European Journal of Gastroenterology & Hepatology最新文献

{"title":"Comparative efficacy and safety of endoscopic submucosal dissection versus transanal endoscopic microsurgery for the treatment of rectal polyps: a systematic review and meta-analysis.","authors":"Ioannis Karniadakis, Stavros P Papadakos, Alexandra Argyroy, Athanasios Syllaios, Vasileios Lekakis, Andreas Koutsoumpas","doi":"10.1097/MEG.0000000000002996","DOIUrl":"10.1097/MEG.0000000000002996","url":null,"abstract":"<p><p>Rectal cancer represents approximately 35% of colorectal cancer cases in the European Union. Early-stage tumors may be treated with less invasive techniques, such as endoscopic submucosal dissection (ESD) and transanal endoscopic microsurgery (TEM). This systematic review and meta-analysis evaluates the comparative efficacy and safety of ESD versus TEM for early-stage rectal cancer. A literature search was conducted in PubMed, Scopus, Embase, and Cochrane databases up to October 2024. Studies comparing ESD and TEM outcomes in adult patients with rectal tumors were included. Outcomes assessed included the rates of en-bloc resection, recurrence, overall complications, R0 resection rates, postoperative bleeding, reoperation rates, perforation rates, operative time, and length of hospital stay. Statistical analyses were performed using both fixed and random effects models. Seven retrospective studies involving 671 patients were included. Pooled analyses showed that ESD achieved higher en-bloc resection rates [odds ratio (OR) = 0.29, 95% confidence interval (CI): 0.10-0.83, P  = 0.02), lower tumor recurrence rates (OR = 0.29, 95% CI: 0.12-0.70, P  = 0.006) and lower overall complication rate (OR = 0.50, 95% CI: 0.31-0.81, P  = 0.005). No significant differences were observed in terms of R0 resection rates, operative time, postoperative bleeding, and reoperation rates. ESD achieves favorable outcomes over TEM for early-stage rectal cancer by achieving higher en-bloc resection rates, lower rates of recurrence, and complications. Despite ESD's technical complexity, its superior precision and lower complication profile make it a promising option for early-stage rectal cancer, though clinician expertise and available resources should guide treatment selection.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1191-1197"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984227","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":"Identification of high-risk group for diabetes-associated hepatocellular carcinoma using noninvasive test for liver fibrosis.","authors":"Kazuya Kariyama, Kazuhiro Nouso, Atsushi Hiraoka, Hidenori Toyoda, Toshifumi Tada, Kunihiko Tsuji, Toru Ishikawa, Takeshi Hatanaka, Ei Itobayashi, Koichi Takaguchi, Akemi Tsutsui, Atsushi Naganuma, Satoshi Yasuda, Satoru Kakizaki, Fujimasa Tada, Hideko Ohama, Akiko Wakuta, Shohei Shiota, Takashi Kumada","doi":"10.1097/MEG.0000000000003017","DOIUrl":"10.1097/MEG.0000000000003017","url":null,"abstract":"<p><strong>Background: </strong>As diabetes-associated hepatocellular carcinoma (DM-HCC) has surged in Japan, there is an urgent need for effective screening methods. The Fibrosis-4 (FIB-4) index is commonly used for screening, but its age component tends to yield false-positive results in older patients. This study aimed to evaluate the value of the newly developed Fibrosis-3 (FIB-3) index, which excludes age, for identifying high-risk groups for DM-HCC across all age groups.</p><p><strong>Methods: </strong>This study included 174 patients with diabetes-associated Barcelona Clinic Liver Cancer stage 0 hepatocellular carcinoma (HCC) and 74 diabetic controls. The ability of the FIB-4 and FIB-3 indices to predict HCC risk was assessed using receiver operating characteristic (ROC) curves and multivariate logistic regression analyses.</p><p><strong>Results: </strong>Both indices effectively identified high-risk groups for DM-HCC (area under the ROC curve: FIB-4, 0.909; FIB-3, 0.911). Notably, the FIB-4 index required age-adjusted cutoffs, whereas a single cutoff FIB-3 maintained its predictive ability across all age groups. Multivariate analysis confirmed FIB-3 as an independent predictor of HCC risk even after adjusting for factors such as BMI, liver function tests, and tumor markers.</p><p><strong>Conclusion: </strong>The FIB-3 index is a promising tool for identifying high-risk groups for DM-HCC without age-dependent cutoffs, potentially enabling earlier diagnosis and better prognosis. Its ability to stratify risk consistently across age groups addresses the limitations of FIB-4.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1269-1274"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505169","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":"Sex disparity in hepatocellular carcinoma recurrence after curative liver resection: a multicenter comprehensive analysis.","authors":"Mu-Gen Dai, Si-Yu Liu, Qing Xu, Wen-Feng Lu, Lei Liang, Jun-Wei Liu, Kun Zhang, Bin Ye","doi":"10.1097/MEG.0000000000003024","DOIUrl":"10.1097/MEG.0000000000003024","url":null,"abstract":"<p><strong>Background and aims: </strong>The impact of sex disparity on the patterns of recurrence after curative resection of hepatocellular carcinoma (HCC) remains controversial. The aim of this study was to comprehensively investigate the influence of sex differences in HCC recurrence following curative hepatectomy.</p><p><strong>Methods: </strong>Patients who underwent curative-intent resection for HCC between July 2015 and June 2020 were identified from a multicenter database and analyzed retrospectively. Tumor recurrence was evaluated using Cox regression and Kaplan-Meier methods. Hazard curves representing the changes in risk of recurrence over time were evaluated. Propensity score matching and a competing risk model were used for sensitivity analysis.</p><p><strong>Results: </strong>Of 1570 patients, 1334 (85.0%) were men, and 236 (15.0%) were women. Female patients showed significantly lower risk for HCC recurrence than males in the multivariate Cox regression analysis (hazard rate: 0.75, 95% confidence interval: 0.61-0.93, P  = 0.008). Landmark analysis showed that sex was an independent risk factor for late recurrence, but not for early recurrence. The hazard function curve for female patients was relatively flat [peak hazard rates (pHR): 0.0234], while males recurred with a peak at 3.0 months (pHR: 0.0302). A lower risk of HCC recurrence was also found in females in the sensitive analysis.</p><p><strong>Conclusion: </strong>Male patients had a higher risk of HCC recurrence than females after surgery, and recurrence hazard rates for different sexes varied substantially with respect to both time and peak rates.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1275-1282"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590784","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":"Significance of surgical resection and resection margins for hepatocellular carcinoma with microvascular invasion: a systematic review and meta-analysis.","authors":"Shuxun Shi, Xi Cui, Cuicui Liu, Hanghang Li, Rui Zhai","doi":"10.1097/MEG.0000000000003028","DOIUrl":"10.1097/MEG.0000000000003028","url":null,"abstract":"<p><strong>Objective: </strong>For hepatocellular carcinoma (HCC) with microvascular invasion (MVI), the choice of surgical resection (SR) and resection margins (RMs) remains to be determined. The aim of this study was to discuss the relationship between SR and RM and MVI-positive HCC.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and Cochrane Library were searched up to 1 September 2024. The methodological quality of eligible articles was assessed using the Newcastle-Ottawa Scale (NOS). Effect models were selected to pool the HR and 95% CI of recurrence and overall survival (OS) based on the presence of heterogeneity to assess the impact of SR and RM in MVI-positive HCC.</p><p><strong>Results: </strong>A total of 12 articles with 6747 cases were included. NOS scale indicated that the studies were of high quality. The results showed that narrow RM were a risk factor for postoperative recurrence and OS in MVI-positive HCC, with a pooled HR of 1.76 (95% CI: 1.49, 2.07) and 1.99 (95% CI: 1.58, 2.49), respectively; whereas nonanatomical resection (NAR) was another risk factor for postoperative recurrence and OS, with a pooled HR of 1.33 (95% CI: 1.15, 1.54) and 1.42 (95% CI: 1.15, 1.75), so wide RM and anatomical resection (AR) was beneficial for postoperative recurrence and long-term survival. In the subgroups, narrow RM were more than twice the risk factor for TTR compared with wide RM; and in the SR subgroup, studies from the Japanese had more than double the risk factor for postoperative recurrence and OS compared with China.</p><p><strong>Conclusion: </strong>For HCC with MVI, treatment modalities recommending anatomical resection and wide margins will have beneficial effects on postoperative recurrence and long-term survival.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1283-1291"},"PeriodicalIF":1.8,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590785","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":"Does Clostridioides difficile infection play a role in premalignant colonic lesions? A retrospective cohort study.","authors":"Nadera A Altork, Thomas Chameli, Advait M Suvarnakar, Lindsay R Ayers, Amer Arman, Mina Al-Hamadani, Spyridon Peppas, Akram I Ahmad, Jiling Chou, Mark C Mattar","doi":"10.1097/MEG.0000000000003007","DOIUrl":"10.1097/MEG.0000000000003007","url":null,"abstract":"<p><strong>Objectives: </strong>Clostridioides difficile infection (CDI) and colorectal cancer pose significant health risks in the US, and yet the potential link between them remains unexplored in humans. We aim to investigate the association between CDI and the risk of developing premalignant and malignant colonoscopic findings in adult patients in inpatient and outpatient settings.</p><p><strong>Methods: </strong>This retrospective cohort study reviewed patient charts from four healthcare facilities, including two tertiary referral centers. A total of 448 adult patients who underwent C. difficile tests (CDT) during the approved timeframe and had colonoscopies completed at least 5 years after CDT were identified using the Clostridium difficile PCR test and International Classification of Diseases codes. Our primary outcome was the rate of premalignant and malignant polyps or masses documented on colonoscopy reports greater than or equal to 5 years from the initial CDT date. Overall lesion frequency, size, histology, and presence of ulcerations were secondary outcomes.</p><p><strong>Results: </strong>There was no significant difference in the development of polyps and masses between the patients with CDT-positive and CDT-negative [odds ratio (OR) = 1.21, 95% confidence interval (CI) = 0.70-2.11). In addition, the presence of malignant and premalignant histology also did not differ. CDT-positive group had a greater frequency of ulcerative lesions compared to the CDT-negative even after stratification for smoking (OR = 6.15, 95% CI = 1.67-22.66).</p><p><strong>Conclusion: </strong>Although no significant association was found between CDI and malignant or premalignant lesions, the study sheds light on the potential link between CDI and inflammatory pathologies such as ulcerative colorectal lesions. It could influence colorectal cancer screening strategies for patients with CDI.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1135-1140"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224822","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":"Changes in antiviral treatment rate for hepatitis B virus before hepatocellular carcinoma diagnosis: a nationwide Korean study.","authors":"Young Eun Chon, Jonghyun Lee, Eileen L Yoon, Soon Sun Kim, Sang Bong Ahn, Soung Won Jeong, Dae Won Jun","doi":"10.1097/MEG.0000000000003000","DOIUrl":"10.1097/MEG.0000000000003000","url":null,"abstract":"<p><strong>Background and aims: </strong>Antiviral treatment (AVT) reduces hepatitis B virus (HBV) reactivation and hepatocsellular carcinoma (HCC) development; however, the impact of AVT timing - before versus after HCC diagnosis - on prognosis remains unclear. This study aimed to evaluate the current status, changes, and clinical outcomes of AVT before HCC diagnosis in Korea.</p><p><strong>Methods: </strong>Data were extracted from the Korean National Health Insurance Service for patients newly diagnosed with HBV-related HCC from 2008 to 2018. Patients were categorized into an early cohort (2008-2013) and a late cohort (2014-2018). AVT trends were analyzed using Joinpoint regression, and clinical outcomes were compared between groups.</p><p><strong>Results: </strong>Among 82 609 patients (early cohort: n = 45 804; late cohort: n = 36 805), the proportion receiving AVT before HCC diagnosis increased from 22.4% in 2008 to 46.8% in 2018. AVT after diagnosis also rose from 16.3 to 21.3%. Overall survival rates in the late cohort were significantly improved compared with the early cohort (P < 0.001). More than half of the patients with HCC who received transplantation or local ablation treatment had received AVT before HCC diagnosis. AVT before HCC diagnosis was associated with reduced mortality rate (adjusted hazard ratio = 0.592; 95% confidence interval: 0.580-0.604; P < 0.001). Elderly patients (≥80 years) consistently had a lower AVT rate before HCC diagnosis compared with other age groups (P < 0.05).</p><p><strong>Conclusion: </strong>The AVT rate before HCC diagnosis significantly increased over the past 10 years in Korea. Further efforts are needed to improve the AVT rate in elderly patients with HBV-related HCC.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":"37 10","pages":"1166-1172"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947765","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":"Inappropriate use of proton pump inhibitors in patients with liver cirrhosis: a cross-sectional study.","authors":"Gasser El-Azab, Talaat Zakareya, Medhat Abdel Aleem, Ahmed Edrees","doi":"10.1097/MEG.0000000000002985","DOIUrl":"10.1097/MEG.0000000000002985","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs) are widely prescribed for acid-related disorders; however, concerns have emerged regarding their misuse, particularly in patients with liver cirrhosis. This study aimed to assess the appropriateness of PPI prescriptions in patients with cirrhosis and to identify factors contributing to their overutilization in this patient population.</p><p><strong>Methods: </strong>In this cross-sectional study, 1000 patients with cirrhosis receiving PPIs were enrolled. Data on demographics, clinical parameters, and endoscopic findings were collected, and indications for PPI therapy were assessed according to established guidelines.</p><p><strong>Results: </strong>Among patients with cirrhosis, 60.5% were prescribed PPIs, with pantoprazole being the most prescribed (55.7%). Inappropriate PPI use was observed in 53.6% of the patients, mainly because of lacking an approved indication (78.54%) or exceeding the recommended treatment duration (21.46%). Causes contributing to misuse included prolonged PPI use postendoscopic band ligation (29.1%), extended treatment for functional dyspepsia (21.46%), failure to discontinue PPIs upon hospital discharge (17.54%), using PPIs for preventing portal hypertensive gastropathy (PHG) or variceal bleeding (16.42%), and stress ulcer prophylaxis in non-ICU patients (15.86%). Multivariate analysis identified independent predictors of inappropriate PPI use, including Child classification C, Mayo End-Stage Liver Disease score greater than 18, hepatocellular carcinoma, and previous variceal bleeding, whereas hematemesis was identified as an independent predictor of appropriate use.</p><p><strong>Conclusion: </strong>This study underscores the prevalent inappropriate prescription of PPIs in patients with liver cirrhosis, particularly in those with advanced liver disease or a history of variceal bleeding. Enhancing prescribing practices and adhering to evidence-based guidelines are essential to mitigate the risks associated with PPI misuse in patients with cirrhosis.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1141-1146"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987342","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 multicenter study on bowel preparation in inflammatory bowel disease patients: comparison between 1L-PEG-ASC and 2L-PEG regimens in an outpatient setting.","authors":"Davide Scalvini, Cristina Bezzio, Stiliano Maimaris, Marco Vincenzo Lenti, Lusetti Francesca, Alessandro Cappellini, Carolina Cicalini, Michele Dota, Roberta Muscia, Daniele Brinch, Ignazio Marzio Parisi, Massimo Devani, Mario Schettino, Aurelio Mauro, Simona Agazzi, Stefano Mazza, Laura Rovedatti, Annalisa Schiepatti, Antonio Di Sabatino, Federico Biagi, Gianpiero Manes, Andrea Anderloni, Simone Saibeni","doi":"10.1097/MEG.0000000000003005","DOIUrl":"10.1097/MEG.0000000000003005","url":null,"abstract":"<p><strong>Background and aims: </strong>There is a paucity of data on which bowel preparation (BP) to use in an inflammatory bowel disease (IBD) outpatient setting, in particular after the introduction of 1L-PEG-ASC. Thus, we aimed to evaluate the most effective BP between 1L-PEG-ASC and 2L-PEG and to identify risk factors for inadequate BP in this IBD population.</p><p><strong>Methods: </strong>This is a multicentric, retrospective, cross-sectional study including IBD patients aged >16 years, who underwent outpatient split-dose colonoscopy between January 2021 and December 2022. Boston Bowel Preparation Scale (BBPS) was used to determine the adequacy of BP. Multivariable logistic regression was fitted to compare BP adequacy between 1L-PEG-ASC and 2L-PEG.</p><p><strong>Results: </strong>Overall, 506 patients (F 42.9%, mean age 48.9 ± 15.2 years) were included and BP was adequate in 440 (87.0%). 1L-PEG-ASC was associated with a higher rate of adequate BP compared to 2L-PEG (89.8% vs. 83.8%, P  = 0.048) and higher BBPS score [median 8, interquartile range (IQR): 7-9 vs. 6, IQR: 6-8, P  < 0.001]. Male sex ( P  = 0.03), previous ileal/colonic surgery ( P  = 0.01), and stricturing Crohn's disease (CD) ( P  = 0.01) were associated with inadequate BP. At multivariable analysis, 1L-PEG-ASC was a predictor of adequate BP [odds ratios (OR) = 1.70, 95% confidence interval (CI): 1.00-2.90, P  < 0.05]; whereas male sex (OR = 0.51, 95% CI: 0.29-0.90, P  = 0.02) and previous ileal/colonic surgery (OR = 0.40, 95% CI: 0.21-0.77, P  < 0.01) were confirmed as risk factors for inadequate BP.</p><p><strong>Conclusion: </strong>Results from this large real-world cohort highlight the efficiency of 1L-PEG-ASC in providing better BP compared to 2L-PEG. However, further studies are needed to validate our retrospective results and confirm the superiority of 1L-PEG-ASC. Male sex and previous ileal/colonic surgery and stricturing CD were related to poor BP.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1127-1134"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The characteristics and outcome of intraductal papillary mucinous neoplasm of the pancreas: an observational study.","authors":"Amrendra K Mandal, Amanda Eisinger, Tessa Doolittle, Auyon Ghosh, Ganesh Aswath, Savio John, Bishnu Sapkota","doi":"10.1097/MEG.0000000000003004","DOIUrl":"10.1097/MEG.0000000000003004","url":null,"abstract":"<p><strong>Background: </strong>Intraductal papillary mucinous neoplasms (IPMNs) are pancreatic cystic lesions with variable risk for malignant transformation. This observational study assessed the long-term natural history of IPMNs, focusing on risk stratification based on imaging and histological features.</p><p><strong>Methods: </strong>We retrospectively reviewed 93 patients with IPMN confirmed by MRI and endoscopic ultrasound (EUS) or both. All patients had a minimum follow-up of 5 years. Demographic, clinical, imaging, procedural, and outcome data were collected. IPMN characteristics including cyst size, duct size, duct involvement, and location were evaluated at baseline. The primary outcome was progression to high-grade dysplasia or invasive carcinoma. Secondary outcomes included the need for surgery, cyst progression, and IPMN-related mortality.</p><p><strong>Results: </strong>The cohort included 93 patients (65.6% female, mean age 70.9 ± 9.9 years). The majority (92.5%) had branch duct IPMN. The mean cyst size was 1.53 ± 1.57 cm, and the duct size was 2.69 ± 1.79 mm. High-grade dysplasia was found in 9.7%. Surgical resection was significantly associated with cyst size >2.6 cm ( P  = 0.031), duct dilation >5.3 mm ( P  = 0.004), and main/mixed duct involvement ( P  < 0.001). Additionally, cyst wall thickening (60%) and mural nodule (67%) were significantly associated with surgical resection. One patient progressed to invasive carcinoma. No IPMN-related deaths were reported.</p><p><strong>Conclusion: </strong>IPMNs evaluated and monitored with MRI/EUS demonstrate indolent behavior over extended follow-up. Surgical resection should be considered based on duct type, cyst size, and presence of dysplasia. Long-term surveillance remains essential for appropriate risk stratification.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1117-1121"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224823","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":"Endoscopic ultrasound features in predicting noncurative resection of endoscopic submucosal dissection in patients with rectal neuroendocrine neoplasms.","authors":"Xiaotong Wang, Min Cao, Xueli Ding, Zimin Liu, Ailing Liu, Hua Liu","doi":"10.1097/MEG.0000000000003002","DOIUrl":"10.1097/MEG.0000000000003002","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the factors influencing noncurative resection (NCR) in patients with rectal neuroendocrine neoplasms (R-NENs) on the basis of endoscopic ultrasonography (EUS) findings and to construct and validate a nomogram prediction model based on these factors.</p><p><strong>Methods: </strong>This retrospective cohort study included 244 patients with pathologically confirmed R-NEN who underwent endoscopic submucosal dissection (ESD) at the Affiliated Hospital of Qingdao University between March 2016 and June 2023. The patients' EUS and clinical features were collected to identify independent factors influencing NCR following ESD. A nomogram prediction model was constructed, and its performance was evaluated with receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>A larger tumor diameter, irregular borders, and submucosal involvement on EUS were identified as independent risk factors for NCR following ESD in patients with R-NENs. A nomogram model integrating these three predictors effectively predicted the occurrence of NCR. ROC curve analysis was used to compare the clinical predictive efficacy of the independent influencing factors and their combination. The results revealed that the area under the curve for the combination of factors was 0.791, with a sensitivity of 68.6% and specificity of 86.0%, indicating good clinical diagnostic value. The Hosmer-Lemeshow goodness-of-fit test ( P  = 0.178) indicated satisfactory model calibration.</p><p><strong>Conclusion: </strong>The nomogram model achieved good predictive performance. This model can assist endoscopists in dynamically assessing the risk of NCR in real time, but its clinical applicability requires verification.</p>","PeriodicalId":11999,"journal":{"name":"European Journal of Gastroenterology & Hepatology","volume":" ","pages":"1110-1116"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752771","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}