Journal of Gastroenterology and Hepatology最新文献

{"title":"Efficacy of Radiofrequency Ablation as a Treatment for High-Risk Gastric Intestinal Metaplasia: A Randomized, Self-Control Study","authors":"Rapat Pittayanon,&nbsp;Kasenee Tiankanon,&nbsp;Natee Faknak,&nbsp;Nathawadee Lerttanatum,&nbsp;Anapat Sanpavat,&nbsp;Naruemon Klaikaew,&nbsp;Rungsun Rerknimitr","doi":"10.1111/jgh.16875","DOIUrl":"10.1111/jgh.16875","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Guidelines recommend endoscopic surveillance for gastric cancer without therapeutic intervention every 3 years in patients with high-risk gastric intestinal metaplasia (GIM). This study aimed to evaluate the efficacy of radiofrequency ablation (RFA) in eradicating high-risk GIM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This randomized self-control trial was conducted between June 2020 and February 2023. Patients with histology-verified high-risk GIM were enrolled. The endoscopist performed a biopsy on both the left and right sides of the stomach (five each) by targeting the suspected GIM area where available; otherwise, a random biopsy was taken. Patients were randomized to receive a unilateral RFA on either the left or right side. A repeated RFA on the assigned side was performed every 2–3 months for a total of two to three times. The primary outcome was complete resolution of GIM at 1 year after RFA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-six patients with a mean age of 66 ± 8 years were analyzed. The complete resolution rate of overall GIM lesions after RFA was significantly higher (49/142; 34/5%) than that in the observation group (29/127; 22.8%, RR = 0.84, 0.73–0.98, <i>p</i> = 0.03). For the subgroup analysis, the complete resolution rate after RFA revealed a significantly higher value than observation only in the incomplete GIM group (24/87; 27.6% vs. 11/82; 13.4%, RR = 0.83, 0.71–0.97, <i>p</i> = 0.02). The percentage of patients with extensive GIM regression after RFA (15/25; 60%) was higher than in the observation group (9/25; 36%) but did not meet statistical significance (RR = 0.62, 0.35–1.09, <i>p</i> = 0.09).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In high-risk GIM, RFA can significantly eradicate incomplete GIM when compared with observation alone.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 4","pages":"891-899"},"PeriodicalIF":3.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779705","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":"Reliable Performance of mALBI Grade-Based Risk Models for Predicting the Prognosis of Patients With Hepatocellular Carcinoma Receiving Atezolizumab Plus Bevacizumab as First-Line Treatment: Comparative Analysis of 13 Risk Models","authors":"Takeshi Hatanaka,&nbsp;Satoru Kakizaki,&nbsp;Atsushi Hiraoka,&nbsp;Toshifumi Tada,&nbsp;Masashi Hirooka,&nbsp;Kazuya Kariyama,&nbsp;Joji Tani,&nbsp;Masanori Atsukawa,&nbsp;Koichi Takaguchi,&nbsp;Ei Itobayashi,&nbsp;Shinya Fukunishi,&nbsp;Kunihiko Tsuji,&nbsp;Toru Ishikawa,&nbsp;Kazuto Tajiri,&nbsp;Hidenori Toyoda,&nbsp;Chikara Ogawa,&nbsp;Hiroki Nishikawa,&nbsp;Takashi Nishimura,&nbsp;Kazuhito Kawata,&nbsp;Hisashi Kosaka,&nbsp;Atsushi Naganuma,&nbsp;Yutaka Yata,&nbsp;Hideko Ohama,&nbsp;Hidekatsu Kuroda,&nbsp;Tomomitsu Matono,&nbsp;Kazunari Tanaka,&nbsp;Fujimasa Tada,&nbsp;Kazuhiro Nouso,&nbsp;Asahiro Morishita,&nbsp;Akemi Tsutsui,&nbsp;Takuya Nagano,&nbsp;Norio Itokawa,&nbsp;Tomomi Okubo,&nbsp;Taeang Arai,&nbsp;Michitaka Imai,&nbsp;Yohei Koizumi,&nbsp;Shinichiro Nakamura,&nbsp;Masaki Kaibori,&nbsp;Hiroko Iijima,&nbsp;Yoichi Hiasa,&nbsp;Takashi Kumada,&nbsp;the Real-life Practice Experts for HCC (RELPEC) Study Group, and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)","doi":"10.1111/jgh.16871","DOIUrl":"10.1111/jgh.16871","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to compare the prognostic performance of the risk models for patients with hepatocellular carcinoma (HCC) receiving atezolizumab and bevacizumab (Atez/Bev) as first-line treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among 449 patients included in this retrospective multicenter study, we compared the prognostic performance of 13 risk models for the 12-month and 18-month survival status using area under the curve (AUC), net reclassification improvement (NRI), and relative integrated discrimination improvement (IDI) analysis. We also constructed a calibration plot to assess the fitness of each model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Regarding the analysis of the 12-month survival status, none of the risk models demonstrated AUC values higher than the modified albumin-bilirubin (mALBI) grade. In the NRI analysis, only the IMmunotherapy with AFP, BCLC staging, mALBI, and DCP evaluation (IMABALI-De score) exhibited a statistically significant improvement compared with the mALBI grade (<i>p</i> = 0.009). While the modified albumin-bilirubin grade (mALF) score and prognostic nutritional index (PNI) did not exhibit significant differences compared to the mALBI grade (<i>p</i> = 0.3 and 0.2, respectively), the remaining risk models were inferior to the mALBI grade. In the relative IDI analysis, none of the risk models showed a significant improvement compared with the mALBI grade. The calibration plot of the PNI was unsatisfactory. The results for the 18-month survival status were consistent with those for the 12-month survival status. A time-dependent ROC analysis demonstrated that both the mALBI grade and the mALBI-based model showed consistent performance over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The mALBI grade, as well as the IMABALI-De and mALF scores (both of which are risk models based on mALBI grade), exhibited reliable performance in predicting the prognosis of patients with HCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 4","pages":"930-939"},"PeriodicalIF":3.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779806","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":"Usefulness of Magnifying Endoscopy With Narrow-Band Imaging for Diagnosis of Ulcerative Colitis–Associated Neoplasia","authors":"Masafumi Nishio,&nbsp;Kingo Hirasawa,&nbsp;Yusuke Saigusa,&nbsp;Zhao Shiqi,&nbsp;Tokomi Kenemura,&nbsp;Takanori Hama,&nbsp;Reo Atsusaka,&nbsp;Daisuke Azuma,&nbsp;Yuichiro Ozeki,&nbsp;Atsushi Sawada,&nbsp;Ryosuke Ikeda,&nbsp;Takehide Fukuchi,&nbsp;Ryosuke Kobayashi,&nbsp;Chiko Sato,&nbsp;Tsuyoshi Ogashiwa,&nbsp;Sawako Chiba,&nbsp;Yoshiaki Inayama,&nbsp;Reiko Kunisaki,&nbsp;Shin Maeda","doi":"10.1111/jgh.16877","DOIUrl":"10.1111/jgh.16877","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Qualitative diagnosis of ulcerative colitis–associated neoplasia (UCAN) is crucial for surveillance colonoscopy in patients with ulcerative colitis (UC). Although the utility of magnifying endoscopy with narrow-band imaging (ME-NBI) in sporadic neoplasia diagnosis has been reported, its efficacy in UCAN remains unclear. This study aimed to evaluate the usefulness of ME-NBI for qualitative diagnosis of UCAN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We generated 60 ME-NBI images (30 UCANs and 30 nonneoplasia lesions, including 10 polypoid and 20 nonpolypoid lesions) from patients with UC who underwent colonoscopy at our hospital between 2015 and 2023. Eleven endoscopists (seven experts and four trainees) independently assessed these images. Lesions were categorized into high- (≥ 80%), moderate- (50%–79%), and low- (&lt; 50%) accuracy groups on the basis of the correct diagnostic rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall sensitivity, specificity, and correct diagnostic rates were 66.5%, 79.0%, and 71.8%, respectively. Experts tended to exhibit higher specificity than trainees (83% vs. 70%). Polypoid lesions showed higher sensitivity (92% vs. 54%) and lower specificity (61% vs. 88%) than nonpolypoid lesions. Overall, the kappa value was 0.411. In UCAN, 37%, 37%, and 24% were classified into the high-, moderate-, and low-accuracy groups, respectively. All endoscopists assessed one case of UCAN in the low-accuracy group as a nonneoplastic vessel with a surface pattern. Only two nonneoplasias were identified as having nonneoplastic vessel and surface patterns by all endoscopists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrated the usefulness of ME-NBI for qualitative diagnosis, along with its limitations. A unique endoscopic diagnostic algorithm for UCAN, incorporating ME-NBI and other modalities, is necessary.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 4","pages":"900-906"},"PeriodicalIF":3.7,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780000","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":"Histone Deacetylase 9 Deletion Inhibits Hepatic Steatosis and Adipose Tissue Inflammation in Male Diet-Induced Obese Mice","authors":"Siqi Hu,&nbsp;Hyunju Kang,&nbsp;Minkyung Bae,&nbsp;Mi-Bo Kim,&nbsp;Hyungryun Jang,&nbsp;Olivia Corvino,&nbsp;Tho X. Pham,&nbsp;Yoojin Lee,&nbsp;Joan A. Smyth,&nbsp;Young-Ki Park,&nbsp;Ji-Young Lee","doi":"10.1111/jgh.16856","DOIUrl":"10.1111/jgh.16856","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The goal of this study was to determine the role of histone deacetylase 9 (HDAC9) in the development of diet-induced metabolic dysfunction-associated steatohepatitis (MASH) and white adipose tissue (WAT) dysfunctions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We fed male and female mice with global <i>Hdac9</i> knockout (KO) and their wild-type (WT) littermates an obesogenic high-fat/high-sucrose/high-cholesterol (35%/34%/2%, w/w) diet for 20 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p><i>Hdac9</i> deletion markedly inhibited body weight gain and liver steatosis with lower liver weight and triglyceride content than WT in male mice but not females. Consistently, hepatic expression of genes crucial for de novo lipogenesis was markedly suppressed only in male, but not female, <i>Hdac9</i> KO mice. However, <i>Hdac9</i> deletion had a minimal effect on hepatic inflammation and fibrosis. In WAT, <i>Hdac9</i> KO showed less adipocyte hypertrophy, inflammation, and fibrosis in male mice compared with WT. In addition, indirect calorimetry demonstrated that male <i>Hdac9</i> KO mice had significantly higher metabolic rates, respiratory exchange ratios, and energy expenditure without altering physical activities than WT, which was not observed in female mice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings indicate that global deletion of <i>Hdac9</i> prevented the development of obesity, hepatic steatosis, and WAT inflammation and fibrosis in male mice with diet-induced obesity and MASH, suggesting that a sex-dependent role of HDAC9 may exist in the pathways mentioned above.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 3","pages":"741-749"},"PeriodicalIF":3.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895178","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 Transfer Learning Radiomics Nomogram to Predict the Postoperative Recurrence of Advanced Gastric Cancer","authors":"Liebin Huang,&nbsp;Bao Feng,&nbsp;Zhiqi Yang,&nbsp;Shi-Ting Feng,&nbsp;Yu Liu,&nbsp;Huimin Xue,&nbsp;Jiangfeng Shi,&nbsp;Qinxian Chen,&nbsp;Tao Zhou,&nbsp;Xiangguang Chen,&nbsp;Cuixia Wan,&nbsp;Xiaofeng Chen,&nbsp;Wansheng Long","doi":"10.1111/jgh.16863","DOIUrl":"10.1111/jgh.16863","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>In this study, a transfer learning (TL) algorithm was used to predict postoperative recurrence of advanced gastric cancer (AGC) and to evaluate its value in a small-sample clinical study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 431 cases of AGC from three centers were included in this retrospective study. First, TL signatures (TLSs) were constructed based on different source domains, including whole slide images (TLS-WSIs) and natural images (TLS-ImageNet). Clinical model and non-TLS based on CT images were constructed simultaneously. Second, TL radiomic model (TLRM) was constructed by combining optimal TLS and clinical factors. Finally, the performance of the models was evaluated by ROC analysis. The clinical utility of the models was assessed using integrated discriminant improvement (IDI) and decision curve analysis (DCA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TLS-WSI significantly outperformed TLS-ImageNet, non-TLS, and clinical models (<i>p</i> &lt; 0.05). The AUC value of TLS-WSI in training cohort was 0.9459 (95CI%: 0.9054, 0.9863) and ranged from 0.8050 (95CI%: 0.7130, 0.8969) to 0.8984 (95CI%: 0.8420, 0.9547) in validation cohorts. TLS-WSI and the nodular or irregular outer layer of gastric wall were screened to construct TLRM. The AUC value of TLRM in training cohort was 0.9643 (95CI%: 0.9349, 0.9936) and ranged from 0.8561 (95CI%: 0.7571, 0.9552) to 0.9195 (95CI%: 0.8670, 0.9721) in validation cohorts. The IDI and DCA showed that the performance of TLRM outperformed the other models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TLS-WSI can be used to predict postoperative recurrence in AGC, whereas TLRM is more effective. TL can effectively improve the performance of clinical research models with a small sample size.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 4","pages":"844-854"},"PeriodicalIF":3.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895150","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":"Comparative Validation of Prediction Models for HCC Outcomes in Living Donor Liver Transplantation: Superiority of Tumor Markers to Imaging Study","authors":"Hwa-Hee Koh,&nbsp;Minyu Kang,&nbsp;Deok-Gie Kim,&nbsp;Jae Hyon Park,&nbsp;Eun-Ki Min,&nbsp;Jae Geun Lee,&nbsp;Myoung Soo Kim,&nbsp;Dong Jin Joo","doi":"10.1111/jgh.16857","DOIUrl":"10.1111/jgh.16857","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Living donor liver transplantation (LDLT) offers timely curative treatment for unresectable hepatocellular carcinoma (HCC). This study aims to validate and compare previous prediction models for HCC outcomes in 488 LDLT recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For 488 patients who underwent LDLT for HCC, pretransplant imaging studies assessed by modified RECSIT criteria, tumor markers such as alpha feto-protein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA II), and explant pathology were recruited. C-index of models for the HCC outcomes was compared, followed by further investigation for the predictive performances of the best model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found MoRAL (11√PIVKA-II + 2√AFP) demonstrated a higher C-index for HCC recurrence than other models that included radiologically viable tumor number and/or size (MoRAL: 0.709, Milan: 0.537, UCSF: 0.575, Up-to-7: 0.572, French AFP: 0.634, Pre-MORAL: 0.637, HALT-HCC: 0.626, Metroticket2.0: 0.629) and also had the highest C-index for HCC-specific deaths (0.706). Five-year HCC recurrence was well stratified upon dividing the patients into three groups by MoRAL cutoffs (11.9% for MoRAL &lt; 100, 29.6% for MoRAL 100–200, and 48.6% for MoRAL &gt; 200, <i>p</i> &lt; 0.001). However, patients with major vessel invasion or portal vein tumor thrombus showed similarly high HCC recurrence regardless of this grouping (<i>p</i> = 0.612).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The MoRAL, based on tumor markers, showed the best predictive performance for HCC recurrence and HCC-specific death among the validated models, except in cases with major vessel invasion or portal vein tumor thrombus.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 3","pages":"626-634"},"PeriodicalIF":3.7,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895156","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 Prognostic Factors for Patients Aged 80 and Older With Superficial Esophageal Squamous Cell Carcinoma Undergoing Endoscopic Submucosal Dissection","authors":"Yugo Suzuki,&nbsp;Daisuke Kikuchi,&nbsp;Kenichi Ohashi,&nbsp;Shu Hoteya","doi":"10.1111/jgh.16859","DOIUrl":"10.1111/jgh.16859","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Endoscopic submucosal dissection (ESD) is an acceptable treatment for superficial esophageal squamous cell carcinoma (ESCC) even in elderly patients. However, studies on the prognostic factors in very elderly patients are limited. Therefore, we aimed to explore the prognostic factors affecting overall survival (OS) in patients aged ≥ 80 with superficial ESCC who underwent ESD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 155 patients aged ≥ 80 who underwent ESD for superficial ESCC. Clinicopathological findings and long-term outcomes were examined. The prognostic nutritional index (PNI) and geriatric nutritional index (GNRI) were used to assess pre-treatment nutritional status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-nine patients (18.7%) were aged ≥ 85. Thirty-five (22.6%) and 61 (39.4%) patients had a GNRI &lt; 92 and PNI &lt; 45, respectively. Metastatic relapse was observed in five cases, four (80%) of which resulted in death due to the primary disease. The median OS of all patients was 86 months. Although factors specifically associated with disease-specific survival were not identified, GNRI, PNI, comorbidity, and physical status were associated with OS. In multivariate analysis, age ≥ 85 years (<i>p</i> = 0.03), GNRI (<i>p</i> &lt; 0.01), and PNI (<i>p</i> &lt; 0.01) remained factors associated with OS. Patients aged ≥ 85 with either GNRI ≥ 92 or PNI ≥ 45 had a median OS of 106 months, whereas those aged ≥ 85 with GNRI &lt; 92 had a median OS of 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GNRI and PNI are important indicators for assessing the suitability of ESD in elderly patients aged ≥ 80. These indices can help predict OS and guide clinical decision-making for this patient population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 3","pages":"635-644"},"PeriodicalIF":3.7,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895194","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":"Asia-Pacific Survey on the Management of Helicobacter pylori Infection","authors":"Koji Otani,&nbsp;Dao Viet Hang,&nbsp;Rapat Pittayanon,&nbsp;Henry Liu,&nbsp;Kee Huat Chuah,&nbsp;John Hsiang,&nbsp;Ning Zhang,&nbsp;Akira Higashimori,&nbsp;Yasuhiro Fujiwara,&nbsp;The Upper GI Focus Group of the APAGE-ELC","doi":"10.1111/jgh.16862","DOIUrl":"10.1111/jgh.16862","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Gastric cancer (GC)-related incidence and mortality rates remain high owing to <i>Helicobacter pylori</i> infection in Asia, and the importance of primary and secondary prevention of GC has been well recognized. We aimed to investigate the extent of overall agreement among clinicians in the Asia-Pacific region regarding the management of <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Upper Gastrointestinal (GI) Focus Group of the Asian Pacific Association of Gastroenterology-Emerging Leaders Committee developed an international survey, which was distributed to 98 clinicians in the Asia-Pacific region, compromising an online questionnaire focusing on the management of <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants responded from Japan (15, 15.3%), Hong Kong (15, 15.3%), Thailand (33, 33.7%), Vietnam (23, 23.5%), Malaysia (4, 4.1%), Singapore (3, 3.1%), and others (5, 5.1%). The most common first-line eradication regimen was clarithromycin (CAM) triple therapy, including proton pump inhibitor (PPI), amoxicillin (AMPC), and CAM (64.3%) for 14 days (70.4%). The most common second-line eradication regimen was levofloxacin (LVX) triple therapy, including PPI, AMPC, and LVX (22.4%) for 14 days (67.3%). Eradication therapy was deemed necessary for all asymptomatic adults and minors (aged ≤ 17 years) currently infected with <i>H. pylori</i> by 81.6% and 64.3% of respondents, respectively, with 82.7% considering upper GI endoscopy for GC screening useful in the secondary prevention of GC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There appears to be a growing consensus among clinicians, acknowledging the necessity of eradication therapy. We anticipate that this study will establish a new benchmark in preventive medicine aimed at eradicating GC in the Asia-Pacific region.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 4","pages":"832-843"},"PeriodicalIF":3.7,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgh.16862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895152","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":"Exploring the Association Between Food Insecurity, Bowel Health, and All-Cause Mortality in the United States: Insights from NHANES 2005–2010","authors":"Yunlong Li,&nbsp;Yang Chen,&nbsp;Ziqing Yu,&nbsp;Xiaoyin Bai,&nbsp;Gechong Ruan,&nbsp;Yinghao Sun,&nbsp;Wei Han,&nbsp;Hong Yang,&nbsp;Xiaoqing Li","doi":"10.1111/jgh.16861","DOIUrl":"10.1111/jgh.16861","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>Functional gastrointestinal disorders such as chronic constipation (CC) and chronic diarrhea (CD) impose a significant burden on global healthcare resources. Food insecurity, a crucial social determinant of health, remains unclearly associated with CC and CD. We aim to explore the association between food insecurity and CC and CD, and its impact on all-cause mortality among participants with abnormal bowel health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from National Health and Nutrition Survey 2005–2010. We assessed food insecurity using the Household Food Security Survey Module, and bowel health, including CD and CC, was evaluated using fecal characteristics and bowel movement frequency from the Bowel Health Questionnaire. Finally, 13 199 participants were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 15.26% (2014) participants experienced food insecurity. Multivariate analysis revealed that food insecurity was associated with a higher proportion of CD (odds ratio [OR]: 1.24, 95% confidence interval [CI]: 1.02–1.52, <i>p</i> = 0.03), especially in women. CC did not exhibit a significant association with food insecurity (OR: 1.10, CI: 0.86–1.40, <i>p</i> = 0.41). Furthermore, food insecurity was significantly linked to higher all-cause mortality in patients with CD (OR: 1.59, CI: 1.01–2.50, <i>p</i> = 0.046) and CC (OR: 2.01, CI: 1.20–3.46, <i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Assessing food insecurity's impact on bowel health is crucial for policy formulation and risk identification. Research should explore links between food insecurity and CD or CC severity, treatment, and psychosocial aspects to improve patient quality of life.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 3","pages":"653-665"},"PeriodicalIF":3.7,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895174","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":"Efficacy of a Novel Adjustable Snare Technique Versus the Conventional Technique for Converting the Orobiliary Catheter to a Nasobiliary Catheter","authors":"Xianglin Li,&nbsp;Yumei Ning,&nbsp;Yue Zhu,&nbsp;Wei Li,&nbsp;Pengcheng Yang,&nbsp;Jing Wang,&nbsp;Xiaojun He,&nbsp;Qiu Zhao,&nbsp;Lingling Duan,&nbsp;Xiaodan Zhang","doi":"10.1111/jgh.16860","DOIUrl":"10.1111/jgh.16860","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Object</h3>\u0000 \u0000 <p>It is a challenging step to guide a nasobiliary catheter from the mouth to the nasal cavity in endoscopic nasobiliary drainage (ENBD), and new methods are always being explored to improve the procedure. We have developed a novel device which is composed of a dedicated adjustable snare and a tongue depressor–like handle, for completing oral–nasal conversion of the ENBD tube. In this study, we aim to assess the utility of our new technique in repositioning the ENBD catheter by comparing it with conventional guidewire technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The patients who underwent ENBD at Zhongnan Hospital of Wuhan University were enrolled to the study. They were randomly divided into the new and conventional technique groups. The primary outcome was the first-time success rate of operation. The secondary outcome included the procedure time, the comfortable degree, and adverse event rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with using the conventional technique, the first-time success rate of operation using the novel adjustable snare technique to replace the ENBD catheter from the mouth to the nostril was significantly improved (76.19% vs. 51.43%, <i>p</i> &lt; 0.001). The procedure time was significantly shorter using the new device (78.96 s vs. 102.4 s, <i>p</i> &lt; 0.001). In addition, the discomfort scores of patients in the new technique group were lower than those in the conventional group (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our novel adjustable snare technique improved the first-time success rate of the nasobiliary catheter repositioning, shortened the procedure time, and alleviated the patient's discomfort.</p>\u0000 \u0000 <p><b>Trial Registration:</b> Chinese Clinical Trial Registry number: ChiCTR2400085838.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 3","pages":"645-652"},"PeriodicalIF":3.7,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895170","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}