Clinical Gastroenterology and Hepatology最新文献

{"title":"Diagnostic Accuracy of Noninvasive Biomarkers and Imaging for Evaluating Postoperative Recurrence in Crohn's Disease.","authors":"Sunil Samnani, Christina M Ray, Priyanka Gill, Levi Stein, Katherine A Buhler, Rupert W Leong, Rebecca L Smith, Peter De Cruz, Gilaad G Kaplan, Cynthia H Seow, Cathy Lu, Leonardo Guizzetti, Frank Hoentjen, John K Marshall, Siddharth Singh, Remo Panaccione, Kerri L Novak, Christopher Ma","doi":"10.1016/j.cgh.2025.03.030","DOIUrl":"10.1016/j.cgh.2025.03.030","url":null,"abstract":"<p><strong>Background & aims: </strong>Colonoscopy is recommended to monitor for Crohn's disease (CD) recurrence after surgical resection. However, repeated colonoscopy is invasive and resource-intensive. We conducted a systematic review and meta-analysis to evaluate the pooled diagnostic accuracy of noninvasive biomarkers and imaging measures for detecting endoscopic CD recurrence, as compared with colonoscopy.</p><p><strong>Methods: </strong>A systematic review was conducted to January 31, 2024, to identify studies evaluating the diagnostic accuracy of C-reactive protein (CRP), fecal calprotectin, computed tomography and magnetic resonance enterography, or intestinal ultrasound (IUS) compared with colonoscopy for detecting CD recurrence. Estimates of sensitivity, specificity, and positive and negative likelihood ratios were pooled using a random-effects hierarchical summary receiver operating characteristic model.</p><p><strong>Results: </strong>A total of 17 studies (N = 1080) evaluated inflammatory biomarkers and 20 studies (N = 1053) assessed imaging measures. The pooled sensitivity and specificity of CRP (threshold, 5.0 mg/L) were 0.45 (95% confidence interval [CI], 0.33-0.58) and 0.83 (95% CI, 0.68-0.92), respectively. Fecal calprotectin (threshold, 50 μg/g) was moderately sensitive 0.76 (95% CI, 0.70-0.82) but less specific 0.66 (95% CI, 0.56-0.75). Sensitivity for computed tomography enterography/magnetic resonance enterography and IUS was 0.89 (95% CI, 0.73-0.96) and 0.92 (95% CI, 0.75-0.96); specificity was 0.65 (95% CI, 0.43-0.82) and 0.76 (95% CI, 0.52-0.90), respectively. Using optimized radiographic parameters for IUS, specificity was improved to 0.85 (95% CI, 0.71-0.93).</p><p><strong>Conclusion: </strong>The high sensitivity of fecal calprotectin (<50 μg/g) and cross-sectional imaging can help reduce the need for invasive and costly colonoscopy monitoring for CD recurrence after surgery. Applying optimal definitions of sonographic recurrence by IUS parameters may further improve specificity for making therapeutic decisions without endoscopy.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-session Combined Endoscopic and Surgical Treatment of Gallstone Ileus.","authors":"Zehra Naseem, Aun Muhammad, Hassan Siddiki","doi":"10.1016/j.cgh.2025.01.045","DOIUrl":"10.1016/j.cgh.2025.01.045","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concomitant Medications and Advanced Therapies in Ulcerative Colitis: Patient-centric Approach for Optimal Disease Control.","authors":"Ferdinando D'Amico, Laurent Peyrin-Biroulet, Silvio Danese","doi":"10.1016/j.cgh.2025.01.040","DOIUrl":"10.1016/j.cgh.2025.01.040","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Age on Disorders of Gut-brain Interaction.","authors":"Tia D Andrade, Vikram Rangan, Sarah Ballou","doi":"10.1016/j.cgh.2025.05.001","DOIUrl":"10.1016/j.cgh.2025.05.001","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Endoscopic Findings of Inverted Esophageal Squamous Cell Carcinoma.","authors":"Xingyu Ding, Lu Xie, Hangbin Jin","doi":"10.1016/j.cgh.2025.04.009","DOIUrl":"10.1016/j.cgh.2025.04.009","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Erythropoietic Protoporphyria Post Liver Transplant.","authors":"Antoine Robert, Shula Schechter, Anna S F Lok","doi":"10.1016/j.cgh.2025.02.019","DOIUrl":"10.1016/j.cgh.2025.02.019","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unusual Complication of Endoscopic Ultrasound-guided Transgastric Liver Biopsy.","authors":"Dhanai Di Paolo, Silvia Paggi, Franco Radaelli","doi":"10.1016/j.cgh.2025.01.043","DOIUrl":"10.1016/j.cgh.2025.01.043","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Noninvasive Tests for Liver Fibrosis: Moving Beyond Simple Tests in Metabolic Dysfunction-associated Steatotic Liver Disease.","authors":"John T Grady, John W Cyrus, Richard K Sterling","doi":"10.1016/j.cgh.2025.02.035","DOIUrl":"10.1016/j.cgh.2025.02.035","url":null,"abstract":"<p><strong>Background & aims: </strong>Noninvasive tests serve as alternative options to liver biopsy for the diagnosis of liver fibrosis. The Fibrosis 4 (FIB-4) index, aspartate platelet ratio index, and liver stiffness measurement by transient and magnetic resonance elastography are guideline-supported tools for noninvasive liver disease assessment but are limited by indeterminate ranges and varying diagnostic performance among different patient populations. In this scoping review, we evaluate the performance of novel noninvasive liver disease assessments in metabolic dysfunction-associated steatotic liver disease (MASLD) not discussed in recent professional guidelines.</p><p><strong>Methods: </strong>We systematically reviewed the literature over the past 5 years (2020 to present) to identify studies evaluating noninvasive liver disease assessments (NILDAs) in MASLD.</p><p><strong>Results: </strong>Of the 912 records, 48 met inclusion criteria: 37 through the systematic review and 11 identified by the authors. Of the 15 novel scores, several perform well in steatotic liver disease in validation studies and included routinely available elements. Although several novel scores had good to excellent discrimination, their cost and availability may limit their use in practice. Based on our review, we propose starting with the FIB-4 index, given its availability, low cost, and high negative predictive value. In those with a FIB-4 >1.3, we propose using Agile 3+ or 4 to identify advanced fibrosis or cirrhosis.</p><p><strong>Conclusions: </strong>NILDAs are effective alternatives to liver biopsy for fibrosis assessment in MASLD and may serve as a tool to identify patients who are candidates for newer therapies.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Endoscopic-Thoracoscopic Surgery for Mediastinal Bronchogenic Cyst.","authors":"Xiaojie Huang, Xiaolu Lin, Wanyin Deng","doi":"10.1016/j.cgh.2025.01.041","DOIUrl":"10.1016/j.cgh.2025.01.041","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustained Clinical Remission in Relapsing IgG4-related Autoimmune Pancreatitis With Dupilumab.","authors":"Yiwen Wang, Yufei Guo, Jian Zhu","doi":"10.1016/j.cgh.2025.01.046","DOIUrl":"10.1016/j.cgh.2025.01.046","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":11.6,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}