Digestion最新文献

{"title":"Impact of Helicobacter pylori on Immune Checkpoint Inhibition in Hepatocellular Carcinoma: A Multicenter Study.","authors":"Najib Ben Khaled, Christian Schulz, Marianna Alunni-Fabbroni, Kathrin Bronny, Leonie S Jochheim, Behnam Kalali, Osman Öcal, Max Seidensticker, Ignazio Piseddu, Stefan Enssle, Monika Karin, Julia S Schneider, Theresa Strasoldo-Graffemberg, Nadine Koch, Lukas Macke, Florian P Reiter, Christian M Lange, Yinghong Wang, Enrico N De Toni, Markus Gerhard, Julia Mayerle, Jens Ricke, Peter Malfertheiner","doi":"10.1159/000542847","DOIUrl":"10.1159/000542847","url":null,"abstract":"<p><strong>Introduction: </strong>Immunomodulating effects of Helicobacter pylori (H. pylori) have been shown to inhibit antitumor immunity. Resistance to immune checkpoint inhibitor (ICI)-based therapies is common among patients with hepatocellular carcinoma (HCC). This study aimed to assess the effect of H. pylori on the outcomes of ICI in patients with HCC.</p><p><strong>Methods: </strong>We conducted a multicenter study in patients with HCC across a broad range of treatments. Patients received either ICI-based combination regimens or sorafenib-based therapy. H. pylori serostatus and virulence factors were determined and correlated with overall survival (OS), progression-free survival (PFS), and safety across the treatment modalities.</p><p><strong>Results: </strong>180 patients with HCC were included; among these, 64 were treated with ICI-based regimen and 116 with sorafenib-based regimen. In patients treated with ICI, median OS was shorter in H. pylori-positive patients (10.9 months in H. pylori-positive vs. 18.3 months; p = 0.0384). H. pylori positivity was associated with a shorter PFS in ICI recipients (3.9 months vs. 6.8 months, p = 0.0499). In patients treated with sorafenib, median OS was not shorter among H. pylori-positive patients (13.4 months in H. pylori-positive vs. 10.6 months; p = 0.3353). Immune-related adverse events and rates of gastrointestinal bleeding were comparable between H. pylori-positive and -negative patients.</p><p><strong>Conclusion: </strong>H. pylori seropositivity was linked to poorer outcomes in patients with HCC treated with ICI. This association was not observed among patients receiving sorafenib-based therapies.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"303-313"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457030","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":"Association between Microbiome Dysbiosis and Postoperative Disorders before and after Gastrectomy.","authors":"Tadashi Fujii, Tsuyoshi Tanaka, Tadashi Fujii, Hideaki Takahashi, Kento Kuramitsu, Kohei Funasaka, Eizaburo Ohno, Shingo Akimoto, Masaya Nakauchi, Susumu Shibasaki, Ichiro Uyama, Yoshiki Hirooka, Koichi Suda, Takumi Tochio","doi":"10.1159/000545678","DOIUrl":"10.1159/000545678","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrectomy considerably affects the gut microbiome; however, the association between dysbiosis and post-gastrectomy syndrome remains to be explored. This study prospectively explored fecal gut microbiota alterations following gastrectomy, investigating their potential association with weight loss.</p><p><strong>Methods: </strong>The gut microbiome of 21 patients with gastric cancer scheduled for gastrectomy in April-October 2022 was analyzed using 16S rRNA gene next-generation sequencing. Stool and blood samples were collected before and 3 months after gastrectomy. The microbiome profiles were compared to those of 85 healthy controls. Bacterial taxa demonstrating significant changes were determined using the linear discriminant analysis effect size algorithm and further analyzed for their relationship with weight loss in the gastrectomy cohort.</p><p><strong>Results: </strong>Postoperative complications (≥grade 2) were observed in 14.3% of patients. Postoperative weight loss was -10.9%, with the following breakdown: distal (-7.0%), total (-13.5%), and proximal (-14.0%) gastrectomy (p = 0.003). Microbiota analysis demonstrated a significant incline in the abundance of the Streptococcus salivarius group and a decline in Bacteroides uniformis in patients with gastric cancer compared to healthy controls. The S. salivarius group exhibited a further increase, while B. uniformis showed signs of recovery after gastrectomy. Additionally, 5α-reductase gene levels, reported to decrease as several cancers progress, were found to elevate post-surgery. Furthermore, patients experiencing greater weight loss showed a significant reduction in Faecalibacterium prausnitzii levels, while lower serum prealbumin and zinc levels were associated with the abundance of Escherichia coli.</p><p><strong>Conclusion: </strong>Gastrectomy significantly alters the gut microbiome. Supporting microbiome health with prebiotics may help alleviate postoperative issues and improve patients' quality of life.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"437-449"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985786","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":"Surveillance after Endoscopic Resection for Colorectal Tumors: A Comprehensive Review.","authors":"Kinichi Hotta, Takahisa Matsuda, Yasushi Sano, Takahiro Fujii, Yutaka Saito","doi":"10.1159/000542665","DOIUrl":"10.1159/000542665","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The goal of surveillance after the endoscopic resection of colorectal tumors is to reduce colorectal cancer (CRC) incidence and mortality. Considering the effective use of the limited endoscopic capacity and the cost of surveillance, it is desirable to develop a surveillance program that is as minimal as possible. In Europe (European Society of Gastrointestinal Endoscopy [ESGE]) and the USA (Multi-Society Task Force [MSTF]), after the results of the National Polyp Study (NPS) were established, guidelines were developed that stratified risk based on initial endoscopy, and surveillance programs for each risk group were proposed. More than 10 years later, the \"colonoscopy screening and surveillance guidelines\" were developed with the basic principle of \"aiming for zero CRC deaths during surveillance, bowel preservation, and emphasis on patient quality of life\" as the guideline principles in Japan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary: &lt;/strong&gt;Randomized controlled trials to evaluate the appropriate surveillance intervals after endoscopic resection of colorectal tumors, the NPS, the Nottingham Study, and the Japan Polyp Study (JPS), are summarized. The ESGE, USMSTF, and Japanese guidelines compared low-risk adenoma, high-risk adenoma, advanced neoplasia, piecemeal resection, and serrated lesions by category.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key messages: &lt;/strong&gt;Surveillance guidelines based on risk stratification were developed in Japan. Guidelines are meaningful only when they are effectively utilized in clinical practice. They must also be revised based on new evidence. It is hoped that new knowledge will be accumulated, especially in Japan, on topics that are currently lacking.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The goal of surveillance after the endoscopic resection of colorectal tumors is to reduce colorectal cancer (CRC) incidence and mortality. Considering the effective use of the limited endoscopic capacity and the cost of surveillance, it is desirable to develop a surveillance program that is as minimal as possible. In Europe (European Society of Gastrointestinal Endoscopy [ESGE]) and the USA (Multi-Society Task Force [MSTF]), after the results of the National Polyp Study (NPS) were established, guidelines were developed that stratified risk based on initial endoscopy, and surveillance programs for each risk group were proposed. More than 10 years later, the \"colonoscopy screening and surveillance guidelines\" were developed with the basic principle of \"aiming for zero CRC deaths during surveillance, bowel preservation, and emphasis on patient quality of life\" as the guideline principles in Japan.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary: &lt;/strong&gt;Randomized controlled trials to evaluate the appropriate surveillance intervals after endoscopic resection of colorectal tumors, the NPS, the Nottingham Study, and the Japan Polyp Study (JPS), are summarized. The ESGE, USMSTF, and Japanese guidelines compared low-risk adenoma, high-risk adenoma, advanced neoplasia, p","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"131-137"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686425","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":"New Progress in the Study of Pathogenesis of Alcoholic Pancreatitis.","authors":"Hanhui Li, Xiaoping Tan, Jie Li, Qing Zhang","doi":"10.1159/000542548","DOIUrl":"10.1159/000542548","url":null,"abstract":"<p><strong>Background: </strong>Alcoholic pancreatitis is a progressive condition characterized by susceptibility to recurrence, progression to chronic pancreatitis, complications, and high morbidity.</p><p><strong>Summary: </strong>The main causes include long-term alcoholism, excessive drinking, the toxic effects of alcohol metabolites, interactions with biliary diseases, and genetic factors. Alcohol is the second leading cause of acute pancreatitis (AP) in the USA, accounting for one-third of all AP cases. A follow-up study on readmission revealed that the readmission rate of alcoholic acute pancreatitis (AAP) patients within 11 months was 43.1%, of which men dominated the admissions and readmissions of AAP. Among this population, 82.3% have alcohol use disorder, over half have tobacco use disorders, 6.7% have tobacco use disorder, 4.5% have opioid use disorder, and 18.5% of patients exhibit signs of potential alcoholic chronic pancreatitis. Numerous animal and clinical studies suggest that alcohol alone does not cause pancreatitis; rather, additional factors such as smoking, endotoxin lipopolysaccharide (LPS), genetic mutations, or other genetic predispositions - are necessary for the disease's progression.</p><p><strong>Key messages: </strong>Given the high rates of admission and readmission for alcoholic pancreatitis, it is essential to further investigate its pathogenesis and pathological processes to develop more effective treatment strategies. Therefore, this paper summarizes the current understanding of the pathogenesis and treatment status of alcoholic pancreatitis, drawing on recently published literature and data to provide insights and references for future research and treatment efforts.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"212-226"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002057","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":"The Link between Metabolic Syndrome and the Brain.","authors":"Spyridon Zouridis, Ahmad Basil Nasir, Patricia Aspichueta, Wing-Kin Syn","doi":"10.1159/000541696","DOIUrl":"10.1159/000541696","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) is a cluster of cardiometabolic conditions that has been linked to high risk for cardiovascular disease, liver complications, and several malignancies. More recently, MetS has been associated with cognitive dysfunction.</p><p><strong>Summary: </strong>Studies have shown an association with minimal cognitive impairment, progression to vascular dementia, and even Alzheimer's disease. MetS components have been individually explored, and glucose intolerance has the strongest association with impairment in several cognitive domains. Several hypotheses have been proposed regarding the pathophysiology underlying the MetS-cognitive dysfunction association, and even though insulin resistance plays a major role, more studies are needed to elucidate this topic. Moreover, several other factors contributing to this association have been identified. Liver disease and more specifically metabolic dysfunction-associated steatotic liver disease can on its own contribute to cognitive decline through systemic inflammation and higher ammonia levels. Gut dysbiosis that has also been identified in MetS can also lead to cognitive impairment through several mechanisms that result in neurotoxicity. Finally, there are several other factors that may modify the MetS-cognitive dysfunction relationship, such as lifestyle, diet, education status, and age. More recently, circadian syndrome was explored and was found to be even more strongly associated with cognitive impairment.</p><p><strong>Key message: </strong>MetS is associated with cognitive decline. Certain cardiometabolic risk factors have a stronger association with cognitive impairment, and there are several factors that may modify this relationship. The aim of this review was to assess and summarize the existing body of evidence on the association between MetS and cognitive impairment and identify areas that necessitate further investigation.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"203-211"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380202","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":"Efficacy and Safety of Etrasimod in Patients with Ulcerative Colitis in Japan: Data from the Phase 3 ELEVATE UC 12 and ELEVATE UC 40 JAPAN Trials.","authors":"Ken Takeuchi, Tadakazu Hisamatsu, Hiroshi Nakase, Katsuyoshi Matsuoka, Michael Keating, Hirotoshi Yuasa, Motoki Oe, Shoko Arai, Rafal Mazur, Toshifumi Hibi","doi":"10.1159/000541383","DOIUrl":"10.1159/000541383","url":null,"abstract":"<p><strong>Introduction: </strong>Etrasimod is an oral, once-daily (QD), selective sphingosine 1-phosphate (S1P)1,4,5 receptor modulator for the treatment of moderately to severely active ulcerative colitis (UC). Here, we report the primary analysis of a phase 3 trial evaluating the efficacy and safety of etrasimod in patients from Japan with moderately to severely active UC.</p><p><strong>Methods: </strong>Patients from Japan who completed the 12-week ELEVATE UC 12 induction trial could enroll in the 40-week ELEVATE UC 40 JAPAN maintenance trial for a combined 52-week treatment period. Patients in this Japan cohort continued their baseline assigned treatment (etrasimod 2 mg QD or placebo) from ELEVATE UC 12. Efficacy was assessed at week 12 and week 52. Treatment-emergent adverse events (TEAEs) pooled from both trials were assessed up to 52 weeks of exposure.</p><p><strong>Results: </strong>The Japan cohort comprised 32 and 16 patients who received etrasimod and placebo, respectively. A numerically greater proportion of patients who received etrasimod versus placebo achieved clinical remission at week 12 (etrasimod: 14.3%; placebo: 7.1%) and week 52 (etrasimod: 25.0%; placebo: 7.1%); a similar trend was observed for all key secondary efficacy endpoints. TEAEs occurred in 84.4% (27/32) and 62.5% (10/16) of patients who received etrasimod and placebo, respectively. No new safety signals were detected.</p><p><strong>Conclusion: </strong>In these induction and maintenance trials evaluating etrasimod in patients from Japan with UC, numerically higher proportions of patients who received etrasimod versus placebo achieved efficacy endpoints. Efficacy and safety findings were consistent with those from the global ELEVATE UC trial populations.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"167-175"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343671","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":"Deep Learning-Based Detection of Malignant Bile Duct Stenosis in Fluoroscopy Images of Endoscopic Retrograde Cholangiopancreatography.","authors":"Kien Vu Trung, Marcus Hollenbach, Gregory Patrick Veldhuizen, Oliver Lester Saldanha, Jakob Garbe, Jonas Rosendahl, Sebastian Krug, Patrick Michl, Jürgen Feisthammel, Thomas Karlas, Jochen Hampe, Albrecht Hoffmeister, Jakob Nikolas Kather","doi":"10.1159/000543049","DOIUrl":"10.1159/000543049","url":null,"abstract":"<p><strong>Introduction: </strong>The accurate distinction between benign and malignant biliary strictures (BSs) poses a significant challenge. Despite the use of bile duct biopsies and brush cytology via endoscopic retrograde cholangiopancreaticography (ERCP), the results remain suboptimal. Single-operator cholangioscopy can enhance the diagnostic yield in BS, but its limited availability and high costs are substantial barriers. Convolutional neural network-based systems may improve the diagnostic process and enhance reproducibility. Therefore, we assessed the feasibility of using deep learning to differentiate BS using fluoroscopy images during ERCP.</p><p><strong>Methods: </strong>We conducted a retrospective review of adult patients (n = 251) from three university centers in Germany (Leipzig, Dresden, Halle) who underwent ERCP. We developed and evaluated a deep learning-based model using fluoroscopy images. The performance of the classifier was evaluated by measuring the area under the receiver operating characteristic curve (AUROC), and we utilized saliency map analyses to understand the decision-making process of the model.</p><p><strong>Results: </strong>In cross-validation experiments, malignant BSs were detected with a mean AUROC of 0.89 ± 0.03. The test set of the Leipzig cohort demonstrated an AUROC of 0.90. In two independent external validation cohorts (Dresden, Halle), the deep learning-based classifier achieved an AUROC of 0.72 and 0.76, respectively. The artificial intelligence model's predictions identified plausible characteristics within the fluoroscopy images.</p><p><strong>Conclusion: </strong>By using a deep learning model, we were able to discriminate malignant BS from benign biliary conditions. The application of artificial intelligence enhances the diagnostic yield of malignant BS and should be validated in a prospective design.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"287-302"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827872","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":"Xiayuxue Decoction Plays an Antidevelopment Role in Hepatocellular Carcinoma through Intestinal-Hepatic Axis.","authors":"Xiaoyan Zeng, Ting Zhou, Liyuan Pei, Ya Chen, Xuejing Wang, Hongyu Fang, Xiaoyan Zeng, Xuefei Tian","doi":"10.1159/000543834","DOIUrl":"10.1159/000543834","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, the effect of \"intestinal-hepatic axis\" in tumorigenesis of hepatocellular carcinoma (HCC) has been paid more and more attention, and the imbalance of gut microbiota is closely related to the pathogenesis of HCC. The Xiayuxue decoction (XYXD) has inhibitory effect on hepatic fibrosis, but the effect of XYXD on HCC is not clear.</p><p><strong>Methods: </strong>We induced HCC mouse model by diethylnitrosamine and CCL4. HCC mice were treated with XYXD gavage. Hematoxylin-eosin staining was used to detect the pathological changes of liver tissue in mice. Immunohistochemistry was used to detect the level of Ki-67 in liver tumor and ZO-1 in colon tissue. The level of inflammatory factors in plasma, liver, and colon tissue of mice was detected by ELISA. The changes of macrophages and neutrophils in colorectal tissues of mice were counted by immunofluorescence. 16S sequencing was used to analyze the effect of XYXD treatment on gut microbiota of HCC mice.</p><p><strong>Results: </strong>Our study found that XYXD could inhibit the progress of HCC. XYXD upregulated the expression levels of ZO-1, occludin, and claudin in colon tissue to repair intestinal mucosal barrier. XYXD could alleviate the infiltration of intestinal immune cells in HCC mice by inhibiting the data of macrophages and neutrophils in colon tissue and downregulating SIgA level. XYXD also regulated the composition of intestinal microorganisms and improved the diversity of gut microbiota, thus affecting the progress of HCC.</p><p><strong>Conclusion: </strong>XYXD inhibits the progress of HCC by influencing gut microbiota to regulate intestinal and liver inflammation and intestinal immune response.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"380-394"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499709","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 Resection for Colorectal Tumors.","authors":"Yuichiro Hirai, Naoya Toyoshima, Yutaka Saito","doi":"10.1159/000541605","DOIUrl":"10.1159/000541605","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic resection techniques for colorectal tumors are constantly evolving with improvements.</p><p><strong>Summary: </strong>Over the past decade, there has been a paradigm shift toward cold polypectomy for the removal of small lesions (<10 mm), known as the \"cold revolution\". In recent years, underwater endoscopic mucosal resection (EMR) has emerged as an alternative to conventional EMR and has been gaining popularity for resection of intermediate and large-sized lesions (≥10 mm). Although colorectal endoscopic submucosal dissection (ESD) requires a high level of advanced skills, improvements in dissection techniques and devices have facilitated the procedure. In Japan, the safety and efficacy of ESD for resecting large lesions (≥20 mm) have been demonstrated in a large-scale, multicenter, prospective cohort study (CREATE-J). ESD is also being increasingly adopted in Western countries. As endoscopic resection continues to advance and include large and more complex defects, a variety of closure techniques and new devices are being developed. Meanwhile, the number of endoscopic resections for T1-colorectal cancer (T1-CRC), including those intended for total excisional biopsy, has been increasing owing to the aging population and improvements in endoscopic technique.</p><p><strong>Key messages: </strong>This review provides a broad summary of endoscopic resection for colorectal tumors including advancements in closure techniques and devices for mucosal defects, as well as the potential role of endoscopic resection for patients with T1-CRC.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"115-121"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575600","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":"The Interpretation of Magnifying Endoscopy for the Diagnosis of Colorectal Lesions.","authors":"Naohisa Yoshida, Ken Inoue, Elsayed Ghoneem, Yoshikazu Inagaki, Reo Kobayashi, Naoto Iwai, Osamu Dohi, Ryohei Hirose, Yoshito Itoh","doi":"10.1159/000543996","DOIUrl":"10.1159/000543996","url":null,"abstract":"<p><strong>Background: </strong>Accurate endoscopic diagnosis is crucial for determining the appropriate treatment strategy for colorectal lesions, which may include cold snare polypectomy, endoscopic mucosal resection, or endoscopic submucosal dissection.</p><p><strong>Summary: </strong>While white light imaging (WLI) serves as the basic and initial method for endoscopic diagnosis, additional techniques such as narrow band imaging (NBI), blue laser/light imaging (BLI), and magnified observation of pit patterns are necessary when WLI results are inconclusive. These advanced diagnostic methods enable precise differentiation of lesions such as adenoma, T1 cancer, and sessile serrated lesion. Furthermore, recent advancements in endoscopic systems have enhanced image clarity and detail, thereby improving diagnostic accuracy.</p><p><strong>Key messages: </strong>This review provides an in-depth discussion on how magnified endoscopy, utilizing the Japan NBI Expert Team (JNET) classification with NBI/BLI and pit pattern classification with chromoendoscopy, aids in the accurate diagnosis of colorectal lesions.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"107-114"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188489","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}