Digestive Diseases最新文献

{"title":"The Overlap between Type 1 Diabetes and Celiac Disease in Children and the Role of Tissue Transglutaminase-IgA Positivity in Endoscopy Decision.","authors":"Elif Eviz, Sinan Sari, Nuray Uslu Kizilkan, Esra Doger, Gul Yesiltepe Mutlu, Ödül Eğritaş, Cigdem Arikan, Aysun Bideci, Buket Dalgic, Sukru Hatun","doi":"10.1159/000543168","DOIUrl":"10.1159/000543168","url":null,"abstract":"<p><strong>Introduction: </strong>Celiac disease (CD)-related antibody positivity in children with type 1 diabetes (T1D) may fluctuate and become negative spontaneously. There are uncertainties about the optimal tissue transglutaminase IgA (tTG-IgA) titre and timing of endoscopy in the diagnosis of CD, and this study aimed to contribute to the debate on the tTG-IgA threshold titre for endoscopy decisions in children with T1D.</p><p><strong>Methods: </strong>The data of 991 children with T1D who had undergone serologic evaluation for CD were analysed retrospectively. The tTG-IgA positivity rate and the upper limit of normal (ULN) tTG-IgA positivity were assessed. Participants were grouped according to the frequency, course, and test results of tTG-IgA tests. Those with and without histopathologic diagnosis of CD by endoscopic biopsy were compared in terms of tTG-IgA screening time and tTG-IgA predictive values.</p><p><strong>Results: </strong>In 10.2% (n:101) of all cases, tTG-IgA antibody was positive and endoscopic biopsy was performed in 68.3% (n:69) of these cases. Of all cases, 4.3% (n:43) were diagnosed with CD by endoscopic biopsy. A tTG-IgA titre of 7×ULN and above was found to be the best predictive value for the diagnosis of CD with 79.1% sensitivity, 80.8% specificity 87.2% positive predictive value, and 70% negative predictive value.</p><p><strong>Conclusions: </strong>Approximately 10% of antibody positive cases showed fluctuating and low-titre positivity, and no CD was detected by endoscopic biopsy in the group with fluctuating antibody course. The results of our study suggest that endoscopy in children with tTG-IgA levels 7×ULN or above may prevent both false-positive results and missed cases.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"225-234"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946460","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":"Associations between Dynamic Contrast-Enhanced Magnetic Resonance Imaging with Histopathological Features in Cholangiocarcinoma.","authors":"Hans-Jonas Meyer, Johann Potratz, Dörthe Jechorek, Kai Ina Schramm, Jan Borggrefe, Alexey Surov","doi":"10.1159/000540958","DOIUrl":"10.1159/000540958","url":null,"abstract":"<p><strong>Introduction: </strong>The relationships between histopathology and imaging remain elusive, and investigating the underlying reasons for tumor microstructure leading to an imaging phenotype is of clinical importance. In the present study, a cross-sectional guided biopsy specimen was used to correlate prebioptic magnetic resonance imaging (MRI) with immunohistochemical staining of the histopathologic specimen using precise spatial biopsy localization.</p><p><strong>Methods: </strong>Twenty-seven patients with mass-forming cholangiocarcinoma (CCA) were included in the present analysis. All patients were imaged with a 1.5 T clinical scanner at least 1 month prior to biopsy. The contrast-enhanced dynamic sequences were analyzed with quantified signal intensities. The bioptic specimens were obtained by cross-sectional guided biopsy and further analyzed for cell density, proliferation index (Ki67), tumor-infiltrating lymphocytes, tumor-stroma ratio (TSR), and collagen.</p><p><strong>Results: </strong>There were no statistically significant correlations between MRI signal intensities and cell count, TSR, Ki67 index, and CD45 count. Only a moderate correlation was observed between relative signal intensities of the venous phase and the collagen-stained area (r = 0.40, p = 0.04).</p><p><strong>Conclusion: </strong>DCE-MRI is not associated with histopathological features in CCA. The complex interactions of tumor and tumor microenvironment are not reflected in the MRI phenotype.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"46-53"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460443","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":"Prediction of Significant Lesions on Capsule Endoscopy in Patients with Suspected Small Bowel Bleeding: External Validation of SSB Capsule Dx Score.","authors":"Tiago Lima Capela, Tiago Cúrdia Gonçalves, Bruno Rosa, José Cotter","doi":"10.1159/000536109","DOIUrl":"10.1159/000536109","url":null,"abstract":"<p><strong>Introduction: </strong>Deciding which patients with suspected small bowel bleeding (SSB) would benefit most from small bowel capsule endoscopy (SBCE) is challenging. Our aim was to perform an external validation of the recently developed SSB Capsule Diagnostic (Dx) score that includes 3 variables (hospital admission with overt bleeding, hemoglobin <6.4 g/dL and age <54 years) and has been shown to be potentially useful in limiting the use of SBCE in SSB low-risk patients.</p><p><strong>Methods: </strong>Retrospectively included all adult patients submitted to SBCE for SSB between November 2007 and December 2019. Patients' demographic, clinical and laboratorial data at the time of SBCE were recorded. Small bowel lesions were classified according to Saurin classification. The SSB Capsule Dx score was calculated, and its calibration and discrimination ability were assessed.</p><p><strong>Results: </strong>We assessed 473 SBCEs for SSB. Patients' mean age was 61.2 ± 17.9 years and 65.8% were female. P2 lesions were present in 36.2% of SBCEs. There was a significant association between the score and P2 lesions (p < 0.001). Mean score was -0.21 ± 0.87 having a fair accuracy toward the outcome (C-statistic 0.700; 95% confidence interval, 0.652-0.749; p < 0.001). A cutoff value of 0 was found to have a high sensitivity (86.0%) and negative predictive value (84.9%) for the diagnosis of P2 lesions at SBCE.</p><p><strong>Conclusion: </strong>Patients with a SSB Capsule Dx score <0 are unlikely to have a significant lesion on SBCE, thus its routine use in the clinical practice may be useful in the identification of low-risk SSB patients.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"96-103"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460445","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 Meta-Analysis of Proton Pump Inhibitor Exposure and the Risk of Adverse Outcomes in Patients with Inflammatory Bowel Disease.","authors":"Qiufeng Zhang, Dandi Lou, Yueming Zhang, Anyi Xu, Yingying Fang, Xiaoshuai Zhou","doi":"10.1159/000542729","DOIUrl":"10.1159/000542729","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the association between proton pump inhibitors (PPIs) exposure and adverse outcomes in patients with inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>According to the guidelines outlined in the PRISMA and Meta-analysis of Observational Studies in Epidemiology (MOOSE), we conducted a comprehensive search of PubMed, Web of Science, Embase, and the Cochrane Library databases for relevant cohort and case-control studies comparing the incidence of adverse outcomes between IBD patients exposed to PPIs and those not exposed, from the inception of the databases to April 2024. The primary adverse outcomes analyzed included hospitalization and surgery.</p><p><strong>Results: </strong>Five studies, encompassing nearly 100,000 subjects, were included in this meta-analysis. The findings indicated that IBD patients exposed to PPIs had a significantly higher incidence of adverse outcomes compared to those not exposed (odds ratio [OR] = 1.24, 95% confidence interval [CI] = 1.07-1.44, p = 0.004), although it was low-quality evidence. This increased risk was observed in both ulcerative colitis (OR = 1.38, 95% CI = 1.04-1.83, p = 0.025) and Crohn's disease (OR = 1.14, 95% CI = 1.02-1.29, p = 0.025). Additionally, the incidence of surgery was higher in IBD patients with PPI exposure (OR = 1.31, 95% CI = 1.02-1.68). However, the OR for hospitalization did not show a statistically significant difference (OR = 1.43, p = 0.244). Moreover, the use of glucocorticoids was more frequent among patients exposed to PPIs (OR = 1.16, 95% CI = 1.06-1.28, p = 0.001).</p><p><strong>Conclusion: </strong>PPI exposure may be associated with an increased risk of adverse outcomes in IBD patients, particularly a higher rate of surgery. Limited by various factors, the evidence is considered low quality.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"28-35"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686423","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":"Markers of Prognosis for Acute Esophageal Necrosis: A Systematic Review.","authors":"Judah Kupferman, Maliyat Matin, Matthew Wend, Jesus Javier Rubio Castillon, Richard Mitchell, Joshua Aron, Rebecca Ye","doi":"10.1159/000543815","DOIUrl":"10.1159/000543815","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Acute esophageal necrosis (AEN) is a rare and lethal condition that may progress to sepsis and perforations. Most related literature comes from case reports; however, a few small reviews have been published. We conducted a large systematic review of AEN using PubMed, Medline, and Embase to organize data into one consolidated manuscript, find potential prognosticators of illness, and determine possible treatment guidelines for AEN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Advanced searches were performed of all English case reports from 1990 to 2021 using medical subject heading terms. Data on patient age, sex, comorbidities, initial presentation, management, progression of illness, and hospital survival were collected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our study included 226 articles, encompassing 319 cases. A total of 32.3% of patients had diabetes, 26.6% had hypertension, and 19.7% had alcohol use disorder. Overall, 66.5% presented with an upper gastrointestinal bleed and 21.9% developed sepsis or esophageal perforation. In total, 60.9% of patients were reported to have survived their illness, but 16.6% of cases did not have their discharge status documented. Interestingly, patients presenting with pain or ketoacidosis demonstrated improved survival.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;AEN becomes more prevalent as patients age and develop cardiovascular disease, which increases the risk of developing a hypoperfusive state and mucosal injury to the distal esophagus. Early fluid resuscitation, acid-reducing agents, and bowel rest may serve as potential lifesaving interventions, and antibiotics should be considered if there is concern for infection. Patients require close follow-up in anticipation of impending stricture.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Acute esophageal necrosis (AEN) is a rare and lethal condition that may progress to sepsis and perforations. Most related literature comes from case reports; however, a few small reviews have been published. We conducted a large systematic review of AEN using PubMed, Medline, and Embase to organize data into one consolidated manuscript, find potential prognosticators of illness, and determine possible treatment guidelines for AEN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Advanced searches were performed of all English case reports from 1990 to 2021 using medical subject heading terms. Data on patient age, sex, comorbidities, initial presentation, management, progression of illness, and hospital survival were collected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our study included 226 articles, encompassing 319 cases. A total of 32.3% of patients had diabetes, 26.6% had hypertension, and 19.7% had alcohol use disorder. Overall, 66.5% presented with an upper gastrointestinal bleed and 21.9% developed sepsis or esophageal perforation. In total, 60.9% of patients were reported to have survived their illness, but 16.6% of cases did not have their discharge status documented. Interestingly, patien","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"135-145"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045905","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":"Muscular Injury Is a Risk Factor for Post-Entire Circumferential Esophageal Endoscopic Submucosal Dissection Stricture.","authors":"Daisuke Azuma, Kingo Hirasawa, Reo Atsusaka, Yuichiro Ozeki, Atsushi Sawada, Masafumi Nishio, Ryosuke Kobayashi, Chiko Sato, Shin Maeda","doi":"10.1159/000543846","DOIUrl":"10.1159/000543846","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Endoscopic submucosal dissection (ESD) has become a widely adopted treatment for early esophageal cancer. However, extensive mucosal defects resulting from ESD pose a significant risk of post-procedural strictures. Despite efforts to prevent strictures through various means, including steroid administration, they remain a challenge, significantly impacting patients' quality of life and healthcare costs. Thus, identifying risk factors for refractory strictures following entire circumferential esophageal ESD (EC-E-ESD) is imperative.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between July 2013 and September 2023, 49 patients who underwent EC-E-ESD were retrospectively analyzed. Patients were classified based on the presence of refractory or non-refractory strictures. A refractory stricture was defined as requiring six or more endoscopic balloon dilation procedures before stricture improvement. Clinicopathological features and outcomes were examined using multivariate logistic regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Refractory strictures were observed in 51% of patients. A comparison showed that the refractory group had a significantly higher percentage of muscular injury (52% vs. 8%, p = 0.002) and mucosal defect length ≥50 mm (68% vs. 37%, p = 0.047) than the non-refractory group. Multivariate analysis showed that muscular injury (odds ratio 16.2; 95% confidence interval: 2.04-129.1) was an independent risk factor for refractory strictures after EC-E-ESD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Muscular injury during EC-E-ESD is a risk factor for refractory strictures. Strategies to prevent injury, such as meticulous dissection techniques and effective steroid administration, may mitigate this risk. However, current prophylactic measures are inadequate, highlighting the need for further research into preventive strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Endoscopic submucosal dissection (ESD) has become a widely adopted treatment for early esophageal cancer. However, extensive mucosal defects resulting from ESD pose a significant risk of post-procedural strictures. Despite efforts to prevent strictures through various means, including steroid administration, they remain a challenge, significantly impacting patients' quality of life and healthcare costs. Thus, identifying risk factors for refractory strictures following entire circumferential esophageal ESD (EC-E-ESD) is imperative.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between July 2013 and September 2023, 49 patients who underwent EC-E-ESD were retrospectively analyzed. Patients were classified based on the presence of refractory or non-refractory strictures. A refractory stricture was defined as requiring six or more endoscopic balloon dilation procedures before stricture improvement. Clinicopathological features and outcomes were examined using multivariate logistic regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Refractory strictures were observed in 51% of ","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"125-134"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122379","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":"Helicobacter pylori Infection Is Not Associated with Nonalcoholic Fatty Liver Disease: A Two-Year Cohort Study.","authors":"Huabo Zheng, Tangmeng Guo, Xiaofang Zhao, Kun Wang, Shengshuai Shan, Songpu Xie, Yichen Xu, Chengyun Liu, Weilin Lu","doi":"10.1159/000542180","DOIUrl":"10.1159/000542180","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies reported inconsistent results of the association between Helicobacter pylori infection and nonalcoholic fatty liver disease (NAFLD).</p><p><strong>Methods: </strong>A cohort study of 2,063 adults without NAFLD at baseline, who participated in a repeated health checkup including a 13C-urea breath test and abdominal ultrasonography, was conducted to evaluate the link between H. pylori infection and NAFLD development.</p><p><strong>Results: </strong>During a mean follow-up period of 1.7 years, we did not find a significant association between H. pylori infection and NAFLD (hazard ratio = 1.10 (0.86, 1.40), p = 0.4689). We also found that higher age, body mass index (BMI), systolic blood pressure (systolic BP), diastolic blood pressure (diastolic BP), fasting blood glucose, triglycerides, total cholesterol, low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were risk factors, and high-density lipoprotein cholesterol (HDL-C) was a protective factor for NAFLD development.</p><p><strong>Conclusion: </strong>H. pylori infection might not be positively related to NAFLD development.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"75-83"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575596","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":"Comparison of Genetic Mutations of Gastric Cancer Diagnosed before or after Helicobacter pylori Eradication and between Differentiated and Undifferentiated Types Using Next-Generation Sequencing.","authors":"Masaaki Kodama, Manami Oda, Kazuhiro Mizukami, Ryo Ogawa, Yuka Hirashita, Masahide Fukuda, Kazuhisa Okamoto, Kensuke Fukuda, Takafumi Fuchino, Sotaro Ozaka, Tadayoshi Okimoto, Hisanori Abe, Kazumi Inaba, Masanori Tokoro, Keiko Arita, Hidefumi Nishikiori, Takashi Abe, Takayuki Nagai, Satoshi Yamashita, Kazunari Murakami","doi":"10.1159/000543645","DOIUrl":"10.1159/000543645","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Genetic abnormalities specific to post-Helicobacter pylori eradication gastric cancer (GC), especially those associated with undifferentiated post-eradication GC, are unknown. We conducted next-generation sequencing of GC diagnosed either before or after eradication to investigate the carcinogenesis of post-eradication GC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Five cases of post-eradication differentiated GC [HP(-)-D group], five cases of H. pylori-positive differentiated GC [HP(+)-D group], four cases of post-eradication undifferentiated GC [HP(-)-U group], and six cases of H. pylori-positive undifferentiated GC [HP(+)-U group] underwent analysis. DNA was extracted from tumor samples, and non-tumor samples of all subjects. Next-generation target sequencing was conducted using the Ion AmpliSeq Library Kit 2.0 with the Ion AmpliSeq Cancer Hotspot Panel v2. Next-generation targeted sequencing results of the cancer part were subtracted from the results of the non-cancer part.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The HP(-)-D group displayed significantly fewer SNPs in hotspot than the other groups (p &lt; 0.01). Definitive DNA mutations were identified by sequencing of cancerous and non-cancerous tissues. 5 of 20 patients had specific somatic mutations, with different TP53 mutations in the HP(+)-D and HP(-)-U groups, CTNNB1 mutations in the HP(+)-U group, and ATM mutations in the HP(+)-U group, but no mutations in the HP(-)-D group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Several definite genetic mutations involved in GC were observed. Mutations were less frequent in post-eradication differentiated GC. However, because of small number of cases analyzed to identify carcinogenic differences, further analysis with a large number of cases and with strictly grading GC samples is needed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Genetic abnormalities specific to post-Helicobacter pylori eradication gastric cancer (GC), especially those associated with undifferentiated post-eradication GC, are unknown. We conducted next-generation sequencing of GC diagnosed either before or after eradication to investigate the carcinogenesis of post-eradication GC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Five cases of post-eradication differentiated GC [HP(-)-D group], five cases of H. pylori-positive differentiated GC [HP(+)-D group], four cases of post-eradication undifferentiated GC [HP(-)-U group], and six cases of H. pylori-positive undifferentiated GC [HP(+)-U group] underwent analysis. DNA was extracted from tumor samples, and non-tumor samples of all subjects. Next-generation target sequencing was conducted using the Ion AmpliSeq Library Kit 2.0 with the Ion AmpliSeq Cancer Hotspot Panel v2. Next-generation targeted sequencing results of the cancer part were subtracted from the results of the non-cancer part.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The HP(-)-D group displayed significantly fewer SNPs in hotspot than the other groups (p &lt; 0.01). Definitive DNA mutations we","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"158-169"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11965840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002032","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":"Prevalence and Endoscopic Features of Colorectal Non-Polypoid Lesions: A Single-Center Retrospective Study from a Large Cohort of Fecal Immunochemical Test-Positive Screening Patients in Northern Italy.","authors":"Alessandro Pezzoli, Francesco Buttitta, Caterina Palmonari, Marzia Simoni, Chiara Pierantoni, Alberto Merighi, Luigi Ricciardiello","doi":"10.1159/000543307","DOIUrl":"10.1159/000543307","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal non-polypoid lesions (NPLs) are flat, hard-to-detect, and mainly right-sided lesions. We aimed to assess the prevalence and endoscopic features of NPL lesions in a large cohort of screening patients in Northern Italy.</p><p><strong>Methods: </strong>Fecal immunochemical test (FIT)-positive subjects between 50 and 69 years old who had undergone at least a screening colonoscopy from March 2005 to December 2017 at the Endoscopy Unit of Ferrara were included. We selected only non-diminutive (>5 mm) and neoplastic polyps (i.e., adenomas, serrated adenomas, and carcinomas). Patients' demographics and polyps' endoscopic-histopathological data were collected. Categorical variables were compared using the Pearson's χ2 test and Fisher's exact test, while odd ratios and confidence intervals were estimated with univariate analysis.</p><p><strong>Results: </strong>A total of 6,676 FIT-positive subjects underwent 7,616 colonoscopies during the study period. Total lesions were 3,231, of which 133 were NPLs and among these 123 were neoplastic. The prevalence of NPLs among total lesions was 4.1%, while prevalence of neoplastic NPLs among total neoplastic lesions was 4.6%. The prevalence of NPLs and neoplastic NPLs among total colonoscopies was 1.7% and 1.6%, respectively. Neoplastic NPLs were more frequent between 60 and 64 years old (p = 0.03) and associated with other colonic polyps in subjects older than 60 years (p = 0.016). Cancerized NPLs were more likely in younger patients (50-59 years old, p = 0.04).</p><p><strong>Conclusions: </strong>Prevalence of NPLs is low among the screening population, but NPLs are frequently associated with other colorectal polyps in patients older than 60 years and carry a higher risk of cancer in patients younger than 60 years old.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"235-245"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001996","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":"Disease Progression for Histologic Diagnosis of Metabolic Dysfunction-Associated Steatotic Liver Disease in the Real-World: A Nationwide US Study.","authors":"Xinrong Zhang, Leslie Yeeman Kam, Scott D Barnett, Linda Henry, Ramsey Cheung, Mindie H Nguyen","doi":"10.1159/000541945","DOIUrl":"10.1159/000541945","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;We compared clinical characteristics and outcomes in real-world metabolic dysfunction-associated steatotic liver disease (MASLD) patients with or without liver biopsy using a nationwide cohort in United States (USA) to fill in gaps in selection of biopsy patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective cohort study of adult MASLD patients using Marketscan® Databases (1/2007-12/2021). Patients were categorized into those with or without liver biopsy during follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We analyzed 540,326 MASLD patients: 23,732 with and 516,594 without biopsy. Only 4% of MASLD patients received liver biopsy and biopsy rate decreased in the last 5 years (9.4%-3.6%). After 1:5 propensity score matching on baseline characteristics including age, sex, and comorbidities, a total of 23,731 patients with biopsy and 118,396 matched patients without biopsy were analyzed. The incidence per 1,000 person-years for hepatocellular carcinoma (HCC) was 0.22 versus 2.18, cirrhosis 29.75 versus 90.44, and hepatic decompensation 15.84 versus 28.25 compared patients with and without biopsy. In multivariable analysis, patients with biopsy had more than 9 times higher risk of developing HCC, 3 times higher risk of cirrhosis, and 78% higher risk of hepatic decompensation. In subgroup analysis, the association remained consistent when stratified by age (&lt;50 and ≥50), sex, and diabetes mellitus. Predictors of having biopsy included age, metabolic diseases, and living in North central or Northeast of USA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These data can inform clinical patient management that biopsy patients likely represent a selected group at higher risk for disease progression, especially in clinical trials for MASLD therapies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;We compared clinical characteristics and outcomes in real-world metabolic dysfunction-associated steatotic liver disease (MASLD) patients with or without liver biopsy using a nationwide cohort in United States (USA) to fill in gaps in selection of biopsy patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective cohort study of adult MASLD patients using Marketscan® Databases (1/2007-12/2021). Patients were categorized into those with or without liver biopsy during follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We analyzed 540,326 MASLD patients: 23,732 with and 516,594 without biopsy. Only 4% of MASLD patients received liver biopsy and biopsy rate decreased in the last 5 years (9.4%-3.6%). After 1:5 propensity score matching on baseline characteristics including age, sex, and comorbidities, a total of 23,731 patients with biopsy and 118,396 matched patients without biopsy were analyzed. The incidence per 1,000 person-years for hepatocellular carcinoma (HCC) was 0.22 versus 2.18, cirrhosis 29.75 versus 90.44, and hepatic decompensation 15.84 versus 28.25 compared patients with and without biopsy. In multivariable analysis, patients w","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"36-45"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460444","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}