Digestive Diseases and Sciences最新文献

{"title":"Management of Gastric Leaks After Bariatric Surgery: Proposed Endoscopic Treatment Algorithm Based on 10-Year Experience.","authors":"Bülent Ödemiş, Kerem Kenarlı","doi":"10.1007/s10620-026-10149-8","DOIUrl":"10.1007/s10620-026-10149-8","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic treatment is the first-line approach for post-bariatric surgery leaks, but treatment algorithms are not standardized. This study aimed to evaluate the outcomes of an endoscopic treatment algorithm and to identify factors associated with clinical success and treatment duration.</p><p><strong>Methods: </strong>This retrospective study was conducted on 61 consecutive patients who underwent endoscopic treatment for post-bariatric surgery leaks between 2014 and 2024. Main endoscopic modalities included bariatric stents, over-the-scope clips (OTSC), cardiac septal occluder devices, endoscopic internal drainage and septotomy. The endoscopic treatment modality to be applied was determined with an algorithmic approach according to clinical condition, timing of presentation and fistula characteristics.</p><p><strong>Results: </strong>Endoscopic treatment was successful in 55 patients (90.2%). Of these, 33 (60%) were managed with a single modality: 14 with bariatric stent, 9 with OTSC, 6 with internal drainage, 3 with cardiac septal occluders, and 1 with septotomy. The remaining 22 patients (40%) required a combination of techniques. Procedure-related complications occurred in 12 patients (19.7%). Endoscopic intervention had failed in six (9.8%) patients. Unsuccessful cases had significantly larger self-limited cavity sizes (p = 0.009). The number of endoscopic sessions and treatment duration was positively correlated with self-limited cavity presence (r = 0.482, p < 0.001 and r = 0.352, p = 0.008) and use of internal drainage (r = 0.477, p < 0.001 and r = 0.479, p < 0.001).</p><p><strong>Conclusions: </strong>Endoscopic management of post-bariatric surgery leaks using an institutional multimodal treatment algorithm achieved high clinical success rates. Self-limited cavities were associated with treatment failure, whereas internal drainage was linked to prolonged treatment duration.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5777-5793"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663708","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":"Compartment-Specific Immunohistochemical Alterations Along the Colorectal Adenoma-Carcinoma Continuum.","authors":"Tevhide Bilgen Özcan, Evrim Erel, Esra Pasaoglu","doi":"10.1007/s10620-026-10184-5","DOIUrl":"10.1007/s10620-026-10184-5","url":null,"abstract":"<p><strong>Purpose: </strong>Colorectal cancer (CRC) progresses through the adenoma-carcinoma sequence, yet the contribution of tumor microenvironment (TME) alterations remains unclear. This study investigated whether the distribution of CD204-positive macrophages, COL11A1-positive stromal cells, and MFAP5 expression patterns differed across colorectal lesion categories and evaluated the diagnostic relevance of integrated TME biomarkers. Expression patterns of CD204, COL11A1, MFAP5, and p53 were analyzed across stages of CRC polyp progression.</p><p><strong>Methods: </strong>A total of 154 CRC lesions-low-grade dysplasia (LGD), high-grade dysplasia (HGD), adenomas with intramucosal carcinoma (IMC), and malignant polyps (MP)-were retrospectively examined. Immunohistochemistry assessed CD204-positive tumor-associated macrophages within lesions (iCD204) and in the perilesional TME (pCD204), COL11A1 (cancer-associated fibroblasts), MFAP5 (ECM integrity), and p53 (epithelial genomic instability). Statistical, trend, correlation, and ROC analyses were performed.</p><p><strong>Results: </strong>Significant differences in TME-related marker distributions were observed across the LGD-HGD-IMC-MP spectrum. While iCD204 showed minimal variation, pCD204 density increased progressively with dysplasia grade (p < 0.001) and demonstrated superior discriminatory performance in ROC analyses, particularly for LGD vs. HGD and IMC vs. MP (p < 0.05). MFAP5 expression inversely correlated with dysplasia (p < 0.001), was preserved in pseudoinvasion, and markedly reduced in true invasion. COL11A1 showed variable expression without a consistent stage-related trend; however, moderate positive correlations between COL11A1 and both intralesional and perilesional CD204-positive macrophages were observed only in the HGD subgroup. p53 positivity increased significantly with lesion grade (p < 0.001) and positively correlated with pCD204.</p><p><strong>Conclusion: </strong>TME-specific immunohistochemical marker distributions differed across colorectal lesion categories. Perilesional CD204-positive macrophage counts demonstrated discriminatory ability in several lesion-group comparisons, whereas MFAP5 expression showed distinct staining patterns between pseudoinvasive and invasive lesions. COL11A1 expression did not demonstrate a consistent category-associated trend but showed moderate correlations with CD204-positive macrophage counts in the HGD subgroup. These findings should be considered exploratory and require validation in larger independent cohorts.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5913-5929"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789406","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":"Prevalence and Impact of Protein-Calorie Malnutrition in Hospitalized Patients with Steatotic Liver Disease.","authors":"Alexandra C Greb, Sowon Kim, Andrew Roney, Peng-Sheng Ting, Berkeley N Limketkai, Po-Hung Chen","doi":"10.1007/s10620-026-10084-8","DOIUrl":"10.1007/s10620-026-10084-8","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with liver disease often experience nutritional insufficiency due to an interplay of metabolic disturbances and dietary alterations leading to decreased muscle mass and the development of protein-calorie malnutrition (PCM). This study aimed to evaluate the prevalence of PCM in patients with steatotic liver disease (alcohol-associated liver disease (ALD) and metabolic dysfunction-associated steatotic liver disease (MASLD)) and their impacts on mortality and healthcare utilization.</p><p><strong>Methods: </strong>We identified hospitalizations with ALD, MASLD, and PCM using International Classification of Diseases codes in the National Inpatient Sample from 2016 to 2020. Descriptive analyses compared hospitalizations with and without PCM. Multivariable linear models adjusting for confounders evaluated the association between PCM and inpatient mortality, length of stay (LOS), and total charges.</p><p><strong>Results: </strong>PCM was found to be significantly more prevalent among hospitalizations with ALD or MASLD than those with neither (ALD 175.5 versus 51.8; MASLD 149.0 vs. 50.7; neither: 49.3 per 1000 hospitalizations; p < 0.001). Among hospitalizations with ALD nor MASLD, PCM was significantly associated with higher mortality (ALD adjusted odds ratio [aOR] 1.61; 95% CI 1.55-1.66; MASLD aOR 1.89; 95% CI 1.84-1.93), LOS (ALD 3.78 more days; 95% CI 3.67-3.88; MASLD 5.65 more days; 95% CI 5.53-5.77), and total charges (ALD $45,013; 95% CI $42,549-$47,477; MASLD $74,502; 95% CI $71,214-$77,789).</p><p><strong>Conclusion: </strong>We found a higher prevalence of PCM among individuals with ALD compared to those with MASLD nor neither condition. PCM was associated with increased mortality, LOS, and total charges in those with ALD and MASLD. Our findings underscore the importance of early identification and management of PCM in patients with steatotic liver disease to mitigate adverse outcomes and reduce healthcare utilization.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5378-5387"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387541","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":"Incidence of Gastrointestinal Adverse Events and Healthcare Resource Utilization in Patients Using Glucagon-Like Peptide-1 Analogs: A Real-World Study.","authors":"Piyush Nathani, Sevag Hamamah, Jena Velji, Harsh K Patel, Rohit Nathani, Dhruvil Radadiya, Aarnav Shandilya, Sachin Srinivasan, Madhav Desai, Alessandro Repici, Cesare Hassan, Prateek Sharma","doi":"10.1007/s10620-026-10112-7","DOIUrl":"10.1007/s10620-026-10112-7","url":null,"abstract":"<p><strong>Purpose: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1) are widely prescribed for diabetes mellitus (DM) and obesity. Growing concerns about gastrointestinal side effects (GI-AE) prompted this real-world study, to assess the incidence of GI-AEs and the associated healthcare burden in patients on GLP-1 s.</p><p><strong>Methods: </strong>Using the TriNetX® network with 120 million patient records, patients with DM and obesity were grouped into GLP-1 and control cohorts. Propensity score matching (1:1) was performed using demographics, comorbidities, Hemoglobin-A1c, BMI, and other confounders. Incidence, number needed to harm (NNH), and Cox-proportional hazard ratios (HR) were used to compare outcomes at 1 year.</p><p><strong>Results: </strong>After matching, 164,987 patients were included in each cohort. At one year, 31.9% of patients on GLP-1 therapy had GI-AEs (NNH 17.2), with incidence of nausea and vomiting, de-novo gastroesophageal reflux disease (GERD), and de-novo gastroparesis being 13%, 8.7%, and 0.7% respectively. GLP-1 use was associated with an increased risk of nausea and vomiting (HR 1.24 [1.21, 1.26]), GERD (HR 1.18 [1.14, 1.22]), proton pump inhibitor use (HR 1.15 [1.12, 1.19]), esophagitis (HR 1.24 [1.19, 1.30]), gastroparesis (HR 1.57 [1.43, 1.73]), drug-induced pancreatitis (HR 2.85 [1.82, 4.48]) and a decreased risk of bowel obstruction (HR 0.86 [0.80, 0.92]). No significant association was seen with cholecystitis (HR 1.10 [0.97, 1.15]) or choledocholithiasis (HR 1.07 [0.94, 1.21]). Esophagogastroduodenoscopy (EGD) utilization (HR 1.25 [1.20, 1.29]) was higher, but emergency room (ER) visits (HR 0.96 [0.95, 0.98]) and hospital admissions (HR 0.92 [0.91, 0.94]) were lower in the GLP-1 cohort.</p><p><strong>Conclusion: </strong>Nearly one-third of patients with DM and obesity on GLP-1 therapy reported GI-AEs, primarily nausea/vomiting and GERD. Providers should be aware of these events, given their association with increased EGD utilization but not higher ER visits or hospital admissions.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5405-5415"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403977","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":"The Potential of Complementary and Alternative Therapies in Improving Diarrhea-Predominant Irritable Bowel Syndrome: Strategies for Long-Term Efficacy.","authors":"Yuqing Deng, Xinyi Ao, Xin Liang, Weian Hao, Yali Liu, Long Zhao, Zhi Li, Shanshan Chen","doi":"10.1007/s10620-026-10134-1","DOIUrl":"10.1007/s10620-026-10134-1","url":null,"abstract":"<p><p>Diarrhea-predominant irritable bowel syndrome (IBS-D) is a common disorder of gut-brain interaction. Current therapeutic approaches frequently fail to provide sustained symptom relief. In recent years, complementary and alternative therapies-particularly traditional Chinese medicine, acupuncture, and dietary interventions-have attracted increasing attention due to their low side-effect profiles and are gradually becoming important adjunct strategies in the management of IBS-D. This review systematically summarizes the research advances of the past decade across these three therapeutic categories for IBS-D with a focus on their clinical efficacy and underlying mechanisms. The findings suggest that traditional Chinese medicine, acupuncture, and dietary interventions can provide sustained relief from core symptoms of IBS-D, including diarrhea and abdominal pain. Their therapeutic effects are mediated through multiple mechanisms, including modulation of the gut microbiota and its metabolites, restoration of intestinal mucosal barrier integrity, attenuation of visceral hypersensitivity, and regulation of the gut-brain axis. These therapies exhibit multi-target and systemic effects with a low incidence of adverse events, highlighting their promising clinical potential. They offer feasible strategies for achieving long-term remission and facilitating personalized management of IBS-D.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"6064-6099"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727757","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":"Beyond Biofeedback: Expanding Perspectives on Pelvic Floor Physical Therapy for Evacuation Disorders.","authors":"Mira M Yang, Cayla Bales, Luis Felipe Carvao, Jenna Iberle, Joy Liu","doi":"10.1007/s10620-026-10089-3","DOIUrl":"10.1007/s10620-026-10089-3","url":null,"abstract":"<p><strong>Purpose: </strong>Pelvic floor physical therapy (PFPT) is recommended for conditions including constipation and fecal incontinence. There is limited evidence exploring characteristics of physical therapy practices, attitudes toward treating evacuation disorders, and potential barriers to care that may influence treatment outcomes. Therefore, a better understanding of these aspects of PFPT is needed. The purpose of this study was to survey PFPT practices, using the Chicagoland area as a microcosm. We aimed to explore practice characteristics, available treatment modalities, and attitudes toward treatment of evacuation disorders.</p><p><strong>Methods: </strong>We conducted a cross-sectional phone and email-based survey of pelvic floor physical therapists across 17 counties in the Chicagoland area. Of 149 eligible contacts, there were 48 respondents representing 58 total PFPT practices. Mixed methods were used to aggregate data quantitatively and perform mapping analysis and thematic analysis.</p><p><strong>Results: </strong>There were geographic disparities in PFPT provider density. Most practices served all gender identities but consisted primarily of female therapists. Levels of PFPT-specific training and certification varied. Respondents felt that education on lifestyle, including diet, was an important therapeutic goal. Biofeedback in a variety of forms was used by most respondents (81%); some suggested that biofeedback was not as effective for chronic constipation as other therapies. Themes of potential barriers to satisfactory outcomes included delayed and vague referrals from other clinicians, as well as patient misinformation and inappropriate expectations.</p><p><strong>Conclusions: </strong>This study provides preliminary insights to guide further work on improving access to PFPT and improving treatment outcomes for bowel symptoms. To strengthen collaboration, we suggest that referring clinicians actively communicate and develop networks with local PFPT offices, and offer earlier, more detailed PFPT referrals to patients.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5511-5520"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454956","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":"Metabolic Syndrome and Its Components Are Associated with Closed-Type Endoscopic Atrophic Gastritis in a Large Screening Cohort.","authors":"Sun Young Yang, Huiyeon Kim, Jung Kim, Ji Hyun Song, Jooyoung Lee, Soie Chung, Eun Young Song","doi":"10.1007/s10620-026-10114-5","DOIUrl":"10.1007/s10620-026-10114-5","url":null,"abstract":"<p><strong>Purpose: </strong>In recent studies, metabolic syndrome (MetS) has been identified as a risk factor for gastric cancer. To enhance risk stratification protocols and prevention for gastric cancer, we sought to determine whether MetS was associated with atrophic gastritis (AG), the premalignant lesion for gastric cancer.</p><p><strong>Methods: </strong>This retrospective cross-sectional study enrolled 12,353 participants who underwent endoscopy during health check-ups between January 2015 and December 2023. Gastric mucosal atrophy was graded according to the Kimura-Takemoto classification. To minimize confounding, propensity score matching was performed using age, sex, smoking status, alcohol consumption, and H. pylori IgG serostatus. Additional analyses were restricted to participants without a history of H. pylori eradication.</p><p><strong>Results: </strong>Among participants without prior H. pylori eradication, MetS was significantly associated with closed-type gastric atrophy (C2-C3) (OR 1.153, 95% CI 1.006-1.321, P = 0.041) after propensity score matching. Among the individual MetS components, abdominal obesity, hypertriglyceridemia, low HDL cholesterol, and elevated blood pressure were significantly associated with closed-type atrophy, whereas elevated fasting glucose was not. Similar findings were observed across alternative definitions of gastric atrophy (C2-O3), whereas no significant association was observed for open-type atrophy (O1-O3).</p><p><strong>Conclusion: </strong>MetS and several of its components were associated with closed-type gastric atrophy (C2-C3), particularly among individuals without prior H. pylori eradication. These findings suggest that metabolic dysfunction may be associated with moderate atrophic gastric changes and support a potential role of metabolic health in gastric mucosal integrity beyond established H. pylori-related risk factors.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5644-5653"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520212","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":"Crohn's Like No Other, Revealed by Macrophage Activation Syndrome and Associated with Leukocytoclastic Vasculitis.","authors":"Najoua Elmoutaoukil, Mehdi Zouaoui, Soukaina Noubail, Salma Fares, Achraf Miry, Youssef Hnach, Mbarek Azouaoui, Nourdin Aqodad","doi":"10.1007/s10620-026-10075-9","DOIUrl":"10.1007/s10620-026-10075-9","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5275-5277"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469585","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":"Temporomandibular Joint Dislocation: A Rare Complication of Esophagogastroduodenoscopy.","authors":"Lana Dardari, Ahmed Nadeem, Waqqas Haroon, Akash Khurana, Bishai Adel, Claire Beveridge","doi":"10.1007/s10620-026-10148-9","DOIUrl":"10.1007/s10620-026-10148-9","url":null,"abstract":"","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5280-5281"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618805","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 Prognostic Model Based on Adipokine-Related Genes for Hepatocellular Carcinoma: Assessment of Patient Outcomes and Tumor Microenvironment Characterization.","authors":"Jianwen Duan, Renya Jiang, Lei Yuan, Xiaofang Xu, Da Sun","doi":"10.1007/s10620-026-10122-5","DOIUrl":"10.1007/s10620-026-10122-5","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality worldwide, and its marked heterogeneity is closely associated with the complex tumormicroenvironment. Adipokines are important mediators linking metabolic regulation and immune modulation; however, the prognostic value of adipokine-related genes (ARGs) andtheir association with drug sensitivity in HCC remain unclear.</p><p><strong>Methods: </strong>Transcriptomic and clinical data for HCC were obtained from public databases. Diff erentially expressed ARGs were identifi ed, and a prognostic risk model was constructedusing univariate Cox regression, least absolute shrinkage and selection operator regression, and multivariate Cox regression, followed by validation in an independent cohort.Immune infi ltration, somatic mutation profi les, and predicted drug sensitivity were further analyzed. PGF was knocked down in Huh7 cells with or without imatinib treatment, andits functional eff ects were evaluated using CCK-8, colony formation, flow cytometry, gene set enrichment analysis, and western blotting.</p><p><strong>Results: </strong>A total of 113 diff erentially expressed ARGs were identifi ed, and a 10-gene prognostic signature was established. The model showed favorable predictive performance inthe TCGA cohort and retained survival stratifi cation ability in the external GEO cohort. Patients in the high-risk group had signifi cantly shorter overall survival and exhibited potentialdiff erences in immune microenvironment characteristics and mutation profi les. PGF expression was positively correlated with the predicted half-maximal inhibitory concentration of imatinib. Invitro experiments showed that PGF knockdown enhanced the inhibitory eff ects of imatinib on Huh7 cell proliferation and colony formation and promoted apoptosis. Further analysessuggested that these eff ects may involve the Pl3K/AKT and MAPK/ERK signaling pathways.</p><p><strong>Conclusion: </strong>This study established an ARG-based prognostic model for HCC and preliminarily suggested that PGF may be involved in regulating the sensitivity of HCC cells toimatinib. These fi ndings provide a preliminary basis for further investigation of ARG-relaterognostic assessment and PGF-mediated drug sensitivity.</p>","PeriodicalId":11378,"journal":{"name":"Digestive Diseases and Sciences","volume":" ","pages":"5556-5574"},"PeriodicalIF":2.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469601","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}