Clinics and research in hepatology and gastroenterology最新文献

{"title":"Comment on \"Can peripheral blood eosinophils predict primary non-response to Infliximab therapy in pediatric Crohn's disease?\"","authors":"Deepti M Sati, Vanashri Dhananjay Shinde, Chhaya Agarwal","doi":"10.1016/j.clinre.2026.102838","DOIUrl":"https://doi.org/10.1016/j.clinre.2026.102838","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":" ","pages":"102838"},"PeriodicalIF":2.4,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is pneumatic dilatation still needed for the treatment of achalasia?","authors":"Dominique Anelone-Ake, Chloé Leandri, Sophie Scialom, Flavius-Stefan Marin, Sarra Oumrani, Marine Carpentier-Pourquier, Arthur Belle, Romain Coriat, Maximilien Barret","doi":"10.1016/j.clinre.2026.102837","DOIUrl":"https://doi.org/10.1016/j.clinre.2026.102837","url":null,"abstract":"<p><strong>Background: </strong>The uncertainty regarding its long-term effectiveness and perforation rates sometimes reaching 4% have led centers to abandon pneumatic dilatation (PD). We evaluated the efficacy and safety of a treatment strategy based on stepwise pneumatic dilations (30, 35 ± 40 mm) in real-world practice among patients with achalasia.</p><p><strong>Methods: </strong>This was a retrospective study including consecutive, treatment naive, achalasia patients treated with PD at a single center. The study was based on a prospectively maintained database. The primary endpoint was the rate of clinical remission, defined as an Eckardt score < 3 at the end of follow-up.</p><p><strong>Results: </strong>We included 132 patients with achalasia between 2018 and 2023. Achalasia was classified as type I in 44 patients (33%), type II in 83 patients (63%), and type III in 5 patients (4%). Ninety-nine patients (75%) underwent a series of two dilations at 30 and 35 mm, 7 patients (5%) underwent a single 30-mm dilation, and 26 patients (20%) received three dilations at 30, 35, and then 40 mm. The clinical success rate at the first 3-month follow-up was 88%, with no statistically significant difference between subtypes. The median follow-up duration was 40 months. At the end of follow-up, 66 patients (65%) were in clinical remission without additional treatment. Three of the 317 procedures (1%) were complicated by perforation.</p><p><strong>Discussion: </strong>Pneumatic dilation provides sustained symptomatic improvement in 65% of patients, with a severe complication rate of 1%. It therefore remains a valuable option to treat achalasia, particularly for frail patients.</p>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":" ","pages":"102837"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on ‘clinical characteristics and risk factors of drug-induced hepatotoxicity in cancer patients following repeated chemotherapy cycles’","authors":"Kishankumar Mahida ,&nbsp;Snehal Rajendra Jagtap","doi":"10.1016/j.clinre.2026.102779","DOIUrl":"10.1016/j.clinre.2026.102779","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 3","pages":"Article 102779"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age and sex differences in intrapancreatic fat deposition: A cross-sectional CT study","authors":"Yiping Zhang,&nbsp;Dingzhe Zhang,&nbsp;Rongzhou Wang,&nbsp;Rui Yu,&nbsp;Yu Wang,&nbsp;Jianhua Wang,&nbsp;Xiao Chen","doi":"10.1016/j.clinre.2026.102770","DOIUrl":"10.1016/j.clinre.2026.102770","url":null,"abstract":"<div><h3>Background/aims</h3><div>Intra-pancreatic fat deposition (IPFD) is associated with health issues, yet its distribution patterns across age and gender remain unclear. This study analyzed differences in computed tomography (CT)-based IPFD content among different age and gender groups.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 1305 adults undergoing chest CT examinations was established. Pancreatic and splenic CT attenuation values were measured, pancreas-to-spleen CT ratio (P/S) and pancreas-to-spleen CT difference (P-S) were also calculated which served as indicators of IPFD. Pearson correlation analysis was employed to assess the relationship between each parameter and age stratified by sex. Multiple linear regression was applied to evaluate the independent effects of age and sex.</div></div><div><h3>Results</h3><div>Pancreatic fat-related CT parameters were negatively correlated with age (<em>r</em> = -0.527 to -0.467, <em>p</em> &lt; 0.001). Compared to young adults aged 21–29 years, pancreatic CT attenuation and both the P/S ratio and P-S difference fallen markedly by the 51–59-year group. An even greater difference was observed in individuals over 70 years of age. The P/S ratio and P-S of males were significantly lower than female in each age group. Multiple linear regression showed that age were independent negative predictors of all parameters (<em>p</em> &lt; 0.001), while gender was an independent influencing factor of the P/S ratio (β = 0.073, <em>p</em> = 0.004) and P-S (β = 0.072, <em>P</em> = 0.004), but had no independent predictive effect on the unadjusted pancreatic CT value.</div></div><div><h3>Conclusion</h3><div>IPFD shows a gradual increase with advancing age and is higher in males compared to females.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 3","pages":"Article 102770"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and risk factors of drug-induced hepatotoxicity in cancer patients following repeated chemotherapy cycles","authors":"Qunxiang Cao ,&nbsp;Siyang Chen ,&nbsp;Yutian Zhang ,&nbsp;Juping Yang ,&nbsp;Zhaohui Wang","doi":"10.1016/j.clinre.2026.102763","DOIUrl":"10.1016/j.clinre.2026.102763","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This study investigates the incidence, clinical characteristics, and risk factors of drug-induced liver injury (DILI) in cancer patients undergoing multiple courses of common chemotherapy drugs, providing evidence for developing DILI prevention and control strategies in clinical practice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective cohort study included 165 cancer patients who received multiple courses of common chemotherapy drugs between January 2023 and January 2025. Participants were divided into a study group (&lt;em&gt;n&lt;/em&gt; = 45, DILI occurrence) and a control group (&lt;em&gt;n&lt;/em&gt; = 120, no DILI occurrence) based on DILI development. Baseline patient data, chemotherapy regimens, and liver function indicators were collected. Univariate analysis screened potential risk factors, while multivariate logistic regression validated independent risk factors. Spearman's rank correlation analyzed associations between risk factors and DILI severity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The overall DILI incidence among 165 patients was 27.27% (45/165), predominantly moderate in severity. Distribution by grade was: Grade 1 (mild) 14 cases (31.11%), Grade 2 (moderate) 24 cases (53.33%), Grade 3 (severe) 7 cases (15.56%), with no Grade 4 injury. Comparison of baseline characteristics between groups revealed higher DILI incidence among patients aged ≥60 years, with alcohol consumption history, viral hepatitis history, underlying liver disease, ≥3 chemotherapy drugs, and without prophylactic hepatoprotective/cholagogue use (all &lt;em&gt;p&lt;/em&gt; &lt; 0.05). Post-chemotherapy, the study group exhibited significantly higher levels of ALT, AST, ALP, GGT, and TBIL compared to the control group (all &lt;em&gt;p&lt;/em&gt; &lt; 0.001). Multivariate analysis confirmed that age ≥60 years (OR=2.964, 95% CI: 1.247–7.043, &lt;em&gt;p&lt;/em&gt; = 0.014), history of alcohol consumption (OR=3.684, 95% CI: 1.523–8.912, &lt;em&gt;p&lt;/em&gt; = 0.004), history of viral hepatitis (OR=3.116, 95% CI: 1.116–8.696, &lt;em&gt;p&lt;/em&gt; = 0.030), underlying liver disease (OR=3.293, 95% CI: 1.312–8.266, &lt;em&gt;p&lt;/em&gt; = 0.011), use of ≥3 chemotherapy drugs (OR=1.666, 95% CI: 1.031–2.690, &lt;em&gt;p&lt;/em&gt; = 0.037), and lack of prophylactic hepatoprotective and cholagogue medication use (OR=0.326, 95% CI: 0.137–0.772, &lt;em&gt;p&lt;/em&gt; = 0.011) were identified as independent risk factors for DILI occurrence. Spearman analysis revealed positive correlations between age, alcohol consumption history, viral hepatitis history, underlying liver disease, and number of chemotherapy drugs with DILI severity, while a negative correlation was observed between hepatoprotective and cholagogue drug use and DILI severity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Tumor patients undergoing multiple courses of common chemotherapy drugs exhibit a high incidence of DILI, predominantly moderate in severity. Age ≥60 years, history of alcohol consumption, history of viral hepatitis, underlying liver disease, use of ≥3 chemotherapy drugs, and lac","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 3","pages":"Article 102763"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and outcomes of appendiceal neoplasms in inflammatory bowel disease: A tertiary care center experience","authors":"Siri A. Urquhart,&nbsp;Luis E. Ospina Velasquez,&nbsp;John B. Kisiel,&nbsp;Nayantara Coelho-Prabhu","doi":"10.1016/j.clinre.2026.102778","DOIUrl":"10.1016/j.clinre.2026.102778","url":null,"abstract":"<div><h3>Background and Aims</h3><div>A direct causal association between inflammatory bowel disease (IBD) and appendiceal neoplasm (AN) is unclear.</div></div><div><h3>Methods</h3><div>Patients with IBD and AN were identified from 1992 to 2023 using bioinformatics and natural language processing tools.</div></div><div><h3>Results</h3><div>Thirty-one patients were identified. The most common type of AN was appendiceal mucinous neoplasm (83.9 %). Three patients with ulcerative colitis (9.7 %) had recurrence after surgical resection due to peritoneal seeding.</div></div><div><h3>Conclusions</h3><div>Incidence and recurrence of AN in patients with IBD is low. Further studies to compare AN in patients with and without IBD are needed to determine if IBD predisposes to development of this complication.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 3","pages":"Article 102778"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher incidence of HBeAg seroclearance with tenofovir alafenamide fumarate than entecavir in HBeAg-positive patients with chronic hepatitis B","authors":"Liang Wang ,&nbsp;Yuliang Zhang ,&nbsp;Xin Wan ,&nbsp;Shipeng Ma ,&nbsp;Qian Liu ,&nbsp;Yulun Tang ,&nbsp;Xiaoping Wu ,&nbsp;Xiaopeng Li ,&nbsp;Lajpat Rai Malhi ,&nbsp;Shanfei Ge","doi":"10.1016/j.clinre.2026.102783","DOIUrl":"10.1016/j.clinre.2026.102783","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and aims&lt;/h3&gt;&lt;div&gt;Hepatitis B e antigen (HBeAg) seroclearance and HBeAg seroconversion are critical milestones indicating reduced viral replication and a lower risk of disease progression to cirrhosis and hepatocellular carcinoma (HCC). Despite entecavir (ETV) and tenofovir alafenamide (TAF) being two first-line agents used for the treatment of patients with chronic hepatitis B (CHB), their comparative efficacy in attaining HBeAg seroclearance or HBeAg seroconversion is still unclear. Consequently, we aimed to directly compare the incidence of HBeAg seroclearance and HBeAg seroconversion in CHB patients treated with ETV or TAF.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This retrospective study included 244 patients who initiated therapy with ETV (&lt;em&gt;n&lt;/em&gt;=145) or TAF (&lt;em&gt;n&lt;/em&gt;=99) from 2017 to 2025. Multivariate Cox proportional hazards analysis was conducted to identify the factors independently associated with HBeAg seroclearance and seroconversion. Kaplan-Meier survival analysis was performed to compare the incidence of HBeAg seroclearance and seroconversion between the ETV and TAF groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A 1:1 propensity score matching yielded 99 patients in each treatment group. The median HBeAg levels were 2.37 log&lt;sub&gt;10&lt;/sub&gt; IU/ml and 2.44 log&lt;sub&gt;10&lt;/sub&gt; IU/ml in the ETV and TAF groups respectively. After a follow-up period of 288 weeks, a total of 47 patients attained HBeAg seroclearance, comprising 20 patients from the ETV group and 27 patients from the TAF group, respectively. Additionally, 37 patients achieved HBeAg seroconversion, with 17 and 20 patients from the ETV and TAF treatment, respectively. The incidence of HBeAg seroclearance was significantly higher in TAF-treated patients than in ETV-treated patients (27.3% vs. 20.2%; &lt;em&gt;p&lt;/em&gt; = 0.016), whereas the incidence of HBeAg seroconversion was comparable between the two groups (20.2% vs. 17.2%; &lt;em&gt;p&lt;/em&gt;=0.075). Notably, compared with ETV, patients treated with TAF (HR=2.04; 95% CI: 1.84-6.47; &lt;em&gt;p&lt;/em&gt;&lt;0.001) showed a significantly higher rate of HBeAg seroclearance. Higher baseline HBsAg levels (HR=0.50; 95% CI: 0.41-0.73; &lt;em&gt;p&lt;/em&gt;&lt;0.001), and higher baseline HBeAg levels (HR=0.48; 95% CI: 0.43-0.75; &lt;em&gt;p&lt;/em&gt;&lt;0.001) were associated with lower rates of HBeAg seroclearance, whereas elevated serum ALT levels (HR=1.001; 95% CI: 1.001-1.002; &lt;em&gt;p&lt;/em&gt;&lt;0.001) were associated with higher rates of HBeAg seroclearance. In addition, factors significantly associated with HBeAg seroconversion included higher baseline HBsAg levels (HR=0.50; 95% CI: 0.45-0.78; &lt;em&gt;p&lt;/em&gt;&lt;0.001) and higher baseline HBeAg levels (HR=0.51; 95% CI: 0.39-0.75; &lt;em&gt;p&lt;/em&gt;&lt;0.001), which were linked to lower rates of HBeAg seroconversion, whereas elevated serum ALT levels (HR=1.001; 95% CI: 1.001-1.002; &lt;em&gt;p&lt;/em&gt;&lt;0.001) were associated with higher rates of HBeAg seroconversion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Higher incidence of HBeAg ","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 3","pages":"Article 102783"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of common diabetes medications on metabolic dysfunction-associated steatotic liver disease as measured by transient elastography and other metabolic parameters: A systematic review","authors":"Kathryn Thompson ,&nbsp;William Breaux ,&nbsp;Lesley S. Miller ,&nbsp;John Nemeth ,&nbsp;Sarah Koumtouzoua ,&nbsp;Natasha Travis","doi":"10.1016/j.clinre.2026.102784","DOIUrl":"10.1016/j.clinre.2026.102784","url":null,"abstract":"<div><h3>Background</h3><div>With the global rise of metabolic dysfunction-associated steatotic liver disease (MASLD) that can lead to metabolic dysfunction-associated steatohepatitis (MASH), there are concerns about the public health and financial repercussions of a growing population developing end-stage liver disease. While numerous studies are being conducted to identify treatments for MASLD and MASH, it is still important to assess how existing diabetes medications affect MASLD, since these medications are readily available and have proven effective in other facets of metabolic syndrome. This systematic review evaluates the effects of five classes of diabetes medications, specifically sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1), dipeptidyl peptidase-4 inhibitors (DPP-4i), metformin, and statins, on MASLD.</div></div><div><h3>Methods</h3><div>We used the Liver Stiffness Measurement (LSM) and Controlled Attenuation Parameter (CAP) by vibration-controlled transient elastography as non-invasive methods for quantifying hepatic fibrosis and steatosis. The literature search was completed on May 1, 2024 using four databases, and 38 studies were included in this review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</div></div><div><h3>Results</h3><div>Among the studies, SGLT2i and GLP-1 led to statistically significant reductions in the LSM and CAP, liver enzymes, body mass index, and hemoglobin A1c. There was less literature available for DPP-4i, metformin, and statins, making it difficult to draw conclusions about their effects on MASLD.</div></div><div><h3>Conclusion</h3><div>This review highlights the need for more trials for each of these five classes of medications, especially trials that incorporate non-invasive testing, to evaluate their effects on MASLD and MASH.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 3","pages":"Article 102784"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the MANTAP score for predicting one-year mortality in intermediate-stage hepatocellular carcinoma patients undergoing transarterial chemoembolization","authors":"Imelda Maria Loho ,&nbsp;Irsan Hasan ,&nbsp;Rino Alvani Gani ,&nbsp;Kuntjoro Harimurti ,&nbsp;Noorwati Sutandyo ,&nbsp;Evy Yunihastuti ,&nbsp;Hamzah Shatri ,&nbsp;Cosmas Rinaldi Lesmana","doi":"10.1016/j.clinre.2026.102781","DOIUrl":"10.1016/j.clinre.2026.102781","url":null,"abstract":"<div><h3>Background and Aim(s)</h3><div>Transarterial chemoembolization (TACE) is the main treatment for intermediate-stage hepatocellular carcinoma (HCC), but its suitability varies due to tumor burden and liver function heterogeneity. TACE may worsen liver function in large tumors. This study aims to develop a model to predict one-year mortality in intermediate-stage HCC patients undergoing TACE as first-line therapy.</div></div><div><h3>Methods</h3><div>A retrospective cohort study analyzed data from the Indonesian National Hepatocellular Carcinoma Registry (RINKAS) at Cipto Mangunkusumo and Dharmais Cancer Hospitals (2006–2022). Prognostic factors for one-year mortality were identified using bivariate and multivariate Cox regression. The resulting model was evaluated for discrimination, calibration, and internal validation using AUROC, Hosmer-Lemeshow test, calibration curve, and bootstrapping.</div></div><div><h3>Results</h3><div>Among 538 intermediate-stage HCC patients, 191 received TACE, with a one-year survival rate of 49.8% and a median survival of 362 days. Significant predictors of mortality included ALBI grade 2–3 (HR 1.97; <em>p</em> = 0.003), nodule size ≥11 cm (HR 1.57; <em>p</em> = 0.04), and AFP ≥1000 ng/mL (HR 2.41; <em>p</em> &lt; 0.001). The MANTAP model, based on these variables, stratifies patients into low-risk (score 0–1, mortality 29.6%), moderate-risk (score 2, mortality 52.9%), and high-risk (score 3–4, mortality 75.1%) groups. The model showed acceptable predictive performance (AUROC 0.72), good calibration (Hosmer-Lemeshow <em>p</em> = 0.343), and robust validation.</div></div><div><h3>Conclusions</h3><div>The MANTAP score proposes a simple risk stratification tool for estimating one-year mortality in intermediate-stage HCC patients undergoing TACE as first-line therapy.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 3","pages":"Article 102781"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensitivity and specificity of magnetic resonance elastography in liver diseases in the pediatric age group","authors":"Paulina Chodnicka,&nbsp;Elżbieta Jurkiewicz,&nbsp;Kamil Janowski,&nbsp;Maria Janowska,&nbsp;Agnieszka Pytlewska,&nbsp;Małgorzata Gołuch,&nbsp;Małgorzata Markiewicz-Kijewska,&nbsp;Maciej Pronicki,&nbsp;Wiesława Grajkowska,&nbsp;Piotr Socha","doi":"10.1016/j.clinre.2026.102768","DOIUrl":"10.1016/j.clinre.2026.102768","url":null,"abstract":"<div><h3>Objectives</h3><div>Liver fibrosis staging in pediatric patients traditionally relies on invasive methods, such as liver biopsy, which pose risks and limitations. Magnetic Resonance Elastography (MRE) has emerged as a promising noninvasive alternative. This study aimed to validate the use of MRE in pediatric liver diseases and assess its diagnostic accuracy.</div></div><div><h3>Methods</h3><div>A total of 110 participants (61 with autoimmune hepatitis (AIH), 33 post-liver transplantation (LTx), and 16 healthy controls) underwent MRE examinations. Liver biopsies were performed based on ESPGHAN indications in patients with AIH and according to institutional post-transplant protocols in LTx patients. Biochemical data were collected including ALT (alanine aminotransferase), AST (aspartate transaminase), INR (international normalized ratio), bilirubin, and platelet counts. The APRI (aspartate aminotransferase to platelet ratio index) and FIB 4 (Fibrosis Index Based on 4 Factors) were calculated.</div></div><div><h3>Results</h3><div>In AIH patients MRE showed a sensitivity of 76.2% and specificity of 84.6% for moderete to severe fibrosis, incomplete cirrhosis and cirrhosis (Ishak 4–6, AUC 0.828, cutoff 3.28 kPa) and a sensitivity of 80% and specificity of 88.9% for incomplete cirrhosis and cirrhosis (Ishak 5–6, AUC 0.896, cutoff 3.68 kPa). In LTx patients, MRE demonstrated a sensitivity of 80% and specificity of 91.3% for moderete to severe fibrosis and cirrhosis (Ishak 4–6, AUC 0.865, cutoff 3.1 kPa). Inter-observer agreement for MRE was excellent (ICC(3,1) of 0.988)</div></div><div><h3>Conclusions</h3><div>MRE is a valuable noninvasive tool offering an accurate assessment of fibrosis. Further research is warranted to expand MRE's utility across diverse pediatric liver conditions. This validation of the MRE highlights its potential to enhance clinical decision-making and patient care in pediatric hepatology.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 3","pages":"Article 102768"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}