Digestion最新文献

{"title":"Cost-Effectiveness Analysis of Endoscopic Treatment versus Medication Strategy for Proton Pump Inhibitor-Refractory Gastroesophageal Reflux Disease.","authors":"Fumiaki Ishibashi, Sho Suzuki, Kentaro Mochida, Takao Tonishi, Yuichi Ishibashi","doi":"10.1159/000543365","DOIUrl":"10.1159/000543365","url":null,"abstract":"<p><strong>Introduction: </strong>Potassium-competitive acid blockers are effective against proton pump inhibitor-refractory gastroesophageal reflux disease; however, their long-term use is associated with economic disadvantages. Endoscopic procedures may reduce potassium-competitive acid blocker use. This study aimed to determine the optimal treatment strategy for patients with proton pump inhibitor-refractory gastroesophageal reflux disease from a cost-effectiveness perspective.</p><p><strong>Methods: </strong>Using a Markov state transition model to simulate symptom changes in patients with proton pump inhibitor-refractory gastroesophageal reflux disease, the cost-effectiveness of two strategies was compared: endoscopic treatment (anti-reflux mucosectomy or endoscopic submucosal dissection for gastroesophageal reflux disease) followed by potassium-competitive acid blocker versus medication with high-dose potassium-competitive acid blocker. In both strategies, potassium-competitive acid blocker maintained symptoms at the lowest controllable dose. The time horizon varied from 10 to 50 years. The quality-adjusted life year and incremental cost-effectiveness ratio were calculated. Willingness to pay was set at 5,000,000 Japanese yen.</p><p><strong>Results: </strong>The quality-adjusted life years gained were 0.90 and 0.95 for the endoscopic treatment and medication strategies, respectively. The incremental cost-effectiveness ratio varied with the follow-up period after the initial treatment, with the endoscopic treatment strategy being more cost-effective than the medication strategy at ≥50 years of follow-up. A dose reduction success rate of <84.1% for high-dose potassium-competitive acid blocker and an endoscopic treatment success rate of >66.8% were required to determine the superiority of the endoscopic treatment strategy at the 50-year follow-up after treatment.</p><p><strong>Conclusions: </strong>The endoscopic treatment strategy is not cost-effective unless the patient is followed up for >50 years after the initial treatment.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"277-286"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Questionnaire Survey on the Diagnosis and Treatments of Eosinophilic Gastrointestinal Diseases in Asia.","authors":"Yoshikazu Tsuzuki, Akiko Shiotani, Kazuya Miyaguchi, Shouko Ono, Yutaka Saito, Mitsushige Sugimoto, Yuji Naito, Sachiyo Nomura, Osamu Handa, Tadakazu Hisamatsu, Mitsuhiro Fujishiro, Takahisa Matsuda, Yoshinori Morita, Naohisa Yahagi, Francis K L Chan, Tiing Leong Ang, Murdani Abdullah, Maria Carla Tablante, Varayu Prachayakul, Baiwen Li, Hwoon-Yong Jung, Hisashi Matsumoto, Rie Shiomi, Hiroyuki Imaeda","doi":"10.1159/000544725","DOIUrl":"10.1159/000544725","url":null,"abstract":"<p><strong>Introduction: </strong>Eosinophilic gastrointestinal disease (EGID) is divided into eosinophilic esophagitis (EoE) and non-eosinophilic esophagitis eosinophilic gastrointestinal disease (non-EoE-EGID), based on the involved gastrointestinal organs. The present survey was performed to provide an overview of the current status of the epidemiology, diagnosis, and treatment of EGID in Asia.</p><p><strong>Methods: </strong>Responses to the questionnaire were obtained from 228 doctors at various institutions in eight Asian countries. The questionnaire consisted of 52 questions on EoE and non-EoE EGID.</p><p><strong>Results: </strong>Responses to questionnaire were obtained from 228 doctors from eight countries. The most common participation facilities were university hospitals, followed by public hospitals, private hospitals, and private clinics. 1-10 were the most frequent patients per year in each institution for both EoE and non-EoE-EGID. The 30s and 40s are common age groups for both EoE and non-EoE-EGID. Although endoscopic findings vary among countries, 15 or more eosinophil infiltrations in high-power fields as a diagnostic criterion are used in all countries for EoE. As treatments, the prescription rates of Proton pump inhibitor, diet, topical and systemic steroids, and biologics were similar among the eight countries in EoE. Non-EoE-EGID showed a similar trend to EoE in epidemiology, symptoms, diagnosis, and treatment.</p><p><strong>Conclusion: </strong>The questionnaire survey partially revealed the current status of the epidemiology, symptoms, diagnosis, and treatment of EGID in Asian countries.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"153-164"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibitory Effects of Probiotic and Gastro-Intestinal Bacteria on Helicobacter pylori in vitro.","authors":"Johannes Raphael Westphal, Nadine Koch, Lukas Macke, Riccardo Vasapolli, Didem Saka, Ramiro Vilchez-Vargas, Tianjun Song, Peter Malfertheiner, Christian Schulz","doi":"10.1159/000543447","DOIUrl":"10.1159/000543447","url":null,"abstract":"<p><strong>Introduction: </strong>Helicobacter pylori is a highly prevalent pathogen affecting approximately 50% of the world population, causing chronic gastritis and subsequently adenocarcinoma. Antibiotic resistance rates in H. pylori are increasing, thus demanding alternative treatment options. Some beneficial bacteria, including probiotics and gastrointestinal commensals, were shown to inhibit H. pylori growth, viability, and initial attachment to the gastric epithelium.</p><p><strong>Methods: </strong>In this review, we systematically summarized the currently available literature for in vitro inhibition of H. pylori through beneficial bacteria from the Lactobacillales order. We performed research on PubMed and Google Scholar in accordance with the PRISMA guidelines.</p><p><strong>Results: </strong>A multitude of species were shown to possess anti-H. pylori activity, although the majority of investigated bacteria belonged to only one bacterial genus: Lactobacillus. Anti-H. pylori activity was mediated through transcriptional modulation of virulence factors, competition for binding sites, the induction of a dormancy state of H. pylori, and the secretion of anti-H. pylori compounds.</p><p><strong>Conclusion: </strong>Many bacterial compounds that show probiotic properties are capable of inhibiting H. pylori in in vitro experiments. However, a huge variety of test methods to detect anti-H. pylori effects demands standardization.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"349-364"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between Serum Insulin-Like Growth Factor-Related Molecules and Colorectal Cancer Risk by Tumor Location: A Nested Case-Control Study.","authors":"Yasushi Adachi, Yasushi Adachi, Masanori Nojima, Yingsong Lin, Yasushi Sasaki, Hiro-O Yamano, Hiroshi Nakase, Kenji Wakai, Mitsuru Mori, Akiko Tamakoshi","doi":"10.1159/000545457","DOIUrl":"10.1159/000545457","url":null,"abstract":"<p><strong>Introduction: </strong>The activity of the mitogen insulin-like growth factor (IGF) is controlled by IGF-binding protein (IGFBP). Colorectal cancers (CRCs) are heterogeneous, with left- and right-sided CRCs, showing different clinical and molecular characteristics. This case-control study, nested in the Japan Collaborative Cohort study, assessed associations between serum levels of IGF-related molecules and incidences of CRC by location.</p><p><strong>Methods: </strong>A baseline survey obtained serum samples from 39,242 participants. Subjects diagnosed with CRC during follow-up were regarded as cases. Conditional logistic regression modeling was used to calculate odds ratios (ORs) for cancer incidence associated with IGF-related molecules.</p><p><strong>Results: </strong>This analysis included 176 cases and 524 controls. No IGF-related molecules appeared associated with risks of overall or left-sided CRC. Both total IGFBP3 and free IGFBP3 (estimated as IGFBP3 - [IGF1 + IGF2]) were associated with incidence of right-sided CRC (p for trends = 0.027 and 0.003, respectively), with the third tertile of total and free IGFBP3 showing the highest risk (OR = 6.25 and 7.96, respectively). Free IGF, estimated as (IGF1 + IGF2)/IGFBP3, was inversely associated with incidence of right-sided CRC (p for trends = 0.014), with the third tertile showing the lowest risk (OR = 0.18). Among subjects followed for over 3 years, the association of IGF-related molecules with overall CRC was similar. Free IGFBP3 was associated with the incidence of right-sided CRC (p for trends = 0.004). Free IGF was inversely associated with the incidence of right-sided CRC (p for trends = 0.002). However, free IGFs were associated with a risk of left-sided CRC (p for trends = 0.041), with the third tertile showing the highest risk (OR = 3.10).</p><p><strong>Conclusions: </strong>Serum IGF-related molecules are associated with the risk of CRC. These associations might differ by tumor location.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"450-461"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-Kit Immunohistochemical Expression as a Complementary Method to Assess Mast Cell Density in Helicobacter pylori-Mediated Gastritis.","authors":"Ava T Ismael, Rafal A Abdulhameed, Bushra A Hamdi, Rawaz D Tawfeeq, Aram Ommar","doi":"10.1159/000541387","DOIUrl":"10.1159/000541387","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic gastritis is a group of conditions commonly characterized by stomach lining inflammation. The study aimed to investigate the clinical and pathological aspects that play a role in its development. Additionally, the study examines the use of CD117 as an immunohistochemistry marker in evaluating mast cell density (MCD).</p><p><strong>Methods: </strong>This retrospective, cross-sectional study was conducted in Iraqi Kurdistan with a sample size of 380 patients. Patient data included gastritis type, neutrophil infiltration severity, mononuclear cell infiltration within the lamina propria, intestinal metaplasia, and glandular atrophy, which were categorized and given a score. The CD117 level was identified using an anti-human rabbit polyclonal antibody.</p><p><strong>Results: </strong>A statistically significant association was revealed between Helicobacter pylori-mediated gastritis and non-specific gastritis with age, activity, H. pylori and MCD, dysplasia, and malignancy. Meanwhile, no association was found with gender, inflammatory infiltrate, intestinal metaplasia, and glandular atrophy. C-Kit exhibited a marked increase in MCD in patients with H. pylori-mediated gastritis, intestinal metaplasia, atrophy, and gastric carcinoma. However, a significant decrease in MCD was observed on repeating endoscopy evaluations for patients after treatment.</p><p><strong>Conclusion: </strong>Regions that exhibit severe inflammation, metaplasia, atrophy, and carcinoma demonstrated an increase in MCD with H. pylori-mediated gastritis. A detailed investigation in clinical practice to screen early diagnosis and treatment needs to be performed in high H. pylori prevalence.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"23-29"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NEIL3 Upregulated by TFAP2A Promotes M2 Polarization of Macrophages in Liver Cancer via the Mediation of Glutamine Metabolism.","authors":"Fabiao Zhang, Binfeng Wang, Wenlong Zhang, Yongfu Xu, Caiming Zhang, Xiangyang Xue","doi":"10.1159/000540804","DOIUrl":"10.1159/000540804","url":null,"abstract":"<p><strong>Introduction: </strong>Tumor-associated macrophages, which are part of the tumor microenvironment, are a major factor in cancer progression. However, a complete understanding of the regulatory mechanism of M2 polarization of macrophages (Mø) in liver cancer is yet to be established. This study aimed to investigate the potential mechanism by which NEIL3 influenced M2 Mø polarization in liver cancer.</p><p><strong>Methods: </strong>Bioinformatics analysis analyzed NEIL3 expression and its enriched pathways in liver cancer tissue, as well as its correlation with pathway genes. The upstream transcription factor of NEIL3, TFAP2A, was predicted and its expression in liver cancer tissue was analyzed. The binding relationship between the two was analyzed by dual-luciferase reporter and chromatin immunoprecipitation experiments. qRT-PCR assessed NEIL3 and TFAP2A levels in liver cancer cells. Cell viability was detected by CCK-8, while CD206 and CD86 expression was detected by immunofluorescence. IL-10 and CCR2 expressions were assessed using qRT-PCR, and M2 Mø quantity was detected using flow cytometry. Reagent kits tested glutamine (Gln) consumption, α-ketoglutarate, and glutamate content, as well as NADPH/NADP+ and GSH/GSSG ratios. Expression of Gln transport proteins was detected using Western blot. An animal model was established to investigate the influence of NEIL3 expression on liver cancer growth.</p><p><strong>Results: </strong>NEIL3 was highly expressed in liver cancer and promoted Mø M2 polarization through Gln metabolism. TFAP2A was identified as the upstream transcription factor of NEIL3 and was highly expressed in liver cancer. Rescue experiments presented that overexpression of NEIL3 reversed the suppressive effect of TFAP2A knockdown on Mø M2 polarization in liver cancer. In vivo experiments demonstrated that the knockdown of NEIL3 could significantly repress the growth of xenograft tumors.</p><p><strong>Conclusion: </strong>This study suggested that the TFAP2A/NEIL3 axis promoted Mø M2 polarization through Gln metabolism, providing a theoretical basis for immune therapy targeting the liver cancer TME.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"30-44"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-Based Clinical Guidelines for Chronic Constipation 2023.","authors":"Eikichi Ihara, Noriaki Manabe, Hidenori Ohkubo, Naotaka Ogasawara, Haruei Ogino, Kazuki Kakimoto, Motoyori Kanazawa, Hidejiro Kawahara, Chika Kusano, Shiko Kuribayashi, Akinari Sawada, Tomohisa Takagi, Shota Takano, Toshihiko Tomita, Toshihiro Noake, Mariko Hojo, Ryota Hokari, Tatsuhiro Masaoka, Tomohiko Machida, Noboru Misawa, Yoshiyuki Mishima, Hiroshi Yajima, Sayuri Yamamoto, Hiroshi Yamawaki, Tatsuya Abe, Yasumi Araki, Kunio Kasugai, Takeshi Kamiya, Akira Torii, Atsushi Nakajima, Koji Nakada, Shin Fukudo, Yasuhiro Fujiwara, Hiroto Miwa, Hiromi Kataoka, Akihito Nagahara, Kazuhide Higuchi","doi":"10.1159/000540912","DOIUrl":"10.1159/000540912","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The Japan Gastroenterological Association published the first version of its clinical guidelines for chronic constipation 2023. Based on the latest evidence, these guidelines describe the definition, classification, diagnostic criteria, diagnostic testing methods, epidemiology, pathophysiology, and treatment of chronic constipation. They include flowcharts for both diagnosis and treatment of chronic constipation. In the treatment of chronic constipation, the first step involves differentiating between secondary forms, such as organic disease-associated constipation, systemic disease-associated constipation, and drug-induced constipation. The next step is to determine whether the chronic constipation stems from a motility disorder, a form of primary chronic constipation. For functional constipation and constipation-predominant irritable bowel syndrome, treatment should be initiated after evaluating symptoms like reduced bowel movement frequency type or defecation difficulty type. The first line of treatment includes the improvement of lifestyle habits and diet therapy. The first drugs to consider for oral treatment are osmotic laxatives. If these are ineffective, secretagogues and ileal bile acid transporter inhibitors are candidates. However, stimulant laxatives are exclusively designated for as-needed use. Probiotics, bulk-forming laxatives, prokinetics, and Kampo medicines, for which there is insufficient evidence, are considered alternative or complementary therapy. Providing the best clinical strategies for chronic constipation therapy in Japan, these clinical guidelines for chronic constipation 2023 should prove useful for its treatment worldwide. The Japan Gastroenterological Association published the first version of its clinical guidelines for chronic constipation 2023. Based on the latest evidence, these guidelines describe the definition, classification, diagnostic criteria, diagnostic testing methods, epidemiology, pathophysiology, and treatment of chronic constipation. They include flowcharts for both diagnosis and treatment of chronic constipation. In the treatment of chronic constipation, the first step involves differentiating between secondary forms, such as organic disease-associated constipation, systemic disease-associated constipation, and drug-induced constipation. The next step is to determine whether the chronic constipation stems from a motility disorder, a form of primary chronic constipation. For functional constipation and constipation-predominant irritable bowel syndrome, treatment should be initiated after evaluating symptoms like reduced bowel movement frequency type or defecation difficulty type. The first line of treatment includes the improvement of lifestyle habits and diet therapy. The first drugs to consider for oral treatment are osmotic laxatives. If these are ineffective, secretagogues and ileal bile acid transporter inhibitors are candidates. However, stimulant laxatives are exclusively designated for","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"62-89"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Akkermansia muciniphila and Its Extracellular Vesicles Affect Endocannabinoid System in in vitro Model.","authors":"Pegah Noori, Fattah Sotoodehnejadnematalahi, Pooneh Rahimi, Seyed Davar Siadat","doi":"10.1159/000543446","DOIUrl":"10.1159/000543446","url":null,"abstract":"<p><strong>Introduction: </strong>Recent studies indicate that the gut microbiota controls the host's immune system. Probiotics use different signaling pathways to regulate intestinal permeability, barrier integrity, and energy balance.</p><p><strong>Methods: </strong>This research examined how Akkermansia muciniphila and its extracellular vesicles (EVs) impact inflammation and genes related to the endocannabinoid system in the STC-1 cell line through RT-PCR and ELISA assays.</p><p><strong>Results: </strong>The study's results indicated that EVs had a significant impact on GLP-1 expression compared to the multiplicity of infections (MOI) ratio. Notably, there was a substantial increase in the expression of PYY and GLP-1 genes across all treatments (p < 0.05). Conversely, the expression of CB-1, CB-2, and FAAH genes notably decreased in the STC-1 cell line when treated with MOI 50 of A. muciniphila and an EV concentration of 100 μg/mL (p < 0.05). Both MOI 50 of A. muciniphila and an EV concentration of 100 μg/mL significantly enhanced the expression of the TLR-2 gene. In contrast, EVs at a concentration of 100 μg/mL substantially reduced TLR-4 gene expression. A. muciniphila-derived EVs notably decreased the levels of inflammatory cytokines (TNF-α and IL-6), while increasing IL-10 expression at MOI 100 and an EV concentration of 100 μg/mL. These findings suggest that A. muciniphila and its EVs could regulate the expression of specific genes, serving as targets for maintaining host energy balance.</p><p><strong>Conclusions: </strong>In summary, this study illustrates that A. muciniphila-derived EVs exhibit anti-inflammatory properties and have the potential to modulate gene expression in cases of obesity and gastrointestinal tract inflammation.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"338-348"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic and Clinicopathological Features of a Colorectal Mucin-Rich Variant of Traditional Serrated Adenoma.","authors":"Eiji Kamba, Takashi Murakami, Naoki Tsugawa, Yudai Otsuki, Kei Nomura, Yuichiro Kadomatsu, Hirofumi Fukushima, Tsuyoshi Saito, Tomoyoshi Shibuya, Takashi Yao, Akihito Nagahara","doi":"10.1159/000543700","DOIUrl":"10.1159/000543700","url":null,"abstract":"<p><strong>Introduction: </strong>The mucin-rich variant of traditional serrated adenoma (MR-TSA), pathologically defined by the presence of goblet cells comprising over 50% of the lesion compared to the absorptive epithelial eosinophilic cytoplasm, was recently introduced as one morphological variants of traditional serrated adenoma (TSA). This study aimed to characterize the endoscopic and clinicopathological characteristics of MR-TSAs.</p><p><strong>Methods: </strong>Lesions pathologically diagnosed as TSAs at our hospital between 2011 and 2023 were reviewed. We analyzed the endoscopic and clinicopathological features of 49 MR-TSAs and 236 conventional TSAs (C-TSAs). Furthermore, immunohistochemical and genetic analyses were performed to ensure that there were no discrepancies with our previous study.</p><p><strong>Results: </strong>MR-TSAs, like C-TSAs, were often located in the sigmoid colon and rectum, with no significant difference in lesion size. Macroscopically, MR-TSAs frequently appeared as type 0-Is with a weak reddish color and had a mucous cap, less often exhibiting a pinecone-like or coral-shaped appearance compared to C-TSAs (p < 0.001). Magnifying endoscopy showed expanded crypt openings in 80% of MR-TSAs (p < 0.001). Both groups had similar IIIH and IVH pit patterns. Immunohistochemical analysis revealed that MUC5AC was expressed more frequently in MR-TSAs than in C-TSAs. Additionally, genetic analysis showed that MR-TSAs more frequently harbored the BRAF mutation than C-TSAs (p < 0.001), whereas MR-TSAs less frequently harbored the KRAS mutation than C-TSAs (p = 0.047).</p><p><strong>Conclusion: </strong>MR-TSAs, frequently harboring the BRAF but not KRAS mutation, exhibited several distinct endoscopic findings, including a sessile morphology, lack of pinecone-like or coral-like appearance, weak reddish color, and mucous cap.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"314-326"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Anti-Parietal Cell Antibody Titer Measurement Kit for Diagnosis of Autoimmune Gastritis.","authors":"Masanori Ito, Masanori Ito, Yasuhiko Maruyama, Shuichi Terao, Kimaru Okubo, Kaori Hidaka, Tomotaka Sakamoto, Ken Haruma","doi":"10.1159/000545454","DOIUrl":"10.1159/000545454","url":null,"abstract":"<p><p><p>Introduction: Recent findings revealed that autoimmune gastritis (AIG) is not rare in Japan. Therefore, the accurate diagnosis of AIG is essential in upper gastrointestinal practice. Diagnostic criteria for AIG were established in 2023; however, the conventional fluorescent antibody (FA) method for anti-parietal cell antibody (APCA) titer measurements has low accuracy and is clinically problematic.</p><p><strong>Methods: </strong>We developed a latex agglutination (LA) method using a new human-derived antigen. Samples subjected to measurements were sera from AIG cases (127 cases, 49 males, average age 65.9 years) and control cases (129 cases, 81 males, average age 66.1 years) provided by the main facility and three affiliated facilities in Japan. APCA in whole serum was measured using the FA and LA methods.</p><p><strong>Results: </strong>The diagnostic ability of AIG using the FA method was as follows: sensitivity of 99.2%, specificity of 41.1%, and an overall agreement rate of 69.9%, with low specificity previously being reported. On the other hand, the new LA method had good diagnostic performance with a sensitivity of 93.7%, a specificity of 95.4%, and an overall agreement rate of 94.5%.</p><p><strong>Conclusion: </strong>We developed a new APCA measurement system that will contribute to the accurate diagnosis of AIG. The use of this measurement system in clinical practice will facilitate the diagnosis and treatment of AIG. </p>.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"462-468"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}