Clinical Gastroenterology and Hepatology最新文献

{"title":"Prevalence and Progression of Subtypes of Gastric Premalignant Lesions: A Systematic Review and Meta-Analysis.","authors":"Yendé Grell, Duco T Mülder, Anne I Hahn, Robert J Huang, Margaret J Zhou, Benjamin Blake, Omonefe Omofuma, John D Murphy, Daniela S Gutiérrez-Torres, Ann G Zauber, James F O'Mahony, M Constanza Camargo, Uri Ladabaum, Jennifer M Yeh, Chin Hur, Iris Lansdorp-Vogelaar, Reinier Meester, Monika Laszkowska","doi":"10.1016/j.cgh.2026.08.020","DOIUrl":"10.1016/j.cgh.2026.08.020","url":null,"abstract":"<p><strong>Background & aims: </strong>Gastric intestinal metaplasia (IM) and dysplasia are precursor lesions for gastric cancer. This systematic review and meta-analysis examined the global prevalence and progression rates of subtypes of these understudied lesions.</p><p><strong>Methods: </strong>We searched databases for publications reporting prevalence and progression of subtypes of IM and dysplasia among individuals undergoing endoscopy, including incomplete/complete IM, limited (antrum-restricted)/extensive (corpus-involving) IM, and low-grade dysplasia (LGD) and high-grade dysplasia (HGD). Random-effects models were used to estimate pooled prevalence and progression rates to gastric cancer. The I² statistic was used to determine heterogeneity.</p><p><strong>Results: </strong>Eighty-three studies were included for prevalence and 23 for progression. The prevalence of complete IM was 11% (95% confidence interval [CI], 8%-15%) and of incomplete IM was 10% (95% CI, 6%-14%), with corresponding progression rates of 1.73 (95% CI, 1.08-2.79) vs 12.15 (95% CI, 5.28-27.94) per 1000 person-years, respectively (P < .01). The prevalence of limited vs extensive IM was 12% (95% CI, 8%-17%) vs 5% (95% CI, 4%-8%), respectively, and the corresponding progression rates were 3.31 (95% CI, 1.18-9.32) vs 4.19 (95% CI, 0.95-18.41) per 1000 person-years (P = .80). The prevalence of LGD was 2% (95% CI, 1%-4%) and of HGD was 0.28% (95% CI, 0.14%-0.55%), with corresponding progression rates of 11.55 (95% CI, 5.93-22.47) vs 344.48 (95% CI, 144.88-819.09; P < .01). Substantial heterogeneity was observed for all estimates.</p><p><strong>Conclusions: </strong>Although lesion subtypes with high progression risk like incomplete IM account for a large portion of the total burden of precancerous lesions, subtyping remains underutilized in clinical practice. Although estimates are limited by heterogeneity, differences in progression rates between lesion subtypes support risk stratification of these lesions within management guidelines, particularly complete vs incomplete IM and LGD vs HGD.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extrahepatic Autoimmune Disease in People With Primary Biliary Cholangitis: Nationwide Occurrence and Relation to Outcome","authors":"Gemma H.X. Weijsters,Ellen Werner,Tiki Blom,Maria C. van Hooff,Rozanne C. de Veer,Ulrich Beuers,Joost P.H. Drenth,Frans J.C. Cuperus,Remco van Dijk,Bart J. Veldt,Michael Klemt-Kropp,Suzanne van Meer,Robert C. Verdonk,Hajo J. Flink,Jan M. Vrolijk,Matthijs Kramer,Cyriel Y. Ponsioen,Femke Boersma,Khalida Soufidi,Martijn J. ter Borg,Menno Beukema,Edith M.M. Kuiper,J. van Kemenade,Marcel Cazemier,Matthias C. Jurgens,Ludger S.M. Epping,Lisette J.H. van Dam,Roberta M. Manzat,Hans H.K. Thio,Laurens A. van der Waaij,Djuna L. Cahen,Paul G. van Putten,P.L.A. van Daele,Bettina, E. Hansen,Harry L.A. Janssen,Adriaan J. van der Meer,Sunje Abraham,Rob P.R. Adang,Huseyin Aktas,Yasser A. Alderlieste,Maria N. Aparicio-Pages,L. (Bert) C. Baak,Martine A.M.C. Baven-Pronk,A. (Sander) van der Beek,Frank C. Bekkering,Jeroen D. van Bergeijk,Ulrich Beuers,Menno Beukema,Tiki D. Blom,Wink de Boer,Femke Boersma,Kirsten Boonstra,Frank ter Borg,Martijn J. ter Borg,Pieter C.J. ter Borg,Gijs J. de Bruin,Paul J. Bus,Djuna L. Cahen,Marcel Cazemier,Frans J.C. Cuperus,Lisette J.H. van Dam,Maaike J. Denters,Remco van Dijk,Joost P.H. Drenth,Ludger S.M. Epping,Nicole S. Erler,Hajo J. Flink,Philip W. Friederich,Nicole F.M. van Gerven,Tom J.G. Gevers,Bettina E. Hansen,Sven J. van den Hazel,Bart van Hoek,Maria C. van Hooff,Daphne M. Hotho,Harry L.A. Janssen,Hendrik J.M. de Jonge,Matthias C. Jurgens,J.(Netty) van Kemenade,Marjo J. Kerbert-Dreteler,Michael Klemt-Kropp,Ingrid C.A.W Konings,Sander de Kort,Matthijs Kramer,Edith M.M. Kuiper,Johan P.H. Kuyvenhoven,Roberta M. Manzat,Adriaan J. van der Meer,Suzanne van Meer,M.J.F. Meijnen,Susanne L. Onderwater,Leendert H. Oterdoom,Cyriel Y. Ponsioen,Paul G. van Putten,Janne E. van Rooij,Robert Roomer,Johannes Schmidt-Böhmer,Stephan Schmittgens,Tim C.M.A. Schreuder,Jerome Sint Nicolaas,Hanneke van Soest,Khalida Soufidi,Stephan H.C. van Stiphout,Hans H.K. Thio,Merel M. Tielemans,Sigrid Vandebosch,Rozanne C. de Veer,Bart J. Veldt,Robert C. Verdonk,J. Marleen de Vree,Elsemieke de Vries,Anne Vrieze,Jan Maarten Vrolijk,Laurens A. van der Waaij,Gemma H.X. Weijsters,Ellen Werner,Ulrike de Wit,Frank H.J. Wolfhagen","doi":"10.1016/j.cgh.2026.09.023","DOIUrl":"https://doi.org/10.1016/j.cgh.2026.09.023","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"31 1","pages":""},"PeriodicalIF":12.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149049121","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":"AGA Clinical Practice Update on the Evaluation and Management of Metabolic Dysfunction– and Alcohol-Associated Liver Disease: Expert Review","authors":"Juan Pablo Arab,Harmeet Malhi,Gerald Scott Winder,Robert J. Fontana","doi":"10.1016/j.cgh.2026.07.027","DOIUrl":"https://doi.org/10.1016/j.cgh.2026.07.027","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"222 1","pages":""},"PeriodicalIF":12.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020289","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":"Reply.","authors":"Daan H C A Bosch, Daniel Keszthelyi","doi":"10.1016/j.cgh.2026.08.024","DOIUrl":"10.1016/j.cgh.2026.08.024","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872779","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":"IMPROVED SEVERITY AND QUALITY-OF-LIFE MEASURES FOR FECAL INCONTINENCE: DEVELOPMENT OF THE MINNESOTA (MiNi)-FISI AND MiNi-FI-QOL","authors":"Nicholas R. Oblizajek,Todd Rockwood,Janet T. Lee,Liliana G. Bordeianou,Robert G. Madoff,Ann C. Lowry,Satish S.C. Rao,William E. Whitehead,Isuzu Meyer,William D. Chey,Marie G. Gantz,Holly E. Richter,Stacy B. Menees,Lawrence A. Szarka,Jan Busby-Whitehead,Kent R. Bailey,Frank Hamilton,Adil E. Bharucha","doi":"10.1016/j.cgh.2026.09.026","DOIUrl":"https://doi.org/10.1016/j.cgh.2026.09.026","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"52 1","pages":""},"PeriodicalIF":12.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149049125","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":"Altered cognition and patient-reported outcomes predict 1-year hospitalization risk in a multi-center outpatient cirrhosis cohort","authors":"Jasmohan S. Bajaj,Jacqueline G. O’Leary,Jennifer C. Lai,Puneeta Tandon,Florence Wong,Guadalupe Garcia-Tsao,Scott W. Biggins,Philip Vutien,Hugo E. Vargas,Patrick S. Kamath,Jawaid Shaw,Tahira Shaikh,Stefanie Tsai,Dorothea Kent,Daniela Goyes,Brian J. Bush,Scott Silvey,K.Rajender Reddy","doi":"10.1016/j.cgh.2026.09.025","DOIUrl":"https://doi.org/10.1016/j.cgh.2026.09.025","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"18 1","pages":""},"PeriodicalIF":12.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149049126","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 Data Deluge: Balancing Information Overload and Evidence-Based Medicine in Gastroenterology Fellowship","authors":"Siobhan Proksell,Frank I. Scott","doi":"10.1016/j.cgh.2026.08.018","DOIUrl":"https://doi.org/10.1016/j.cgh.2026.08.018","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"13 1","pages":""},"PeriodicalIF":12.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149020288","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":"Effectiveness of Medical-Behavioral Therapy in Patients with Fecal Incontinence","authors":"Muhammad Abdul Rehman,Steven Heymen,Satish S.C. Rao,William D. Chey,William E. Whitehead,Isuzu Meyer,Marie G. Gantz,Holly E. Richter,Stacy B. Menees,Nicholas R. Oblizajek,Lawrence A. Szarka,Jan Busby-Whitehead,Kent R. Bailey,Frank A. Hamilton,Adil E. Bharucha","doi":"10.1016/j.cgh.2026.09.024","DOIUrl":"https://doi.org/10.1016/j.cgh.2026.09.024","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"5 1","pages":""},"PeriodicalIF":12.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149049128","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":"Gastric and Duodenal Cancer in Lynch Syndrome: Incidence and Endoscopic Surveillance—Systematic Review and Meta-analysis","authors":"Víctor Ausina-Poüs,Sandra Baile-Maxía,María Sáez-Rico,Noelia Sala-Miquel,Carolina Mangas-Sanjuan,Irene Martínez-Tévar,Carmen Sánchez-Ardila,Pedro Zapater,Giulia-Martina Cavestro,Alessandro Mannucci,Zohar Levi,Gregory Idos,Carol A. Burke,Rodrigo Jover","doi":"10.1016/j.cgh.2026.09.027","DOIUrl":"https://doi.org/10.1016/j.cgh.2026.09.027","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":"17 1","pages":""},"PeriodicalIF":12.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149049127","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":"Serious Infections in Patients With Inflammatory Bowel Disease and Corticosteroids: A Propensity Score-Matched Study.","authors":"Anders Forss, Jordan Axelrad, Jonas Söderling, Karl Mårild, Olof Grip, Johann P Hreinsson, Jonas Halfvarson, Pontus Naucler, Jonas F Ludvigsson, Ola Olén","doi":"10.1016/j.cgh.2026.08.019","DOIUrl":"10.1016/j.cgh.2026.08.019","url":null,"abstract":"<p><strong>Background & aims: </strong>Absolute risk estimates of serious infections in inflammatory bowel disease (IBD) across therapies and concomitant corticosteroid treatment are limited. We aimed to assess serious infection risk in patients with IBD receiving different therapies, with or without corticosteroids.</p><p><strong>Methods: </strong>Using nationwide Swedish registers (2007-2024), we compared rates of serious infections in patients with IBD treated with different therapies vs matched population comparators (≤10 per patient), stratified by corticosteroid use. We also performed 1:1 propensity score-matching for direct comparison of infection risk in IBD with or without concomitant corticosteroids exposure across advanced therapies. Incidence rates (IRs) and adjusted hazard ratios (aHRs) with 95% confidence intervals were calculated.</p><p><strong>Results: </strong>We identified 145,125 exposure periods in patients with IBD naïve to immunomodulators and advanced therapies, 82,675 to immunomodulators, and 90,181 to advanced therapies (tumor necrosis factor-α inhibitors with and without immunomodulator, anti-integrins, anti-interleukins, and Janus kinase inhibitors). Across therapies, exposure periods with corticosteroids carried a higher risk of serious infections than periods without, both compared with the general population (IR difference range, 3.6-10.2/100 person-years; aHR range, 4.52-15.86) and in propensity score-matched within therapy group comparisons (IR difference range, 3.9-8.5/100 person-years; aHR, 1.82-3.60). The relative risk was highest in children and increased with cumulative corticosteroid dose.</p><p><strong>Conclusions: </strong>Patients with IBD receiving corticosteroids had significantly higher rates of serious infections compared with those not receiving corticosteroids across therapies, with rate differences across age groups and combinations of treatments. These data will inform infection risk assessment and consideration of individualized infection-prevention strategies.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":16.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849786","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}