Journal of Gastroenterology and Hepatology最新文献

{"title":"The Clinical Utility of Adding Laminin Gamma 2 Monomer to the PAGE-B Score for Hepatocellular Carcinoma Surveillance in Chronic Hepatitis B.","authors":"Chung-Feng Huang, Po-Cheng Liang, Chao-Kuan Huang, Michael Stec, Mark Anderson, Gavin Cloherty, Pei-Chien Tsai, Tzu-Chun Lin, Yu-Min Ko, Yi-Shan Tsai, Kuan-Yu Chen, Ching-Chih Lin, Tyng-Yuan Jang, Chih-Wen Wang, Yu-Ju Wei, Yi-Hung Lin, Ming-Yen Hsieh, Zu-Yau Lin, Ming-Lun Yeh, Jee-Fu Huang, Chia-Yen Dai, Wan-Long Chuang, Ming-Lung Yu","doi":"10.1111/jgh.70792","DOIUrl":"https://doi.org/10.1111/jgh.70792","url":null,"abstract":"<p><strong>Background and aims: </strong>A residual risk of hepatocellular carcinoma (HCC) persists despite the use of nucleos(t)ide analogs (NA) in chronic hepatitis B (CHB) patients. We aimed to assess the utility of baseline serum laminin gamma 2 monomer (LG2m) by integrating PAGE-B score to predict HCC.</p><p><strong>Methods: </strong>NA-treated CHB patients whose baseline serum LG2m, alpha-fetoprotein (AFP) and PAGE-B score were measured. We evaluated the predictive value of LG2m in subgroups stratified by cirrhosis status and PAGE-B score and proposed a HCC surveillance algorithm.</p><p><strong>Results: </strong>HCC developed in 56 of 1016 patients over a follow-up of 3651 person-years (annual incidence: 1.53%). None of the low PAGE-B patients developed HCC over 5 years. LG2m did not significantly stratify risk in high PAGE-B patients. Conversely, LG2m was significantly predictive of HCC in nonhigh PAGE-B patients (5-year incidence: 5.5% vs. 1.0% for high vs. low LG2m, p = 0.004). Integrating LG2m, AFP, and high PAGE-B achieved a sensitivity of 98.2% for HCC detection. Among patients with a nonhigh PAGE-B score, elevated LG2m was associated with a higher risk of HCC (adjusted HR, 4.40; 95% CI, 1.26-15.44), whereas AFP did not significantly stratify HCC risk in a separate analysis. Intermediate PAGE-B patients with high LG2m should receive closer HCC surveillance (annual incidence: 1.4%) as with high PAGE-B patients did (annual incidence: 1.9%).</p><p><strong>Conclusion: </strong>Serum LG2m level was predictive of HCC specifically among patients with intermediate PAGE-B score. Integration of LG2m into a PAGE-B-oriented algorithm provides a biomarker-driven tool for individualized surveillance, which is vital for improving early-stage HCC detection.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127783","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":"Deep Learning-Based Detection of Sessile Serrated Lesions in Colonoscopy Images: Optimization of a YOLOv3 Framework With Mucus Cap Feature Enhancement for Sessile Serrated Lesion Detection.","authors":"Hongna Lu, Pan Jiang, Tianyin Chen, QinQin Hu, Jiahua Wu, Xi Deng, Mengyao Ge, Ting Weng, Liangshun Zhang, Wenying Guo, Xiaolin Chen, Feng Xu","doi":"10.1111/jgh.70712","DOIUrl":"https://doi.org/10.1111/jgh.70712","url":null,"abstract":"<p><strong>Background and aim: </strong>Sessile serrated lesions (SSLs) are difficult to detect during colonoscopy via standard white-light imaging (WLI) because they are flat, have indistinct borders, and are often hidden by mucus caps. Although narrowband imaging (NBI) can help, its effectiveness is inconsistent. This study evaluated the feasibility of an artificial intelligence (AI)-assisted approach incorporating mucus cap features and both WLI and NBI for SSL detection and diagnosis.</p><p><strong>Methods: </strong>This study developed an AI model for SSL detection by training it on 1980 colonoscopic images (2023-2025). The model enhances standard detection frameworks by specifically integrating mucus cap features and optimizing WLI performance. Model performance was evaluated using detection rate, accuracy, and AUC.</p><p><strong>Results: </strong>At the image level, the SSL detection model achieved an accuracy of 98.7% (sensitivity 100.0%, specificity 97.4%). Lesion-level detection improved from 77.4% with the conventional model to 95.0% after incorporation of mucus cap screening, representing an improvement of 17.6%, with detection rates of 95.9% for mucus cap-free lesions and 98.4% for mucus cap-containing lesions. For morphology-based typing, the WLI-based model achieved an accuracy of 85.8% (AUC 0.89), whereas the NBI-based model showed superior performance with an accuracy of 91.6% (AUC 0.94).</p><p><strong>Conclusions: </strong>This study provides real-world clinical evidence validating AI-based models for SSL detection and diagnosis. Although representing an incremental step rather than a novel framework, such evidence is essential for improving model generalizability and enabling stable extrapolation across clinical settings. Further prospective and multicenter studies are required before reliable clinical deployment.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127795","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":"Early Changes in Lymphocyte Counts Predict Clinical Outcomes in Hepatocellular Carcinoma Treated With Durvalumab Plus Tremelimumab.","authors":"Yuichi Honma, Shigeo Shimose, Takanori Ito, Issei Saeki, Joji Tani, Takanori Matsuura, Tetsu Tomonari, Yasuto Takeuchi, Nobuhito Taniki, Kyo Sasaki, Ryu Sasaki, Takeshi Hatanaka, Satoru Kakizaki, Naoki Yoshioka, Takehito Naito, Mamiko Takeuchi, Tetsuya Yasunaka, Masahiro Sakata, Hideki Iwamoto, Tomotake Shirono, Satoshi Itano, Norikazu Tanabe, Takafumi Yamamoto, Atsushi Naganuma, Yuki Kanayama, Hisamitsu Miyaaki, Sohji Nishina, Nobuhiro Nakamoto, Motoyuki Otsuka, Tetsuji Takayama, Yuzo Kodama, Hideki Kobara, Taro Takami, Hiroki Kawashima, Takumi Kawaguchi, Masaru Harada","doi":"10.1111/jgh.70793","DOIUrl":"https://doi.org/10.1111/jgh.70793","url":null,"abstract":"<p><strong>Background: </strong>Durvalumab plus tremelimumab (Dur/Tre) has shown promising efficacy in advanced hepatocellular carcinoma (HCC), but predictive biomarkers remain unclear. This study aimed to determine whether early changes in peripheral blood lymphocyte counts during Dur/Tre therapy can predict clinical outcomes.</p><p><strong>Methods: </strong>In this multicenter retrospective study, we evaluated 299 patients with advanced HCC to assess whether early changes in peripheral blood lymphocyte counts predict clinical outcomes during Dur/Tre therapy. Changes in lymphocyte counts at 2 weeks after treatment initiation (2w-Δlymphocyte) were analyzed in relation to objective response rate (ORR), progression-free survival (PFS), and overall survival.</p><p><strong>Results: </strong>Patients with a high-2w-Δlymphocyte (> +107/μL) demonstrated a significantly higher ORR (29.6% vs. 14.0%, p < 0.001) and longer PFS (4.3 vs. 2.8 months, p = 0.035) compared with those with a low-2w-Δlymphocyte (≤ +107/μL). Subgroup analyses showed that higher 2w-Δlymphocyte values were associated with better PFS across modified albumin-bilirubin grades (p = 0.011), Barcelona Clinic Liver Cancer stages (p = 0.007), and baseline lymphocyte-to-monocyte ratio (p < 0.001).</p><p><strong>Conclusions: </strong>Early increases in peripheral blood lymphocyte counts, particularly 2w-Δlymphocyte, may be associated with treatment response to Dur/Tre and provide complementary dynamic information to established prognostic factors. Although a favorable association with PFS was observed, this association was attenuated after propensity score matching. Further prospective studies are warranted to validate the clinical utility of 2w-Δlymphocyte.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110849","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":"Letter to the Editor: Clinical Spectrum of Esophageal Motility Disorders in Nonobstructive Dysphagia: A Multicenter, Multiethnic Study.","authors":"Xiaojian Du, Yanfang Wang","doi":"10.1111/jgh.70794","DOIUrl":"https://doi.org/10.1111/jgh.70794","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110865","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 \"Post-Translational Modifications in Pancreatic Cancer: Mechanisms to Clinical Applications\".","authors":"Haleema Rahman, Nisha Kumari","doi":"10.1111/jgh.70797","DOIUrl":"https://doi.org/10.1111/jgh.70797","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110907","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":"Response to \"Commentary on: A Simplified Endoscopic Grading Model for Gastric Intestinal Metaplasia With Preserved Diagnostic Accuracy\".","authors":"Chu-Po Chou, Shih-Chi Hu, Jyh-Ming Liou, Tzu-Chan Hong","doi":"10.1111/jgh.70790","DOIUrl":"https://doi.org/10.1111/jgh.70790","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110842","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":"When \"Non-VCTE\" Does Not Mean VCTE-Free: Reassessing Machine Learning-Based HCC Prediction in Chronic Hepatitis B.","authors":"Yanyang Ying, Mengying Zhu, Yuxiu Zheng, Xingyi Yang","doi":"10.1111/jgh.70798","DOIUrl":"https://doi.org/10.1111/jgh.70798","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110868","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":"Beyond the Ceiling Effect: Interpreting Human-AI Interaction in CADe-Assisted TXI Colonoscopy.","authors":"Lütfullah Zahit Koç, Gökhan Köker","doi":"10.1111/jgh.70787","DOIUrl":"https://doi.org/10.1111/jgh.70787","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110816","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":"Interpreting Decision Thresholds in Young Adults With MASLD.","authors":"Chengfeng Wu, Guohong Ge","doi":"10.1111/jgh.70789","DOIUrl":"https://doi.org/10.1111/jgh.70789","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110831","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":"HCC Surveillance: Reevaluating the Evidence and Limitations.","authors":"Xiaorong Zhou, Yaling Li, Jun Li","doi":"10.1111/jgh.70796","DOIUrl":"https://doi.org/10.1111/jgh.70796","url":null,"abstract":"","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110829","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}