent GLOBOCAN estimates underscore the continuing rise and absolute burden of colorectal, gastric and esophageal cancers worldwide [ 1] . While endoscopy is the diagnostic gold standard, its cost, invasiveness and limited accessibility constrain population coverage [2,3] . Non-invasive screening tools, such as fecal immunochemical testing and risk-stratified questionnaires, have improved early detection but still leave gaps in sensitivity, specificity and uptake, motivating complementary, scalable biomarkers to triage risk, enrich screening pools and support longitudinal surveillance [4,5] .  \nThe tongue offers a unique, readily accessible window into systemic health. In traditional Chinese medicine (TCM), tongue inspection synthesizes macroscopic features (color, shape, moisture, fissures, sublingual venous distension) and tongue coating characteristics (thickness, distribution and hue), into diagnostic impressions thought to reflect internal organ function and systemic homeostasis [6] . Derived  \nCONTACT Wen Hao  [hao-wen08@outlook.com](hao-wen08@outlook.com)  Department of Gastroenterology, Lanxi Hospital of Traditional Chinese Medicine, 108 Lanyin Road, 321100, Lanxi City, Jinhua, Zhejiang Province, China; Yongsheng Zh","cbCaidfW6hYg5v6Y","https://ap.wps.com/l/cbCaidfW6hYg5v6Y","pdf",4497034,18,"English","# Abstract\n# Introduction\n## Background and rationale for non-invasive biomarkers\n## Tongue inspection in traditional Chinese medicine\n# Materials and methods\n## Literature search strategy and study selection\n## Data synthesis and statistical models\n# Results\n## Included studies and overall associations\n## Tongue body features and coating features\n## Microbiome diversity and differential taxa\n## Subgroup analyses by cancer type\n# Discussion\n# Conclusion","[{\"question\":\"What was the main objective of the systematic review and meta-analysis?\",\"answer\":\"To synthesize evidence on how tongue features and tongue-coating microbiota relate to GI cancer detection.\"},{\"question\":\"How were studies selected and how were results combined?\",\"answer\":\"The review systematically searched PubMed, EMBASE, Cochrane, and Chinese databases until July 2025 and pooled data using fixed- or random-effects models.\"},{\"question\":\"Which tongue features showed significant differences between GI cancer patients and controls?\",\"answer\":\"GI cancer patients had higher rates of abnormal tongue body morphology, tongue body color, abnormal tongue coating texture, and abnormal tongue coating color compared with controls.\"},{\"question\":\"What limitation and need for further research did the authors emphasize?\",\"answer\":\"Heterogeneity and methodological limitations indicated the need for larger-scale prospective studies to validate the findings.\"}]","The association between tongue features and tongue coating microbiota and gastrointestinal cancer - a systematic review and meta-analysis | PDF",1790128468,45]