{"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}
Gut and LiverPub Date : 2025-07-18DOI: 10.5009/gnl250053
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
{"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}
Gut and LiverPub Date : 2025-07-18DOI: 10.5009/gnl240581
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
{"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}
Gut and LiverPub Date : 2025-07-15Epub Date: 2025-03-05DOI: 10.5009/gnl240462
Dan Li, Can Liu, Renwang Hu
{"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<sup>+</sup>-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<sup>+</sup>-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<sup>+</sup>-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<sup>+</sup>-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<sup>+</sup>-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<sup>+</sup>-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<sup>+</sup>-CTCs can serve as a novel biomarker for gastrointestinal malignancies. A new model based on FR<sup>+</sup>-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}
Gut and LiverPub Date : 2025-07-15Epub Date: 2025-04-01DOI: 10.5009/gnl240383
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
{"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":3.2,"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}
Gut and LiverPub Date : 2025-07-15Epub Date: 2025-04-21DOI: 10.5009/gnl250114
Ik Hyun Jo, Hyun Gun Kim
{"title":"Comments on Risk Factors for Perforation in Endoscopic Treatment for Early Colorectal Cancer: A Nationwide ENTER-K Study: Reply.","authors":"Ik Hyun Jo, Hyun Gun Kim","doi":"10.5009/gnl250114","DOIUrl":"10.5009/gnl250114","url":null,"abstract":"","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"629-630"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997474","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}
Gut and LiverPub Date : 2025-07-15Epub Date: 2025-04-01DOI: 10.5009/gnl240352
Yeonjin Je, Yuna Kim, Su-Jin Shin, Jie-Hyun Kim, Goeun Park, Jaeyoung Chun, Young Hoon Youn, Hyojin Park, Sung Hoon Noh, In Gyu Kwon
{"title":"Tumor Budding as an Additional Factor in Determining the Need for Surgery after Endoscopic Resection in Mucosal Invasive Gastric Cancer: A Retrospective Study from a Korean Tertiary Hospital.","authors":"Yeonjin Je, Yuna Kim, Su-Jin Shin, Jie-Hyun Kim, Goeun Park, Jaeyoung Chun, Young Hoon Youn, Hyojin Park, Sung Hoon Noh, In Gyu Kwon","doi":"10.5009/gnl240352","DOIUrl":"10.5009/gnl240352","url":null,"abstract":"<p><strong>Background/aims: </strong>The presence of individual cancer cells at the invasive tumor front is referred to as tumor budding (TB). The purpose of this study was to assess the clinicopathological significance of TB in patients with early gastric cancer (EGC).</p><p><strong>Methods: </strong>A total of 939 patients who received radical surgery for EGC were included in this retrospective study. We assessed clinicopathological features in relation to TB including the grade of histologic differentiation, the extent of invasion depth, the width of submucosal (SM) invasion, and the presence of lymphovascular invasion (LVI), lymph node metastasis (LNM) and perineural invasion (PNI).</p><p><strong>Results: </strong>TB was identified in 59.5% of the patients with EGC, 38.7% of the patients with mucosal invasive cancer, and 80.4% of the patients with SM invasive cancers. TB showed significant association with male sex, undifferentiated tumor types, SM invasion, LVI, PNI, and LNM. The presence of SM invasion (odds ratio [OR], 8.750; p<0.001), TB (OR, 5.586; p<0.001), and an undifferentiated-type histology (OR, 2.648; p=0.0005) were found to be significantly associated with LNM/LVI. TB was the sole significant risk factor for LNM/LVI (OR, 7.181; p=0.0016) among the mucosal invasive cancers. In SM invasive cancers, three independent risk factors for LNM/LVI were identified: a tumor located in the lower third of the stomach (OR, 3.425; p=0.0061), an undifferentiated-type histology (OR, 2.320; p=0.0177), and an SM invasion width greater than 4,000 μm (OR, 2.849; p=0.0041).</p><p><strong>Conclusions: </strong>TB may be an important factor associated with LNM, particularly in mucosal gastric cancer.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"559-568"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763641","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}
Gut and LiverPub Date : 2025-07-15Epub Date: 2025-04-01DOI: 10.5009/gnl240439
Jianguo Wang, Xiangbo Wu
{"title":"TEAD4 Transcriptionally Activates TRIB3 to Induce Ferroptosis Resistance through the MEK/ERK Signaling Pathway in Colorectal Cancer.","authors":"Jianguo Wang, Xiangbo Wu","doi":"10.5009/gnl240439","DOIUrl":"10.5009/gnl240439","url":null,"abstract":"<p><strong>Background/aims: </strong>Colorectal cancer (CRC) is the third most prevalent malignancy and the second leading cause of cancer-associated death worldwide. Ferroptosis is a form of regulated cell death that has been linked to the treatment of CRC. Tribbles homolog 3 (TRIB3) and TEA domain transcription factor (TEAD4) are linked with the progression of various cancers, but their role in ferroptosis remains unclear.</p><p><strong>Methods: </strong>We analyzed TRIB3 and TEAD4 expression in CRC tissues using bioinformatics and examined the TRIB3-ferroptosis association. Immunohistochemistry was employed to determine the expression levels of TRIB3 and glutathione peroxidase 4 (GPX4). Real-time quantitative polymerase chain reaction was utilized to measure the mRNA levels of TRIB3 and TEAD4. Western blot was performed to assess the changes in the levels of proteins related to ferroptosis and MEK/ERK pathway. Dual luciferase assays and chromatin immunoprecipitation assays were employed to detect TEAD4TRIB3-TEAD4 targeting. We also employed colony formation assays to analyze cell proliferation, flow cytometry to measure reactive oxygen species levels, and detection kits to measure Fe2 +, glutathione and NADPH levels.</p><p><strong>Results: </strong>TRIB3 was upregulated in CRC cells and tissues and was implicated in the ferroptosis pathway, demonstrating a positive association with GPX4. TRIB3 positively modulated ferroptosis proteins and the MEK/ERK signaling pathway, increasing the ferroptosis resistance of CRC cells. Overexpression of TRIB3 in TEAD4-knockdown cells significantly increased the ferroptosis resistance of CRC cells.</p><p><strong>Conclusions: </strong>TEAD4 increases the expression level of TRIB3 through transcriptional activation, thereby controlling the MEK/ERK signaling pathway and inducing ferroptosis resistance in CRC cells.</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"579-591"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763244","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}
Gut and LiverPub Date : 2025-07-15Epub Date: 2025-04-01DOI: 10.5009/gnl240541
Ji Eun Kim, Eun Ran Kim, Jae Jun Park, Kyeong Ok Kim, Yehyun Park, Young Joo Yang, Hyun Joo Jang
{"title":"Comparative Study of MiroCam MC2000 and PillCam SB3 in Detecting Small Bowel Bleeding: A Multicenter Prospective Randomized Crossover Study.","authors":"Ji Eun Kim, Eun Ran Kim, Jae Jun Park, Kyeong Ok Kim, Yehyun Park, Young Joo Yang, Hyun Joo Jang","doi":"10.5009/gnl240541","DOIUrl":"10.5009/gnl240541","url":null,"abstract":"<p><strong>Background/aims: </strong>The MiroCam MC2000 (MC2000) is a double-tip capsule with a camera on each side. It is designed to provide more extensive visualization of the small bowel mucosa, potentially reducing the chance of missing lesions. This study aimed to compare the detection rates for lesions in the ampulla of Vater (AoV) and the small bowel of the MC2000 and the PillCam SB3 (SB3) for patients with suspected small bowel bleeding.</p><p><strong>Methods: </strong>This prospective, multicenter, randomized crossover trial compared the lesion detection capabilities of the MC2000 and SB3 capsules, ingested one hour apart by patients with suspected small bowel bleeding. The primary outcome was the detection of lesions in the AoV, while the secondary outcome was the assessment of the detection of P1 and P2 lesions, known underlying causes of small bowel bleeding.</p><p><strong>Results: </strong>There was no significant difference in AoV lesion detection rates between the devices. However, MC2000 demonstrated significantly greater detection of red spots in patients with visible bleeding (p=0.018) and tended to detect a greater number of small bowel lesions, including P2 lesions. Minor complications included device stasis, with fewer incidents with the MC2000 than with the SB3, and one instance of small bowel retention due to ulcers.</p><p><strong>Conclusions: </strong>The MC2000's dual-camera system appears to enhance the detection of small bowel lesions over the SB3, especially for more important lesions. These findings suggest that the MC2000 may offer superior diagnostic capabilities for patients with suspected small bowel bleeding, potentially leading to better clinical outcomes (this trial registered KCT0005591).</p>","PeriodicalId":12885,"journal":{"name":"Gut and Liver","volume":" ","pages":"569-578"},"PeriodicalIF":3.4,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763122","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}