Digestive Diseases最新文献

{"title":"The Different Prognoses of Hepatocellular Carcinoma with Previous Tenofovir versus Entecavir Treatment for Chronic Hepatitis B Virus: Analysis Based on 15 Propensity Score-Matched Studies.","authors":"Jiancun Hou,&nbsp;Zhe Qiang,&nbsp;Yang Li,&nbsp;Yamin Zhang","doi":"10.1159/000528711","DOIUrl":"https://doi.org/10.1159/000528711","url":null,"abstract":"<p><strong>Background: </strong>Currently, enough studies with aggregated study-level data have demonstrated that there was no clinically meaningful difference in the risk of hepatocellular carcinoma (HCC) between patients who received entecavir and patients who received tenofovir treatment for chronic hepatitis B virus (CHBV). However, many studies found many differences in prognosis of these HCC patients. This meta-analysis of high-quality propensity score-matched (PSM) studies was designed to provide robust estimates for comparative HCC prognosis between groups receiving tenofovir or entecavir.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to July 10, 2022, for relevant studies that compare the different prognoses of HCC between tenofovir and entecavir treatment. The primary outcomes were the difference of overall death or liver transplantation between tenofovir and entecavir treatment. The secondary outcomes included risk factors of overall death or liver transplantation and different treatment responses between tenofovir and entecavir treatment for CHBV. All statistical analyses were performed using the standard statistical procedures provided in Review Manager 5.2.</p><p><strong>Results: </strong>A total of 15 PSM studies were identified, with 24,035 sample sizes in tenofovir group and 61,410 sample sizes in entecavir group, respectively. Pooled data indicated that, compared with entecavir, patients receiving tenofovir experienced significantly lower overall death or liver transplantation, with a pooled OR of 0.55 (95% CI: 0.45-0.68; p < 0.00001). Subgroup analysis by population also found similar results with pooled ORs of 0.52 (95% CI: 0.38-0.70; p < 0.0001) in entire cohort and 0.62 (95% CI: 0.50-0.77; p < 0.0001) in PSM cohort. Similarly, the subgroup analysis also found that HCC patients without cirrhosis receiving tenofovir experienced significantly lower overall death or liver transplantation than entecavir (OR: 0.56; 95% CI: 0.49-0.66), but no significant result was found in HCC patients with cirrhosis. In addition, both univariate (OR: 0.46; 95% CI: 0.31-0.69) and multivariable analyses (OR: 0.86; 95% CI: 0.82-0.91) also indicated significant reduction of overall death or liver transplantation in tenofovir group than entecavir group.</p><p><strong>Conclusion: </strong>Our analysis indicated that there was clinically meaningful difference in prognosis of HCC between patients who received entecavir and patients who received tenofovir. Patients who received tenofovir experienced much lower overall death or liver transplantation than patients who received entecavir. Tenofovir treatment may be one of independent favorable factors of prognosis for HCC patients with CHBV.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 3","pages":"476-488"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9549286","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":"Interstitial Brachytherapy for Hepatocellular Carcinoma: Analysis of Prognostic Factors for Overall Survival and Progression-Free Survival and Application of a Risk Stratification Model.","authors":"Maximilian Thormann, Franziska Heitmann, Vanessa Wrobel, Constanze Heinze, Christine March, Peter Hass, Robert Damm, Alexey Surov, Maciej Pech, Jazan Omari","doi":"10.1159/000531732","DOIUrl":"10.1159/000531732","url":null,"abstract":"<p><strong>Introduction: </strong>Interstitial brachytherapy (iBT) is an effective treatment for hepatocellular carcinoma (HCC). Identification of prognostic factors is pivotal for patient selection and treatment efficacy. This study aimed to assess the impact of low skeletal muscle mass (LSMM) on overall survival (OS) and progression-free survival (PFS) of iBT in patients with HCC.</p><p><strong>Methods: </strong>For this single-center study, we retrospectively identified 77 patients with HCC who underwent iBT between 2011 and 2018. Follow-up visits were recorded until 2020. The psoas muscle area, psoas muscle index, psoas muscle density (MD), and the skeletal muscle gauge were assessed on the L3 level on pre-treatment cross-sectional CT scans.</p><p><strong>Results: </strong>Median OS was 37 months. 42 patients (54.5%) had LSMM. An AFP level of &gt;400 ng/ml (hazard ratio [HR] 5.705, 95% confidence interval [CI]: 2.228-14.606, p = 0.001), BCLC stage (HR 3.230, 95% CI: 0.972-10.735, p = 0.026), and LSMM (HR 3.365, 95% CI: 1.490-7.596, p = 0.002) showed a relevant association with OS. Weighted hazard ratios were used to form a predictive risk stratification model with three groups: patients with low risk (median OS 62 months), intermediate risk (median OS 31 months), and high risk (median OS 9 months). The model showed a good prediction of 1-year mortality, with an AUC of 0.71. Higher MD was associated with better PFS (HR 0.920, 95% CI: 0.881-0.962, p &lt; 0.001).</p><p><strong>Conclusion: </strong>In patients undergoing iBT for HCC, LSMM is associated with worse OS. A risk stratification model based on LSMM, AFP &gt;400 ng/mL, and BCLC stage successfully predicted patient mortality. The model may support and enhance patient selection.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"957-966"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10716867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9699119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights from an Exploratory Retrospective Cohort Study: Are Face-to-Face Follow-Up Consultations after Colonoscopy a Thing of the Past?","authors":"Jerrald Lau,&nbsp;Ning-Qi Pang,&nbsp;Chermaine Ang,&nbsp;Ker-Kan Tan","doi":"10.1159/000530165","DOIUrl":"10.1159/000530165","url":null,"abstract":"<p><strong>Background: </strong>Colonoscopy is a commonly performed procedure, but most patients will not actually be found with colorectal cancer. Subsequent face-to-face consultations to explain post-colonoscopy findings are common despite the time and cost-saving benefits of teleconsultation, especially in a post-COVID-19 era. This exploratory retrospective study examined the proportion of post-colonoscopy follow-up consultations that could have been converted to teleconsultation within a tertiary hospital in Singapore.</p><p><strong>Methods: </strong>A retrospective cohort of all patients who underwent colonoscopy in the institution from July to September 2019 was identified. All follow-up face-to-face consultations related to the index colonoscopy from the scope date to 6 months post-colonoscopy were traced. Clinical data relevant to the index colonoscopy and these consultations were extracted from electronic medical records.</p><p><strong>Results: </strong>The cohort consisted of 859 patients (68.5% male, age range: 18-96 years). Of these, 15 (1.7%) had colorectal cancer, but the majority (n = 643, 74.9%) were scheduled for at least one post-colonoscopy visit - a total of 884 face-to-face clinical visits. The final sample was 682 (77.1%) face-to-face post-colonoscopy visits that did not involve any procedures performed or indicated the need for any subsequent follow-up.</p><p><strong>Conclusion: </strong>If such \"unnecessary\" post-colonoscopy consultations exist within our institution, then similar situations possibly occur elsewhere. As COVID-19 continues to periodically tax healthcare systems worldwide, preservation of resources will remain integral alongside quality standards of routine patient care. There is a need for detailed analyses and modeling to hypothesize potential savings by also considering the start-up and maintenance costs of switching to a teleconsultation-dominated system.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 4","pages":"600-603"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10627111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9809949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Anxiety and Depression on the Symptoms of Achalasia Patients: A Retrospective Cohort Study in China during COVID-19.","authors":"Lingyun Zhang,&nbsp;Lili Zhang,&nbsp;Wei Zhao,&nbsp;Bangmao Wang","doi":"10.1159/000528802","DOIUrl":"https://doi.org/10.1159/000528802","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic achalasia (AC) may be affected by anxiety and/or depression; however, reliable evidence is still lacking. The present retrospective cohort study aimed to explore the influence of psycho-mental factors on the severity of AC.</p><p><strong>Methods: </strong>All patients in the AC database of the Tianjin Medical University General Hospital from 2012 to 2020 were divided into two subgroups, intervention (n = 202) and medication (n = 84), according to previous treatments. Healthy people (n = 300) who underwent gastrointestinal endoscopy comprised the control group. The severity of symptoms and the anxiety and depression score of AC patients and controls were monitored by telephone and compared before and during COVID-19. In addition, the factors of AC symptoms during the COVID-19 were discussed by multiple linear regression.</p><p><strong>Results: </strong>During COVID-19, the anxiety and depression levels of AC patients and healthy individuals were deteriorated. For AC patients, before and after COVID-19, symptoms, anxiety, and depression scores in the medication group were more serious than those in the intervention group. Furthermore, previous therapy, depression, and gender were found to be significantly related to the severity of AC symptoms during COVID-19.</p><p><strong>Conclusions: </strong>The outbreak of COVID-19 made AC patients and healthy people anxious and depressed. Depression rather than anxiety might worsen the AC symptoms. Interventional therapy might protect AC patients against psychological abnormalities during COVID-19.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 3","pages":"362-368"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10090403/pdf/ddi-0001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9920729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-3682-3p Activated by c-Myc Aggravates the Migration and Stemness in Hepatocellular Carcinoma Cells by Regulating PTEN/PI3K/AKT/β-Catenin Signaling.","authors":"Yu Zhang,&nbsp;Hua Cai,&nbsp;Ming-Hao Wu,&nbsp;Dan-Hua Zhu,&nbsp;Xiang-Yang Wang,&nbsp;Zhi-Yuan Chen,&nbsp;Li Yang,&nbsp;Peng Liu,&nbsp;Zhan Liu","doi":"10.1159/000527800","DOIUrl":"https://doi.org/10.1159/000527800","url":null,"abstract":"Background: Hepatocellular carcinoma (HCC) is a leading cancer worldwide. miRNA has been linked to cancer processes. We want to figure out what the underlying mechanism and functions of miR-3682-3p are in HCC. Methods: Thirty pairs of tumor tissues and adjacent tissues were obtained from HCC patients. mRNA and protein expressions were detected by quantitative real-time PCR and Western blot, respectively. The migration and invasion were measured using transwell or wound-healing assays. Dual luciferase and ChIP assays were utilized to detect gene interactions. Results: miR-3682-3p was highly expressed in HCC tissues and cell lines. Silencing of miR-3682-3p inhibited cell migration and invasion, increased E-cadherin expression, and decreased N-cadherin, vimentin, and snail expressions, as well as the SOX2, OCT4, and Bmi1 expression, thereby restraining EMT and stemness of HCC in vitro. miR-3682-3p was positively activated by c-Myc and could directly target PTEN to activate PI3K/AKT/β-catenin pathway. In addition, inhibition of PTEN weakened the anti-migration and anti-stemness effects of miR-3682-3p downregulation in HCC cells. Conclusion: miR-3682-3p promoted HCC migration and stemness through PTEN/PI3K/AKT/β-catenin signaling, implying that miR-3682-3p might be a promising target for HCC clinical treatment.","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 3","pages":"447-457"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9602215","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":"The Application of Probe-Based Confocal Laser Endomicroscopy as a Diagnostic Tool in Choledochoscopic Gallbladder-Preserving Surgery.","authors":"Bofu Tang,&nbsp;Yujing Jia,&nbsp;Tong Dang,&nbsp;Jianyuan Chai,&nbsp;Qiuhong Wang,&nbsp;Zhiheng Chang,&nbsp;Weijie Han,&nbsp;Xiaolong Li,&nbsp;Yongqiang Ma","doi":"10.1159/000526678","DOIUrl":"https://doi.org/10.1159/000526678","url":null,"abstract":"<p><strong>Background and aims: </strong>Choledochoscopic gallbladder-preserving surgery (CGPS) has the advantage of treating benign gallbladder diseases on the premise of gallbladder preservation. However, it has no reliable preoperative diagnosis if the gallbladder is benign. Probe-based confocal laser endomicroscopy (pCLE) can obtain real-time and clear endoscopic images at the cell level in vivo. It is widely used in the diagnosis of digestive system diseases, but not in gallbladder diseases yet. We applied these two technologies in a complementary way into the diagnosis of gallbladder diseases and thereby lifted the reliability of CGPS.</p><p><strong>Methods: </strong>We retrospectively analyzed the total 28 patients with the indication of CGPS with intraoperative pCLE scan referred to the Second Affiliated Hospital of Baotou Medical College between October 2019 and July 2020. The intraoperative pCLE results were compared with the postoperative pathology in various gallbladder diseases.</p><p><strong>Results: </strong>We compared the intraoperative pCLE diagnosis with the postoperative pathological diagnosis and found a complete match without exception in both sensitivity and specificity.</p><p><strong>Conclusions: </strong>Based on our investigation, pCLE can provide the same accuracy as the traditional pathology in the diagnosis of gallbladder diseases with the additional advantages like noninvasive, real time, and instancy. This study serves to validate the correlation between CLE and histology. It holds a broad prospect in the application of pCLE as an intraoperative diagnosis in CGPS.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 2","pages":"325-334"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10826033","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":"High Visceral-To-Subcutaneous Fat Ratio Is Associated with an Increased Risk of Gastroesophageal Reflux Disease in Nonobese Adults.","authors":"Ja Eun Koo,&nbsp;Hye-Sook Chang,&nbsp;Hye Won Park,&nbsp;Sungwon Park,&nbsp;Inyoung Bae,&nbsp;Ji Young Lee,&nbsp;Jaewon Choe","doi":"10.1159/000529814","DOIUrl":"https://doi.org/10.1159/000529814","url":null,"abstract":"<p><strong>Introduction: </strong>Abdominal obesity increases the risk of gastroesophageal reflux disease (GERD). This study aimed to determine the association between GERD and abdominal fat area quantified by computed tomography (CT).</p><p><strong>Methods: </strong>We analyzed the effect of abdominal fat area on gastroesophageal reflux symptoms and erosive esophagitis using logistic regression models in 5,338 participants who underwent abdominal fat measurement CT and screening esophagogastroduodenoscopy.</p><p><strong>Results: </strong>Participants with reflux symptoms and erosive esophagitis were diagnosed in 1,168 (21.9%) and 671 (12.5%), respectively. Multivariate analysis showed that subcutaneous and visceral fat areas were significantly associated with reflux symptoms and erosive esophagitis. The adjusted odds ratio (OR) in the fourth quartile of visceral fat area compared with that in the lowest quartile was 1.98 (95% confidence interval (CI) 1.63-2.39) for reflux symptoms and 2.33 (95% CI 1.80-3.01) for erosive esophagitis. Visceral fat area had a stronger effect in the younger age-group. In the group &lt;50 years, the adjusted OR in fourth quartile of visceral fat area was 2.70 (95% CI 1.86-3.94) for reflux symptoms and 3.59 (95% CI 2.22-5.80) for erosive esophagitis. High visceral-to-subcutaneous fat ratio (VSR) increased the risk of reflux symptoms and erosive esophagitis in participants with body mass index &lt;25 kg/m2 and normal waist circumference.</p><p><strong>Conclusion: </strong>Subcutaneous and visceral fat areas were associated with an increased risk of reflux symptoms and erosive esophagitis. High VSR increased the risk of reflux symptoms and erosive esophagitis in participants with normal body weight and waist circumference.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 4","pages":"666-676"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10130120","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":"Diagnostic Challenges in Endoscopy.","authors":"Hung Leng Kaan, Khek Yu Ho","doi":"10.1159/000531733","DOIUrl":"10.1159/000531733","url":null,"abstract":"","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"833-834"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10367403","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":"Anemia Is Associated with Disease Severity, Hepatic Complications, and Progression of Wilson Disease: A Retrospective Cohort Study.","authors":"Si-Qi Wang,&nbsp;Yong-Qiang Zhan,&nbsp;Xuan Hu,&nbsp;Yu-Pei Zhuang,&nbsp;Hong-Qian Liu,&nbsp;Ming-Fan Hong,&nbsp;Hao-Jie Zhong","doi":"10.1159/000530473","DOIUrl":"https://doi.org/10.1159/000530473","url":null,"abstract":"<p><strong>Introduction: </strong>Anemia is a common manifestation of chronic liver diseases. It is a predictor of severe disease, a high risk of complications, and poor outcomes in various liver diseases. However, it remains unclear whether anemia serves as a similar indicator in patients with Wilson disease (WD). Therefore, this study aimed to investigate the relationship between anemia and severity, hepatic complications, and the progression of WD.</p><p><strong>Methods: </strong>Medical data were collected retrospectively from January 1, 2016, to December 31, 2020. Univariate and multivariate analyses were carried out to investigate the relationship between anemia and liver-associated disease severity, hepatic complications, and the progression of WD.</p><p><strong>Results: </strong>A total of 288 WD patients (48 with and 240 without anemia) were enrolled in the study. Multivariate linear regression revealed that WD patients with anemia had significantly higher levels of bilirubin, alanine transaminase, prothrombin time, international normalized ratio, type Ⅳ collagen, and hyaluronic acid and significantly lower levels of albumin, total cholesterol, and high-density lipoprotein-cholesterol (all p &lt; 0.05). Multivariate logistic regression showed that anemia was a risk factor for gastric varices and ascites (all p &lt; 0.05). Fully adjusted Cox regression revealed that anemia was an independent risk factor for advanced Child-Pugh classification (p = 0.034).</p><p><strong>Conclusions: </strong>Anemia was common in WD patients and was associated with greater disease severity, a higher risk of hepatic complications, and a faster progression.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 4","pages":"632-640"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9750519","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":"Differences in the Intestinal Microbiome Associated with Diarrhea during Lenvatinib Treatment for Hepatocellular Carcinoma.","authors":"Yosuke Inukai,&nbsp;Kenta Yamamoto,&nbsp;Takashi Honda,&nbsp;Takanori Ito,&nbsp;Norihiro Imai,&nbsp;Yoji Ishizu,&nbsp;Masanao Nakamura,&nbsp;Hiroki Kawashima,&nbsp;Masatoshi Ishigami","doi":"10.1159/000524298","DOIUrl":"https://doi.org/10.1159/000524298","url":null,"abstract":"<p><strong>Introduction: </strong>Lenvatinib has been widely used for the treatment of advanced hepatocellular carcinoma (HCC). Some adverse events, including diarrhea, have been reported for lenvatinib. Diarrhea may be associated with the changes in the intestinal microbiome; however, the underlying mechanism has not been elucidated.</p><p><strong>Aim: </strong>In this study, we aimed to investigate the relationship between the intestinal microbiome and diarrhea caused by lenvatinib via analysis of fecal samples collected before treatment.</p><p><strong>Methods: </strong>A total of 21 patients with advanced HCC who were treated with lenvatinib were enrolled. Fecal samples were collected from patients. The patients were divided into diarrhea (n = 8) and nondiarrhea groups (n = 12). We compared the characteristics of patients, incidence of adverse events, composition of the intestinal microbiome, and enrichment of functional pathways between both groups using QIIME2 and PICRUSt2.</p><p><strong>Results: </strong>The median age of the two groups was 73 years. The nondiarrhea group comprised a relatively higher number of male patients than the diarrhea group; however, there were no significant differences in patient characteristics between both groups. The proportion of the microbiome was similar, and alpha and beta diversities were not significantly different between both groups. The relative abundance of order Bacteroidales, including Parabacteroides and Prevotella, was higher in the diarrhea group than in the nondiarrhea group. PICRUSt2 analysis showed some metabolic pathways, including butanoate (butyrate) metabolism, were enriched in the nondiarrhea group when compared with those in the diarrhea group.</p><p><strong>Conclusion: </strong>Differences in the intestinal microbiomes and their functions may influence the incidence of diarrhea during lenvatinib treatment.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":"41 1","pages":"138-147"},"PeriodicalIF":2.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9909711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9926287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}