Journal of Gastroenterology and Hepatology最新文献

{"title":"Efficacy of Biliary Brush Cytology With Rapid On-Site Cytological Evaluation for the Detection of Malignant Biliary Strictures.","authors":"Il Sang Shin, Jun Ho Myeong, Jong Ho Moon, Yun Nah Lee, Jae Woo Park, Hee Kyung Kim, Jae Kook Yang, Tae Hoon Lee, Young Deok Cho, Sang-Heum Park","doi":"10.1111/jgh.16865","DOIUrl":"https://doi.org/10.1111/jgh.16865","url":null,"abstract":"<p><strong>Background and aims: </strong>Brush cytology is a widely used diagnostic method in conjunction with intraductal biopsies during endoscopic retrograde cholangiopancreatography, but its diagnostic yield remains a limitation. This study evaluated the efficacy of biliary cytology using a newly developed brush device with rapid on-site cytological evaluation (ROSE) for detecting malignant biliary strictures (MBSs).</p><p><strong>Methods: </strong>In total, 58 patients with suspected intrinsic MBS identified by intraductal ultrasound were enrolled. After achieving tissue sampling with ROSE through a maximum of two brushing passes, a transpapillary forceps biopsy (TPB) was performed. The primary outcome was diagnostic accuracy, and the secondary outcomes were technical success, sampling adequacy, and procedure-related adverse events.</p><p><strong>Results: </strong>Biliary cytology with ROSE was technically successful in all patients (58/58), with a sampling adequacy of 96.6% (56/58). The technical success and sampling adequacy of TPB were 94.8% (55/58) and 91.4% (53/58), respectively. Brush cytology with ROSE and TPB yielded sensitivity rates of 91.8% and 85.7%, specificity rates of 88.9% for both, and accuracy rates of 88.9% for both. The receiver operating characteristic curve comparing the diagnostic accuracies of brush cytology with ROSE and TPB combined versus TPB alone showed a significantly higher value for the combined approach (0.93) than TPB alone (0.87) (p = 0.010).</p><p><strong>Conclusion: </strong>Biliary brush cytology using a novel brush device with ROSE is effective and can be used complementarily to TPB in patients with suspected MBS.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The West Catching Up With the East: High-Magnification NBI Is Accurate for the Diagnosis of Gastric Neoplasia in a Western Population.","authors":"Edward Young, Nicholas Wan, Hamish Philpott, Rajvinder Singh","doi":"10.1111/jgh.16905","DOIUrl":"https://doi.org/10.1111/jgh.16905","url":null,"abstract":"<p><strong>Background and aim: </strong>Accurate endoscopic prediction of histology is key to recognition of early gastric neoplasia and selection of appropriate resection techniques. Narrow-band imaging with magnification (M-NBI) has proven to be highly accurate for gastric lesions in eastern countries; however, we sought to examine whether it can be effectively utilized in the west where evidence is scarce.</p><p><strong>Methods: </strong>This is an analysis of a prospective database of gastric lesions at a single Australian center from 2009 to 2023. All lesions were assessed endoscopically using M-NBI and a determination made whether the lesion was neoplastic or non-neoplastic, as well as prediction of histological subtype. This was then correlated with final histology.</p><p><strong>Results: </strong>A total of 232 lesions in 183 patients were included: 135 non-neoplastic and 97 neoplastic lesions. Thirty-five were adenomas, 29 early gastric cancers, and 6 advanced adenocarcinomas. For differentiating neoplastic versus non-neoplastic lesions, M-NBI had a sensitivity of 97.9% (CI 92.6%-99.7%) and specificity of 97.1% (CI 92.7%-99.2%). M-NBI was also highly accurate (97.0%, CI 93.9%-98.8%) for identifying lesions suitable for endoscopic resection. The observed agreement between the M-NBI predicted histology and the final pathology was 91.8% with a derived kappa statistic of 0.87, indicating excellent agreement. Comparatively, prior biopsies had an observed agreement of 40.4% with final histology, with a derived kappa statistic of 0.27.</p><p><strong>Conclusions: </strong>M-NBI can be used with a high degree of accuracy in a western population. M-NBI can effectively differentiate neoplastic from non-neoplastic gastric lesions and delineate histological subtypes with superior accuracy to previous biopsies.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382527","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":"Management of Helicobacter pylori Infection: Do We Completely See Eye to Eye?","authors":"Vaneet Jearth","doi":"10.1111/jgh.16904","DOIUrl":"https://doi.org/10.1111/jgh.16904","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365067","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":"RFA for Gastric Intestinal Metaplasia-Should We Do It Just Because We Can?","authors":"Guo-Jeng Tan, Sanjiv Mahadeva","doi":"10.1111/jgh.16902","DOIUrl":"https://doi.org/10.1111/jgh.16902","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365068","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":"Gastrointestinal: White Granules in the Stomach Caused by Lymphangitis Carcinomatosis From Signet-Ring Cell Gastric Carcinoma.","authors":"Kazuya Hara, Fumiaki Kawara, Kodai Yamanaka, Chiharu Nishioka","doi":"10.1111/jgh.16894","DOIUrl":"https://doi.org/10.1111/jgh.16894","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365066","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":"Comment on \"Sarcopenia and Survival in Colorectal cancer Without Distant Metastasis: A Systematic Review\".","authors":"Erkan Topkan, Duriye Ozturk, Ugur Selek","doi":"10.1111/jgh.16901","DOIUrl":"https://doi.org/10.1111/jgh.16901","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189391","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":"Long-Term Liver Morbidity and Mortality After Hepatitis C Virus Elimination by Direct-Acting Antivirals.","authors":"Eiichi Ogawa, Akira Kawano, Motoyuki Kohjima, Toshimasa Koyanagi, Kazufumi Dohmen, Aritsune Ooho, Takeaki Satoh, Kazuhiro Takahashi, Norihiro Furusyo, Eiji Kajiwara, Koichi Azuma, Yasunori Ichiki, Rie Sugimoto, Hiromasa Amagase, Takeshi Senju, Masatake Tanaka, Makoto Nakamuta, Hideyuki Nomura, Jun Hayashi","doi":"10.1111/jgh.16892","DOIUrl":"https://doi.org/10.1111/jgh.16892","url":null,"abstract":"<p><strong>Background and aim: </strong>More accurate stratification of patients with chronic hepatitis C after permanent hepatitis C virus (HCV) clearance by direct-acting antivirals (DAAs) is important for improving long-term surveillance and treatment. The aim of this study was to stratify patients with chronic hepatitis C who are at risk of developing hepatocellular carcinoma (HCC) after HCV cure.</p><p><strong>Methods: </strong>This multicenter, retrospective cohort study included 3177 consecutive adult chronic hepatitis C patients without decompensated cirrhosis who were treated with all-oral DAAs. The primary study endpoints were long-term cumulative de novo HCC incidence, HCC recurrence rates, and survival. Additionally, we analyzed the development of HCC by patients without cirrhosis, stratified by age and fibrosis status according to the FIB-4 index.</p><p><strong>Results: </strong>After exclusions, data from 3024 patients were available for analysis. The overall median follow-up period was 6.5 years. None of the patients with non-cirrhosis/FIB-4 < 1.45 (n = 475) developed HCC regardless of background factors. For patients with non-cirrhosis/FIB-4 ≥ 3.25, older age had a greater impact on HCC incidence (log-rank test: p = 0.038). In addition, metabolic factors, including body mass index and diabetes mellitus, were not related to HCC incidence. HCC recurrence commonly occurred within 5 years after HCV cure; nevertheless, HCV cure contributed to an improvement of survival rates.</p><p><strong>Conclusions: </strong>Age is a pivotal factor in predicting de novo HCC development following HCV cure in patients with moderate to advanced fibrosis. Conversely, patients with mild fibrosis (FIB-4 < 1.45) may be eligible for discharge from specialized care after achieving HCV elimination.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080380","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":"Review Article: Albumin and Its Role in Inflammatory Bowel Disease: The Old, the New, and the Future.","authors":"Karla Cameron, Anke L Nguyen, David J Gibson, Mark G Ward, Miles P Sparrow, Peter R Gibson","doi":"10.1111/jgh.16895","DOIUrl":"https://doi.org/10.1111/jgh.16895","url":null,"abstract":"<p><strong>Background: </strong>Circulating albumin concentrations are frequently measured in clinical practice. This review explores biochemical properties and physiological roles of albumin, its place in nutritional assessment, current understanding of perturbed circulating concentrations, and role in clinical management, with special focus on patients with inflammatory bowel disease (IBD).</p><p><strong>Methods: </strong>A detailed literature search was performed.</p><p><strong>Results: </strong>Albumin is synthesized by hepatocytes and comprises 3% of total body protein. It has a prolonged intravascular half-life (17-19 h) due to neonatal Fc-receptor-mediated salvage and has a multitude of physiological functions. Albumin homeostasis is affected in disease states often resulting in reduced level, which is not a direct marker of malnutrition. In patients with IBD, morbid albumin concentrations provide prognostic information, identification of nonintestinal conditions, guidance to the required aggressiveness of therapy and biologic dosage, monitoring of disease activity, and potential need for therapeutic escalation. Barriers to utilization of morbid albumin levels include the lack of consensus regarding cutoff values and the deficiency of high-quality data in this domain due to the retrospective design of the majority of studies. Serum levels hold greatest clinical potential in prognostication in acute severe ulcerative colitis. The premorbid level in the individual may provide insight into dosing of biologics and potentially enhance interpretation of morbid levels.</p><p><strong>Conclusions: </strong>Understanding the physiology and pathophysiology of albumin is fundamental to interpreting its circulating levels. The clinical value of its measurement in patients with IBD may be undervalued, as it assists in evaluation of disease severity, prognosis, and therapeutic decision-making.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080398","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":"APAGE Position Statements on Green and Sustainability in Gastroenterology, Hepatology, and Gastrointestinal Endoscopy.","authors":"Tiing Leong Ang, Dao Viet Hang, James Weiquan Li, Jacky Chiu Leung Ho, Marianne Linley Sy-Janairo, Raja Affendi Raja Ali, Govind K Makharia, Sridhar Sundaram, Tanyaporn Chantarojanasiri, Hyun-Gun Kim, Hiroyuki Isayama, Nonthalee Pausawasdi, Kaichun Wu, Ari Fahrial Syam, Than Than Aye, Sher Rehman, Madunil Anuk Niriella, Ricardo Jurawan, Liangjing Wang, Wai Keung Leung, Jyh-Ming Liou, Chantelle Rizan, Justin Che Yuen Wu, Choon Jin Ooi","doi":"10.1111/jgh.16896","DOIUrl":"https://doi.org/10.1111/jgh.16896","url":null,"abstract":"<p><strong>Background and aim: </strong>The APAGE Position Statements aimed to provide guidance to healthcare practitioners on clinical practices aligned with climate sustainability.</p><p><strong>Methods: </strong>A taskforce convened by APAGE proposed provisional statements. Twenty-two gastroenterologists from the Asian Pacific region participated in online voting and consensus was assessed through an anonymized and iterative Delphi process.</p><p><strong>Results: </strong>There were five sections that addressed the rationale for climate action, the importance of adopting principles of waste management, clinical practice, gastrointestinal endoscopy, and issues related to advocacy and research. Sixteen statements achieved consensus and included the following: 1. APAGE recommends adopting prompt measures to reduce the carbon footprint of clinical practice due to the importance of climate action and its health cobenefits. 5. APAGE recommends adherence to professional clinical guidelines to optimize clinical care delivery in gastroenterology and hepatology to avoid the environmental impact of unnecessary procedures and tests. 8. APAGE recommends an emphasis on health promotion, disease prevention, and appropriate screening and surveillance, when resources are available, to reduce the environmental impact of managing more advanced diseases that require more intensive resources. 12. APAGE recommends that technological advances in endoscopic imaging and artificial intelligence, when available, be used to improve the precision of endoscopic diagnosis to reduce the risk of missed lesions and need for unnecessary biopsies. 13. APAGE recommends against the routine use of single-use endoscopes.</p><p><strong>Conclusion: </strong>The position statements provide guidance to healthcare practitioners on clinical practices in gastroenterology, hepatology, and endoscopy that promote climate sustainability.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065576","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":"Factors Influencing Liver Cirrhosis Progression in Wilson's Disease Patients: A Retrospective Cohort Study Over 5 Years.","authors":"Jieru Peng, Lu Zhang, Yao Dong, Wencheng Long, Yueshan Wang, Qiwen Zhang, Zhong Li, Yaxin Li, Qiaolin Jin, Lin Deng, Juan Liao, Linshen Xie, Chunxia Yang","doi":"10.1111/jgh.16889","DOIUrl":"https://doi.org/10.1111/jgh.16889","url":null,"abstract":"<p><strong>Objectives: </strong>Wilson's disease (WD) is a rare autosomal recessive inherited disorder characterized by dysregulated copper metabolism, amenable to treatment with chelating agents. It manifests with hepatic and neurological symptoms, often precipitating the development of liver cirrhosis as a prominent complication. This study aims to elucidate the factors, biomarker alterations, and therapeutic modalities influencing the progression of cirrhosis in WD patients.</p><p><strong>Methods: </strong>This retrospective cohort study utilized WD patient data from West China Fourth Hospital (May 2018-September 2023). The primary outcome was the development of cirrhosis in initially cirrhosis-free WD patients. LASSO-COX regression identified predictive factors. The 1:1 propensity score matching generated a matched subgroup for robust Cox regression validation.</p><p><strong>Results: </strong>Among 133 initially cirrhosis-free WD patients, 47 developed cirrhosis during 35.98 (22.04-49.21) months. Significant differences were observed between the cirrhosis and non-cirrhosis groups in age at enrollment, age at WD diagnosis, clinical symptoms, educational levels, and administration of dimercaptosuccinic acid, compound glycyrrhizin polyene, and phosphatidylcholine. Multivariate Cox regression identified age at enrollment (hazard ratio [HR]: 1.038, 95% CI: 1.002-1.075), the use of glycyrrhizin (HR: 0.421, 95% CI: 0.192-0.926), erythrocyte (HR: 0.748, 95% CI: 0.626-0.895), and platelet counts (HR: 0.993, 95% CI: 0.988-0.998) associated with cirrhosis. Robust Cox analysis on the matched subgroup confirmed these findings.</p><p><strong>Conclusion: </strong>Glycyrrhizic acid emerges as a potential hepatoprotective agent for WD patients. Furthermore, the progression of cirrhosis in WD patients is characterized by advanced age and decreased baseline levels of erythrocytes and platelets, suggesting their potential utility as prognostic indicators.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065608","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}