Clinics and research in hepatology and gastroenterology最新文献

{"title":"Precision oncology in colorectal cancer: An anatomical revolution through molecular-clinical integration across colonic subsites","authors":"Jiefeng Zhao,&nbsp;Daxing Miao","doi":"10.1016/j.clinre.2025.102613","DOIUrl":"10.1016/j.clinre.2025.102613","url":null,"abstract":"<div><div>Colorectal cancer (CRC) exhibits significant heterogeneity across different colonic subsites, which vary in embryological origin, microbiome, metabolome, and molecular profiles, affecting tumorigenesis, treatment response, and prognosis. We emphasize the importance of this subsite heterogeneity to advance precision medicine in CRC.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102613"},"PeriodicalIF":2.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070639","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":"A wandering spleen","authors":"Francesco Guerra,&nbsp;Francesco Matarazzo,&nbsp;Giuseppe Giuliani,&nbsp;Andrea Coratti","doi":"10.1016/j.clinre.2025.102614","DOIUrl":"10.1016/j.clinre.2025.102614","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102614"},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144068425","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":"Hepatocellular carcinoma risk in ICD-coded non-cirrhotic nonalcoholic fatty liver disease refined by fatty liver index: A nationwide South Korean cohort study","authors":"Chang Hun Lee ,&nbsp;Min Gu Kang ,&nbsp;Shinyoung Oh ,&nbsp;In Sun Gwak ,&nbsp;Chen Shen ,&nbsp;Ha Ram Oh ,&nbsp;Young Ran Park ,&nbsp;Jong Seung Kim ,&nbsp;Ji Hyun Park","doi":"10.1016/j.clinre.2025.102612","DOIUrl":"10.1016/j.clinre.2025.102612","url":null,"abstract":"<div><h3>Background/Aims</h3><div>Hepatocellular carcinoma (HCC) is an increasing global health burden, driven by demographic shifts and the growing prevalence of risk factors such as non-alcoholic fatty liver disease (NAFLD), now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD). Despite the majority of NAFLD patients being in the non-cirrhotic stage, there is a notable lack of data on HCC incidence and risk factors, making it challenging to implement effective public health screening and prevention strategies.</div></div><div><h3>Methods</h3><div>This study conducted a longitudinal analysis of a nationwide cohort of NAFLD patients using big data from the National Health Insurance Service of South Korea to assess HCC incidence and risk factors, focusing on non-cirrhotic patients. NAFLD was identified through ICD-10 codes and refined using a fatty liver index (FLI) score above 30.</div></div><div><h3>Results</h3><div>A total of 529,811 patients were enrolled. After a washout period, 36,760 patients were newly diagnosed with NAFLD. The incidence rate of HCC per 100,000 person-years was 10.00 in healthy controls and 31.66 in NAFLD patients, further divided into 24.87 in non-cirrhotic NAFLD and 721.5 in cirrhotic NAFLD. In the 1:1 Propensity Score Matched analysis, HCC incidence in non-cirrhotic NAFLD was 24.89 per 100,000 person-years compared to 9.72 in matched healthy controls, yielding an adjusted hazard ratio (HR) of 2.69 (95 % CI 1.33–5.44). Multivariate Cox regression analysis indicated that both cirrhotic and non-cirrhotic NAFLD significantly increased the risk of developing HCC, with additional factors such as age, male sex, and type 2 diabetes. A subsequent analysis of non-cirrhotic NAFLD patients confirmed that advanced age and male sex remained significant risk factors for the development of HCC.</div></div><div><h3>Conclusions</h3><div>This study demonstrates that non-cirrhotic NAFLD patients, particularly males and those aged 70–79 years, have a significantly increased risk of HCC compared to healthy controls. Given the applicability of NAFLD concepts to MASLD, our findings could provide insights for identifying high-risk individuals within the MASLD spectrum and developing effective strategies to reduce the risk of HCC.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102612"},"PeriodicalIF":2.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143941814","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":"Circulating tumor DNA: A new tool to predict recurrence and guide treatment of colorectal cancer","authors":"Erwan Vo-Quang ,&nbsp;Annalice Gandini ,&nbsp;Valerie Taly ,&nbsp;Pierre Laurent-Puig ,&nbsp;Aziz Zaanan ,&nbsp;Julien Taieb","doi":"10.1016/j.clinre.2025.102611","DOIUrl":"10.1016/j.clinre.2025.102611","url":null,"abstract":"<div><div>Circulating tumor DNA (ctDNA) has emerged as a promising biomarker with diverse applications across different stages of colorectal cancer management. One of its primary roles is as a prognostic biomarker for detecting post-surgical molecular residual disease and predicting recurrence risk. Compared to traditional biomarkers and tissue biopsies, ctDNA provides a minimally invasive, dynamic, and comprehensive representation of tumor burden and molecular heterogeneity. However, challenges persist in standardizing ctDNA testing, improving sensitivity for early-stage disease, and ensuring widespread accessibility. In this review, we explore the biological characteristics of ctDNA, the methodologies for its detection, and its broad clinical applications in both localized and metastatic colorectal cancer.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 7","pages":"Article 102611"},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971062","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":"Evaluation of long-term changes in liver function and structure in patients exposed to SARS-CoV-2 infection: A prospective study","authors":"Erkin Saeed Saifi ,&nbsp;Francesco Faita ,&nbsp;Matteo Nardin ,&nbsp;Paola Orizio ,&nbsp;Alessandra Arrigoni ,&nbsp;Bianca Maria Roccon ,&nbsp;Beatrice Accordini ,&nbsp;Stefania Cecchinel ,&nbsp;Paolo Poisa ,&nbsp;Giovanni Pelizzari ,&nbsp;Anna Paini ,&nbsp;Massimo Salvetti","doi":"10.1016/j.clinre.2025.102606","DOIUrl":"10.1016/j.clinre.2025.102606","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) binds to Angiotensin Converting Enzyme – 2 (ACE2) receptor targeting various organs including liver. Liver injury is a common feature of SARS-CoV-2 acute infection. A few studies have also described chronic hepatic alterations in patients with previous COVID-19. We hypothesize that steatosis seen in COVID-19 patients reflects their metabolic profile and is not caused by persistent inflammation sustained by SARS-CoV-2.</div></div><div><h3>Methods</h3><div>We conducted a prospective study to evaluate long-term changes in liver function and structure in patients hospitalized for COVID-19. Patients without a prior known hepatic disease with mild to moderate COVID-19 were enrolled during hospitalization and reevaluated during a follow-up visit at a medium 16 months. Complete blood panels with metabolic profile, BMI, alcohol consumption and physical activity were compared between baseline and follow-up. Specific ultrasound scans were obtained during hospital stay and at follow-up to quantify steatosis using Steatoscore2.0.</div></div><div><h3>Results</h3><div>Among 55 eligible patients, 33 were included in the analysis and only 3 (9 %) had a new diagnosis of steatosis at follow-up. Steatoscore2.0 did not change significantly from baseline to follow-up (1.7 vs 1.73, <em>p</em> = 0.348), while changes occurred in body mass index and physical activity estimated by IPAQ questionnaire (26.3 vs 26.6 kg/m², <em>p</em> = 0.005; 540 vs. 480, <em>p</em> = 0.015, respectively). There was a statistically significant increase in total cholesterol (144.5 vs 187.0 mg/dl, <em>p</em> = 0.003) and low-density lipoprotein-cholesterol (73.8 vs 113.9 mg/dl, <em>p</em> = 0.003). Inflammatory markers normalized at follow-up, including C-reactive protein (41.1 vs. 0.8 mg/L, <em>p</em> &lt; 0.001), and ferritin (410.0 vs. 91.0 ng/dl, <em>p</em> &lt; 0.001). Four patients had a 3-time rise in liver transaminase levels at baseline, and this was not confirmed at follow-up. Change in Steatoscore2.0 correlated significantly with Triglyceride-glucose index as a surrogate of insulin resistance.</div></div><div><h3>Conclusions</h3><div>In our study, long term functional and structural changes were not observed in patients with previous SARS-CoV-2 infection. There was a significant deterioration of metabolic profile post COVID-19</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102606"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927419","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":"Evaluating the influence of maternal anti-HBs status on the antibody levels in vaccinated children","authors":"Naim Abu-Freha ,&nbsp;Safa Shibli ,&nbsp;Ohad Etzion ,&nbsp;Yaser Afianish ,&nbsp;Johnny Amer ,&nbsp;Heba Abu Kaf ,&nbsp;Nachum Zohar ,&nbsp;David Yardeni ,&nbsp;Rifaat Safadi","doi":"10.1016/j.clinre.2025.102608","DOIUrl":"10.1016/j.clinre.2025.102608","url":null,"abstract":"<div><div>Background and Aims: The mother's Hepatitis B Virus (HBV) vaccination status may impact the child's response. We aimed to investigate the children's vaccine response based on the mother's vaccination status. Methods: In a retrospective study, we included children ≤10 years old born to HBsAg negative mothers, with available maternal and children anti-HBs antibodies. Children of vaccinated and unvaccinated mothers were compared and categorized based on anti-HBs titers: 0–9.9, 10–100, 101–500, 501–1000, and ≥1001 mlU/ml. Results: 14,485 children were included. No significant difference in the anti-HBs positivity rate was found among the children of vaccinated and unvaccinated mothers (70.4 % vs. 69.7 %, <em>p</em> = 0.337). Vaccine response in vaccinated vs. unvaccinated mothers was 93.5 % vs. 92.1 % for the first year of age, 87.7 % vs. 87.3 % for age 3 years, and 82.5 % vs. 82.2 % for age 5 years, respectively. Young children (7–36 months) had higher protective titer rates than older children. A higher proportion of the ≥1001 mlU/ml category was recorded among children of mothers with negative or low anti-HBs antibodies in the first year of age, reaching 40.9 %. With age, the proportion of children with 10–100 mlU/ml increased, corresponding to the mother's titer. Conclusion: The maternal HBV vaccination status does not impact the children's response, but the mother's anti-HBs titers may affect the child's antibody level. Maternal anti-HBs antibody titers may neutralize the vaccine HBsAg to impair the reponse.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102608"},"PeriodicalIF":2.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927420","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":"Lack of prior screening for advanced liver fibrosis in patients with newly diagnosed hepatocellular carcinoma: Results from a prospective multicentre study","authors":"Nour Ben Yedder ,&nbsp;Paul Girot ,&nbsp;Carelle Koudougou ,&nbsp;Matthieu Schnee ,&nbsp;Sylvie Métairie ,&nbsp;Annie Lim ,&nbsp;Kouceila Soualah ,&nbsp;Samuel Andrault ,&nbsp;Maëva Salimon ,&nbsp;Yann Touchefeu","doi":"10.1016/j.clinre.2025.102607","DOIUrl":"10.1016/j.clinre.2025.102607","url":null,"abstract":"<div><h3>Introduction</h3><div>Hepatocellular carcinoma (HCC) most commonly occurs in a cirrhotic liver. In France, a screening rate of 20 % to 35 % has been reported in clinical cohorts. In these studies, patients were generally enrolled in centers of the same category (university or general hospitals). The aim of this study was to prospectively investigate the circumstances of HCC diagnosis and the causes of HCC screening failure in a cohort of patients from a regional network.</div></div><div><h3>Methods</h3><div>This prospective multicenter study enrolled patients with newly diagnosed HCC from October 2022 to July 2024. Investigators were from one university hospital, two private clinics, and three general hospitals.</div></div><div><h3>Results</h3><div>Two hundred patients were included. Diagnosis was made by screening in 31.0 % of cases. Most patients had comorbidities that could lead to screening for liver fibrosis: current or past history of alcohol consumption (74.6 %), diabetes (51.4 %), hypertension (75.7 %), dyslipidemia (47.4 %). The FIB-4 score was ≥ 2.67 in 74.5 % of patients in the “in screening” group and 63.9 % in the “not in -screening” group. Among the 138 patient in the ”not in screening” group, 115 (83.3 %), 34 (24.6), 23 (16.7 %) and 13 (9.4 %) declared they had visited a general practionner, a cardiologist, a gastroenterologist, and/or an endocrinologist within the 12 months prior to HCC diagnosis, respectively.</div></div><div><h3>Conclusion</h3><div>Recognition by general practitioners of patients at risk of chronic liver disease and identification of advanced fibrosis are major areas for optimization of HCC screening.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102607"},"PeriodicalIF":2.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916216","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 outcomes in patients with autoimmune hepatitis and primary biliary cholangitis overlap syndrome in the United States","authors":"Ritik M. Goyal ,&nbsp;Bhavik Bansal ,&nbsp;Mohammed Ayyad ,&nbsp;Aagamjit Singh ,&nbsp;Esli Medina Morales ,&nbsp;Imran Qureshi ,&nbsp;Muhammad Hassaan Arif Maan ,&nbsp;Paul J. Gaglio","doi":"10.1016/j.clinre.2025.102598","DOIUrl":"10.1016/j.clinre.2025.102598","url":null,"abstract":"<div><h3>Background</h3><div>There is evidence of overlap between autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC), two autoimmune hepatobiliary diseases. This retrospective analysis aimed to investigate extra-hepatic auto-immune diseases and compare outcomes of hospitalized patients with AIH-PBC overlap with AIH and PBC. We hypothesize that there are differences in rates of major adverse liver outcomes (MALO’s) when comparing these groups.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using National Inpatient Sample 2016–2020. Patients with AIH, PBC and AIH-PBC were identified using respective ICD-10 codes. We performed weighted logistic and linear regression for predicting complications of cirrhosis, hospitalization outcomes, among AIH-PBC overlap cases when compared separately to AIH and PBC only populations as controls.</div></div><div><h3>Results</h3><div>A total of 2454 AIH, 1464 PBC, and 276 AIH-PBC overlap patients were identified, corresponding to weighted totals of 12,270, 7320 and 1380 patients, respectively. On multivariate analysis, we found that patients with AIH-PBC are more likely to have ascites (OR 3.03; <em>p</em> &lt; 0.001) and portal hypertension (OR 3.75; <em>p</em> &lt; 0.001) compared to AIH; whereas no significant difference was found out compared to PBC. There was no difference in the mortality and liver transplant needs in AIH-PBC overlap group. Overall higher rheumatological disease was present in the AIH-PBC overlap patients compared to AIH (26.45 % vs 8.96 %, <em>p</em> =&lt; 0.001) and PBC (26.45 % vs 9.08 %, <em>p</em> =&lt; 0.001). Specifically, AIH-PBC patients had higher prevalence of Sjogren’s syndrome (<em>p</em> &lt; 0.001), SLE (<em>p</em> &lt; 0.001), and systemic sclerosis (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>AIH-PBC Overlap syndrome is associated with increased rates of certain cirrhotic complications when compared to patients with AIH only. They do not differ in terms of clinical outcomes such as mortality when adjusted for demographics and comorbidities. Patients with AIH-PBC had a higher prevalence of rheumatological disorders; especially Sjogren’s, SLE, and systemic sclerosis.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102598"},"PeriodicalIF":2.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143894928","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":"Endoscopic reduction of a large antro-pyloric lipoma with exuberant ulceration due to transpyloric prolapse (with videos)","authors":"Vincent Zimmer","doi":"10.1016/j.clinre.2025.102600","DOIUrl":"10.1016/j.clinre.2025.102600","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102600"},"PeriodicalIF":2.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882290","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 use of per ERCP bile aspiration in patients with cholangitis: The aspibile study","authors":"Mathilde Sanavio ,&nbsp;Marine Camus ,&nbsp;Jean Paul Nammour ,&nbsp;Alexandre Godmer ,&nbsp;Jean Luc Meynard ,&nbsp;Ulriikka Chaput ,&nbsp;Aymeric Becq","doi":"10.1016/j.clinre.2025.102599","DOIUrl":"10.1016/j.clinre.2025.102599","url":null,"abstract":"<div><h3>Background and study aims</h3><div>Bile aspiration during endoscopic retrograde cholangiopancreatography (ERCP) for cholangitis is not systematic and data on its clinical relevance remain limited. The aim of this study was to evaluate the clinical contribution of biliary aspiration in the setting of cholangitis.</div></div><div><h3>Methods</h3><div>Consecutive patients with ERCP performed for cholangitis were included. The primary outcome was the rate of adaptation of antibiotic therapy to biliary aspirations. Secondary outcomes were length of hospitalization, mortality, cholangitis recurrence at 30 days, duration of antibiotic therapy, antibiotic change, agreement between antibiotic therapy and biliary aspiration.</div></div><div><h3>Results</h3><div>A total of 140 patients were included, 103 (73.6 %) had blood cultures before ERCP. The rate of empiric and adjusted antibiotics effectively targeting bacteria found in bile was 82.1 % and 85.4 %, respectively. The mean length of hospital stay was 15.7 days, cholangitis recurrence rate was 3.2 % and the mortality rate was 5.5 %. The mean duration of antibiotic therapy was 11.3 days with an antibiotic modification rate of 45 %.</div></div><div><h3>Conclusions</h3><div>Bile aspiration during ERCP for acute cholangitis is a valuable complement to blood culture providing a higher diagnostic yield and enabling targeted antibiotic therapy. The rate of antibiotics effectively targeting bacteria found in bile is higher than 80 %.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 6","pages":"Article 102599"},"PeriodicalIF":2.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870767","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}