Gut and Liver最新文献

{"title":"Misclassification of Alcohol Use Disorder in MASLD and MetALD: Prevalence, Clinical Characteristics, and Outcomes.","authors":"Jun-Hyuk Lee, Sung-Ho Ahn, Jimin Park, So Young Jeon, Eileen L Yoon, Hye Sun Lee, Dae Won Jun","doi":"10.5009/gnl250072","DOIUrl":"https://doi.org/10.5009/gnl250072","url":null,"abstract":"<p><strong>Background/aims: </strong>Within metabolic dysfunction and alcohol-associated liver disease (MetALD), there exists a continuum where the condition can conceptually shift between being metabolic dysfunction-associated steatotic liver disease (MASLD) and alcoholic liver disease. However, alcohol use disorder (AUD) can be included in these diagnoses. The aim of this study was to investigate the prevalence and clinical characteristics of misclassified AUD among patients with MASLD and MetALD.</p><p><strong>Methods: </strong>The study included a total of 3,362,552 participants from the 2011 to 2012 National Health Screening Program. Steatotic liver disease was defined as having a hepatic steatosis index score of 36 or higher. Significant alcohol intake was calculated on the basis of self-report questionnaire responses. AUD was defined as having received medical care for an alcohol-related condition at least once during the study period. The mean follow-up period for participants was 9.8 years.</p><p><strong>Results: </strong>MASLD and MetALD prevalence were 23.8% and 1.9%, respectively. AUD was identified in 1.1% (8,481 individuals) of MASLD and 4.7% (2,989 individuals) of MetALD cases. Misclassified AUD was associated with significantly higher all-cause and liver-related mortality. Adjusted hazard ratios for liver-related mortality were 6.53 for AUD misclassified as MASLD and 6.98 for AUD misclassified as MetALD. Extrahepatic cancer mortality risk was also elevated (adjusted hazard ratio: 1.33 in MASLD and 1.44 in MetALD).</p><p><strong>Conclusions: </strong>A significant number of AUD cases were misclassified as MASLD and MetALD in cross-sectional assessment of alcohol consumption. Patients with AUD misclassified as MASLD or MetALD had higher liver-related mortality than the pure MASLD and MetALD groups.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707290","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":"A Real-World Retrospective Cohort Study on the Clinical Effect of Silymarin (Legalon) on Liver Damage and Diseases Using a Domestic Multicenter Common Data Model.","authors":"Byoung Kuk Jang, Seung Kak Shin, Jae Yoon Jeong","doi":"10.5009/gnl240575","DOIUrl":"https://doi.org/10.5009/gnl240575","url":null,"abstract":"<p><strong>Background/aims: </strong>Silymarin has been reported to be hepatoprotective and to improve liver function; however, its clinical effectiveness in specific liver diseases remains unclear. This study aimed to evaluate the impact of Legalon, which contains silymarin as its active ingredient, on changes in liver function test values and to assess its potential use as a practical treatment option for liver diseases.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study used the Common Data Model. Data were collected from adult patients with liver disease who were first prescribed Legalon between January 1, 2013, and December 31, 2022, across 10 medical institutions in South Korea. Changes in liver function test values at follow-up time points were compared with baseline values.</p><p><strong>Results: </strong>Patients who were prescribed Legalon for at least 6 months showed a statistically significant decrease in liver function test values (aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase) compared with baseline values. At 3 and 6 months, aspartate aminotransferase decreased by approximately 23.18% and 24.54%, alanine aminotransferase decreased by 20.24% and 25.12%, and alkaline phosphatase decreased by 3.02% and 5.90%, respectively. All three parameters showed a sustained decline.</p><p><strong>Conclusions: </strong>Our findings indicate that silymarin (Legalon) induces a significant reduction in liver function test values, thus suggesting that this drug exerts medium to long-term hepatoprotective benefits. Moreover, the synergistic effects of silymarin with standard treatments highlight its potential as a complementary therapy for liver diseases.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707288","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":"Disulfiram/Copper Complex Induces Cytotoxicity in Pancreatic Cancer Cells and 5-Fluorouracil-Resistant Cells through Nuclear Factor E2-Related Factor-2 Suppression and Reactive Oxygen Species Modulation.","authors":"Eun Kyoung Kim, Cheong Ran Je, Sung Ill Jang, Jung Hyun Jo, See Young Lee, Young Ju Lee, Jae Hee Cho","doi":"10.5009/gnl250028","DOIUrl":"https://doi.org/10.5009/gnl250028","url":null,"abstract":"<p><strong>Background/aims: </strong>Pancreatic ductal adenocarcinoma (PDAC) is a challenging cancer to treat and has a poor prognosis and limited treatment options. In this study, the anticancer effects of disulfiram combined with copper (DSF/Cu) on PDAC cells, including those resistant to 5-fluorouracil, was assessed.</p><p><strong>Methods: </strong>Human pancreatic cancer cells (BxPC-3 and CFPAC-1) and their 5-fluorouracil-resistant (5FUR) counterparts were treated with DSF/Cu to assess cytotoxicity. Expression levels of nuclear factor E2-related factor-2 (NRF-2) and heme oxygenase-1 (HO-1) were analyzed by reverse transcription quantitative polymerase chain reaction and Western blotting, while intracellular reactive oxygen species (ROS) levels were evaluated using H2DCFDA staining and flow cytometry. The effects of DSF/Cu on protein kinase B (Akt) and mitogen-activated protein kinase (MAPK) signaling pathways were evaluated by Western blot analysis. <i>In vivo</i> efficacy was investigated using a xenograft mouse model, in which mice were orally administered DSF (75 mg/kg) and Cu (2 mg/kg) twice weekly for 5 weeks.</p><p><strong>Results: </strong>We demonstrated that DSF/Cu effectively induced cytotoxicity in both pancreatic cancer cells and their 5FUR counterparts by modulating ROS levels, NRF-2 levels, and associated survival pathways. DSF/Cu treatment significantly decreased NRF-2 expression and reduced ROS levels, specifically in 5FUR cells. DSF/Cu facilitated NRF-2-independent HO-1 expression and differentially modulated Akt and MAPK signaling pathways in pancreatic cancer cells and their 5FUR counterparts. <i>In vivo</i> studies using a xenograft mouse model confirmed the antitumor efficacy of DSF/Cu, as evidenced by reduced tumor volumes and NRF-2 expression.</p><p><strong>Conclusions: </strong>These findings highlight the potential of DSF/Cu as a novel and effective therapeutic strategy for PDAC, specifically for overcoming resistance to standard therapies.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707289","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":"Pharmacological Treatment of Gastritis: A Narrative Review with a Systematic Literature Search.","authors":"Bokyung Kim, Jung Huh, Sang Gyun Kim, Ji Yong Ahn, Ji Won Kim","doi":"10.5009/gnl250267","DOIUrl":"https://doi.org/10.5009/gnl250267","url":null,"abstract":"<p><p>Gastritis, characterized by gastric mucosal inflammation, is a common gastrointestinal disorder with diverse etiologies, such as <i>Helicobacter pylori</i> infection, nonsteroidal anti-inflammatory drugs use, and autoimmune conditions. Pharmacological treatment aims primarily to heal the mucosa and resolve symptoms, and such treatments include mucoprotective agents, histamine-2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), and potassium-competitive acid blockers (P-CABs). Mucoprotective agents enhance gastric mucosal protection through multiple mechanisms, such as by promoting mucosal regeneration, reducing inflammation, and mitigating oxidative stress. Clinical trials have highlighted the effectiveness of these agents in promoting endoscopic healing and ameliorating symptoms, underscoring the clinical significance of these agents. H2RAs have been extensively used to manage gastritis due to their proven efficacy in reducing gastric acid secretion and promoting mucosal healing. Additionally, PPIs along with newer P-CABs provide robust acid suppression and have shown the ability to rapidly relieve symptoms, thus increasing the number of available treatment options. Since each pharmacological agent offers distinct therapeutic benefits, treatment should be selected based on an individual patient's needs and clinical context.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659094","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":"Comparison of the Efficacy of Dipeptidyl Peptidase-4 Inhibitors and Sodium-Glucose Cotransporter-2 Inhibitors in Diabetic Patients with Steatotic Liver Disease.","authors":"Yunmi Ko, Moon Haeng Hur, Youngsu Park, Jeayeon Park, Hyunjae Shin, Yun Bin Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jung-Hwan Yoon, Yoon Jun Kim","doi":"10.5009/gnl240616","DOIUrl":"https://doi.org/10.5009/gnl240616","url":null,"abstract":"<p><strong>Background/aims: </strong>There is currently insufficient evidence to recommend one oral hypoglycemic agent over another for diabetic patients to reduce hepatic steatosis or prevent advanced fibrosis. We aimed to evaluate the efficacy of dipeptidyl peptidase-4 inhibitors (DPP-4i) and sodium-glucose cotransporter-2 inhibitors (SGLT-2i) in patients with type 2 diabetes mellitus (DM) and metabolic dysfunction-associated steatotic liver disease (MASLD).</p><p><strong>Methods: </strong>This study included diabetic patients with steatotic liver disease who newly received either a DPP-4i or an SGLT-2i as a second-line treatment between 2014 and 2021 at a single tertiary hospital. MASLD was categorized as MASLD-H (radiologic steatosis with a hepatic steatosis index [HSI]>36) or MASLD-I (radiologic steatosis only). Changes in the HSI and fibrosis-4 (FIB-4) index were compared at 1 and 3 years after treatment initiation.</p><p><strong>Results: </strong>A total of 3,493 patients were consecutively enrolled, with 3,001 receiving DPP-4i treatment and 492 receiving SGLT-2i treatment. After applying propensity score matching, the SGLT-2i group showed a significantly greater reduction in the HSI than the DPP-4i group in the DM-MASLD population at both 1 year (DM-MASLD-H: DPP-4i vs SGLT-2i, -1.4% vs -3.7%, p<0.001; DM-MASLD-I: -1.3% vs -3.8%, p<0.001) and 3 years (DM-MASLD-H: -2.0% vs -4.0%, p=0.001; DM-MASLD-I: -2.4% vs -4.2, p=0.025). The FIB-4 indices of both groups increased; however, the increase at year 1 was more significant in the DPP-4i than in the SGLT-2i group (DM-MASLD-H: 11.4% vs 5.2%, p<0.001; DM-MASLD-I: 10.7% vs 4.3%, p=0.014).</p><p><strong>Conclusions: </strong>In patients with DM-MASLD, SGLT-2i treatment was associated with a greater reduction in hepatic steatosis and delayed fibrotic progression than DPP-4i treatment.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659092","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":"Dynamic Muscle Atrophy Predicts Outcomes in Patients with Unresectable Hepatocellular Carcinoma Treated with First-Line Lenvatinib: A Retrospective Study in Taiwan.","authors":"Hsing-Yun Lee, Ching-Di Chang, Yen-Hao Chen, Ming-Chao Tsai, Jing-Houng Wang, Sheng-Nan Lu, Tsung-Hui Hu, Chao-Hung Hung, Chien-Hung Chen, Yuan-Hung Kuo","doi":"10.5009/gnl250073","DOIUrl":"https://doi.org/10.5009/gnl250073","url":null,"abstract":"<p><strong>Background/aims: </strong>Muscle volume loss (MVL) is associated with poor outcomes in patients with hepatocellular carcinoma (HCC). However, dynamic muscle atrophy during HCC treatment is also a critical concern. This study aimed to determine the clinical significance of MVL and severe muscle atrophy following lenvatinib treatment among patients with unresectable HCC.</p><p><strong>Methods: </strong>This study included 302 patients with unresectable HCC who received first-line lenvatinib between July 2019 and December 2022. MVL was defined using the psoas muscle index, while severe muscle atrophy was classified as a ≥1.5% decrease in the psoas muscle index per month after lenvatinib initiation. To reduce the risk of selection bias, propensity score matching was performed.</p><p><strong>Results: </strong>After propensity score matching, 168 patients were included, comprising 112 non-MVL and 56 MVL patients. The MVL group had significantly worse overall survival (9.9 months vs 15.0 months, p=0.021) and a higher incidence of treatment-related adverse events (82.8% vs 66.6%, p=0.03) than the non-MVL group. Among 128 patients with dynamic imaging assessments, those with severe muscle atrophy (n=76) had significantly shorter progression-free survival (4.1 months vs 10.9 months, p<0.001) and overall survival (11.1 months vs 25.9 months, p<0.001) than patients with mild atrophy. Multivariate analysis revealed that severe muscle atrophy was an independent risk factor for progression-free survival (hazard ratio [HR], 2.388; 95% confidence interval [CI], 1.519 to 3.756; p<0.001) and overall survival (HR, 2.130; 95% CI, 1.152 to 3.939; p=0.016), while MVL was not.</p><p><strong>Conclusions: </strong>In real-world clinical practice, severe muscle atrophy is a stronger prognostic indicator than MVL among patients with unresectable HCC treated with first-line lenvatinib.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659093","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":"Risk Assessment for Carotid Atherosclerosis in Asymptomatic Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease.","authors":"Hana Park, Ji Young Lee, Sungwon Park, Hyo Jeong Lee, Suh Eun Bae, Jaeil Kim, Hye-Sook Chang, Jaewon Choe, Hye Won Park, Ju Hyun Shim","doi":"10.5009/gnl250053","DOIUrl":"https://doi.org/10.5009/gnl250053","url":null,"abstract":"<p><strong>Background/aims: </strong>Cardiovascular disease remains a major cause of mortality in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This study evaluated the association between subclinical carotid atherosclerosis (SCA) and MASLD or MASLD and increased alcohol intake (MetALD) in asymptomatic individuals.</p><p><strong>Methods: </strong>This cross-sectional study included 56,889 adults undergoing health check-ups in South Korea. Hepatic steatosis was diagnosed by ultrasound, and SCA was defined by carotid plaques or increased intima-media thickness. Liver fibrosis was evaluated using the fibrosis-4 index and elastography.</p><p><strong>Results: </strong>SCA was identified in 13.5%. MASLD and MetALD were significantly associated with SCA in models adjusted for demographic and lifestyle factors (adjusted odds ratio [aOR], 1.26; 95% confidence interval [CI], 1.19 to 1.33; aOR, 1.43; 95% CI, 1.30 to 1.58; respectively, p<0.001 for both). However, these associations attenuated and lost statistical significance when metabolic risk factors were further adjusted. The risk of SCA increased with greater hepatic steatosis and liver fibrosis severity. In patients with MASLD, aORs were 1.70 (hepatic steatosis index >36), 1.23 (fibrosis-4 index ≥1.3), and 1.78 (liver stiffness measurement ≥5.6 kPa), compared to individuals without MASLD. Similar trends were observed in the MetALD group. Additionally, hypertension and clustering of ≥3 cardiometabolic risk factors were significantly associated with SCA in the MASLD group, supporting the role of metabolic burden in SCA development.</p><p><strong>Conclusions: </strong>MASLD and MetALD were associated with increased SCA risk, particularly in individuals with hepatic steatosis and fibrosis. These findings suggest that metabolic burden and liver disease severity jointly contribute to subclinical atherosclerosis risk.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659095","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":"Temporal Dynamics and Treatment Outcomes of Hepatitis C Virus/Human Immunodeficiency Virus Coinfection: A Multicenter Retrospective Study from South Korea.","authors":"Jae Yoon Jeong, Su Jong Yu, Jeayeon Park, Na Ryung Choi, Soon Sun Kim, Jae Hyun Yoon, Hyuk Soo Eun, Jonggi Choi, Ki Tae Yoon, Young Kul Jung, Soo Young Park, Geum-Youn Gwak, Tae Yeob Kim, Dong Yun Kim, Do Young Kim, Ji Hoon Kim, Jin-Woo Lee, Jeong Won Jang","doi":"10.5009/gnl240581","DOIUrl":"https://doi.org/10.5009/gnl240581","url":null,"abstract":"<p><strong>Background/aims: </strong>Due to the very low incidence of human immunodeficiency virus (HIV) infection in South Korea, epidemiological data on hepatitis C virus (HCV)/HIV coinfection are limited. The aim of this study was to investigate the clinical characteristics and treatment outcomes of patients with HCV/HIV coinfection in South Korea.</p><p><strong>Methods: </strong>We retrospectively collected data from patients diagnosed with HCV/HIV coinfection at 12 academic hospitals in South Korea from 2009 to 2020.</p><p><strong>Results: </strong>A total of 124 patients were included in this study; most patients were males (n=112, 90.3%), and the mean age was 46.5±13.5 years. Among the study patients, 11 (8.9%) had cirrhosis, and seven (5.6%) tested positive for the hepatitis B surface antigen. During the follow-up period (mean period: 67.4 months), two patients (1.6%) developed hepatocellular carcinoma, and nine (7.3%) died. Of the 112 patients (90.3%) who underwent HCV genotype testing, most were infected with HCV genotype 2 (n=53, 47.3%) and genotype 1b (n=41, 36.6%). In particular, HCV genotype 1a was identified in 12.5% (n=14) of patients. Ninety-one patients (73.4%) received antiviral therapy, with 104 antiviral treatments administered overall. The sustained virologic response rate was significantly higher in patients treated with direct-acting antiviral agents (DAA) than in those receiving pegylated interferon-based treatment (89.0% vs 58.1%, p<0.001).</p><p><strong>Conclusions: </strong>In South Korea, patients with HCV/HIV coinfection were predominantly male and younger and exhibited a higher prevalence of genotype 1a than those with HCV monoinfection. These patients demonstrated a significantly better treatment response to DAA treatment than to interferon-based therapy.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659096","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":"A New Model Based on Folate Receptor-Positive Circulating Tumor Cells for the Preoperative Prediction of Peritoneal Metastasis in Gastrointestinal Malignancies: A Retrospective Study in China.","authors":"Dan Li, Can Liu, Renwang Hu","doi":"10.5009/gnl240462","DOIUrl":"10.5009/gnl240462","url":null,"abstract":"<p><strong>Background/aims: </strong>To construct a new model based on folate receptor-positive circulating tumor cells (FR⁺-CTC) for the preoperative prediction of peritoneal metastasis in gastrointestinal malignancies and to apply this model in clinical practice.</p><p><strong>Methods: </strong>Patients with gastrointestinal malignancies who had undergone preoperative FR⁺-CTC counts were retrospectively collected. Risk factors for peritoneal metastasis in patients with gastrointestinal malignancies were identified using a logistic regression model. The \"pROC\" package in R software was employed to plot the receiver operating characteristic curve for predicting peritoneal metastasis in these patients based on identified risk factors. Spearman correlation analysis was performed to assess the relationship between FR⁺-CTC counts and risk factors.</p><p><strong>Results: </strong>A total of 396 patients meeting the inclusion criteria were finally included in the study. The number of FR⁺-CTC, albumin level, total protein level, and cancer antigen 125 (CA-125) level were identified as risk factors affecting peritoneal metastasis in gastrointestinal malignancies. The number of FR⁺-CTC was significantly negatively correlated with albumin (R=-0.21, p<0.001), and total protein levels (R=-0.10, p=0.047), and a positively correlated with CA-125 level (R=0.15, p=0.004). The number of FR⁺-CTCs was significantly higher in patients with peritoneal metastasis, lymph node metastasis, vascular invasion, neural invasion, and in those with stage T3-4 and III-IV gastrointestinal malignancies (p<0.05 for all). The model demonstrated stable predictive capacity, as validated through 10-fold cross-validation.</p><p><strong>Conclusions: </strong>FR⁺-CTCs can serve as a novel biomarker for gastrointestinal malignancies. A new model based on FR⁺-CTCs demonstrated strong predictive capabilities for the preoperative assessment of peritoneal metastasis in gastrointestinal cancers.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"536-547"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556693","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":"Endoscopic Features of Gastrointestinal Amyloidosis: A Proposed Endoscopic Classification.","authors":"Joo Hye Song, Hye Mi Jung, Ji Won Kim, Eun Ran Kim, Ga Yeon Lee, Sang Eun Yoon, Seok Jin Kim, Jung-Sun Kim, Dong Kyung Chang, Young-Ho Kim, Eun-Seok Jeon, Kihyun Kim, Sung Noh Hong","doi":"10.5009/gnl240383","DOIUrl":"10.5009/gnl240383","url":null,"abstract":"<p><strong>Background/aims: </strong>Gastrointestinal amyloidosis (GIA) is a common condition that presents with a variety of endoscopic features. However, the classification of these endoscopic features of GIA and its clinical implications have not been investigated.</p><p><strong>Methods: </strong>The endoscopic findings of 127 patients with GIA were reviewed and classified by three experienced endoscopists. The relationships of the endoscopic classification of GIA with clinical amyloidosis entities, symptoms, and patient outcomes were evaluated.</p><p><strong>Results: </strong>Five distinct types of endoscopic lesion features were identified in GIA patients: protruding, granular, hemorrhagic, ulcerative, and nonspecific. The hemorrhagic type was most common (n=32, 25.2%), followed the by protruding (n=30, 23.6%), ulcerative (n=28, 22.0%), granular (n=20, 15.7%), and nonspecific types (n=17, 13.4%). The protruding type was significantly prevalent in patients with localized amyloidosis (23/49, 71.4%), whereas the hemorrhagic type was the most common in patients with immunoglobulin light chain amyloidosis (20/47, 42.6%), and the ulcerative type was the most common in patients with amyloid A amyloidosis (8/17, 47.1%) (p<0.001). The granular type was related to dysmotility symptoms (p=0.018). Among 30 GIA patients with the protruding type, two died, whereas 36.1% of patients with the other endoscopic types (35/97) died during a median follow-up of 95.5 months (interquartile range, 65.8 to 132.0 months) (p=0.007).</p><p><strong>Conclusions: </strong>Five types of GIA lesions were identified, and on this basis, an endoscopic classification system was proposed. This system may be of diagnostic and prognostic value.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"592-601"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763242","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}