Journal of Gastroenterology and Hepatology最新文献

{"title":"Causal Associations Between Lipids, NPC1L1, and Liver Cancer Risk: Insights From Mendelian Randomization and Bioinformatics","authors":"Xiaoyan Guo,&nbsp;Lili Wu,&nbsp;Jing Lai,&nbsp;Yuankai Wu,&nbsp;Dianke Chen","doi":"10.1111/jgh.16897","DOIUrl":"10.1111/jgh.16897","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>The study aims to investigate the potential causal effects of lipids on liver cancer risk and to analyze the possible impact of lipid-lowering drug targets on liver cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Genetic variants linked to lipid traits and drug targets were obtained from the Global Lipids Genetics Consortium and DrugBank. Liver cancer data were sourced from FinnGen. Mendelian randomization (MR) was used to assess causal relationships between lipid traits and liver cancer. Functional analyses included protein–protein interaction (PPI), KEGG pathway enrichment, transcription factor (TF) network analysis, and survival analysis. NPC1L1 expression, DNA methylation, and immune infiltration were analyzed using UALCAN, TCGA-LIHC, and TIMER, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MR analysis showed higher genetically predicted LDL-C levels reduced liver cancer risk (OR = 0.5981, <i>p</i> = 0.034). Drug target MR indicated that NPC1L1 inhibition (OR = 1.0638, <i>p</i> = 0.0311) and elevated PPARɑ levels (OR = 1.1339, <i>p</i> &lt; 0.01) increased liver cancer risk. Functional analysis revealed NPC1L1 was highly expressed in liver cancer tissues due to hypomethylation and linked to immune cell infiltration, indicating its role in immune evasion and tumor progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study demonstrates that elevated LDL-C levels are associated with a reduced risk of liver cancer and NPC1L1 plays a key role in regulating lipid metabolism and influencing immune evasion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1602-1615"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029157","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":"Incidence of Osteopenia or Osteoporosis in Asian Patients With Chronic Hepatitis B","authors":"Hye Won Lee,&nbsp;Sungshin Kwon,&nbsp;Yeo Rae Moon,&nbsp;Hyunjung Ahn,&nbsp;Juyeon Lee,&nbsp;Sang-Hoon Ahn","doi":"10.1111/jgh.16982","DOIUrl":"10.1111/jgh.16982","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In an aging population, patients with chronic hepatitis B (CHB) may face a higher risk of osteopenia, osteoporosis, or fractures. We investigated the epidemiology and risk factors associated with osteopenia or osteoporosis in patients with CHB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included patients ≥ 19 years who underwent bone mineral density (BMD) testing ≥ 2 times between 2005 and 2021 at Severance Hospital, Seoul, South Korea. Demographic factors and comorbidities for patients with or without CHB were matched based on a 1:4 ratio. Cox proportional hazard regression models were used to estimate hazard ratios to assess osteopenia or osteoporosis risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 275 patients with CHB and 7868 patients without CHB who had normal BMD were analyzed. The incidence of osteopenia or osteoporosis in patients with and without CHB was 25.8% and 28.7%, respectively. After propensity score matching, in the second BMD test, 73.8%, 24.7%, and 1.5% of patients with CHB and 70.7%, 26.5%, and 2.8% of patients without CHB had normal BMD, osteopenia, and osteoporosis, respectively. Risk factors for osteopenia or osteoporosis in these patients were age, body mass index &lt; 25, chronic kidney disease, and proton pump inhibitor use. There were no significant differences in cumulative hazard for patients with or without CHB.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with or without CHB showed similar risks of osteopenia or osteoporosis. In addition to providing closer monitoring for patients with CHB with greater bone disease risk, further studies of bone disease in these patients may help to understand the factors that impact bone health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1586-1594"},"PeriodicalIF":3.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013654","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":"AI-Assisted Glucocorticoid Treatment Response Prediction of Active Ulcerative Active Patients.","authors":"Ning Zhang, Yuxi Huang, Bo Peng, Zongpeng Weng, Bin Li, Han Xiao, Sui Peng, Xinming Song, Qin Guo","doi":"10.1111/jgh.16961","DOIUrl":"https://doi.org/10.1111/jgh.16961","url":null,"abstract":"<p><strong>Background: </strong>Glucocorticoids are recommended for the induction and remission phase of ulcerative colitis (UC). Early identification of glucocorticoid therapy response contributes to more precise treatment management. We aim to use deep learning model to predict glucocorticoid response prognosis in active UC.</p><p><strong>Methods: </strong>From January 2006 to December 2023, 485 intestinal histological whole slide images (WSIs) of 212 UC patients from two medical centers in China was collected. We developed and validated a deep learning model (UCG-SwinT) based on WSI and clinical data to predict the treatment response of glucocorticoid induction therapy. Response was defined as steroid effectiveness and steroid dependence. We used area under the curves (AUCs) to evaluate the performance of the model and compared it to clinical factors. Grad-CAM was used to visualize the histological features the model focused when predicting treatment response.</p><p><strong>Results: </strong>The AUCs of predicting response in training, validation, and external testing set were 0.750, 0.727, and 0.723, respectively. The UCG-SwinT model performs better while combining histopathological images with clinical data than simply inputting histopathological images, with AUCs of 0.826, 0.731, and 0.725 in predicting treatment response in the training, validation, and external testing cohorts and outperformed all clinical factors. Grad-CAM showed that increased inflammatory cells and intestinal mucosal microvascular dilation are related to glucocorticoid response in UC patients.</p><p><strong>Conclusions: </strong>UCG-SwinT has the potential to predict glucocorticoid response in active UC patients and has guiding significance for individualized clinical treatment.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029152","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":"Increased Prevalence of Barrett's Esophagus in Taiwan: A Prospective Multicenter Study.","authors":"Fu-Jen Lee, Ming-Chang Tsai, Chien-Lin Chen, Ming-Wun Wong, Hsu-Heng Yen, Jeng-Yih Wu, Chen-Shuan Chung, Ping-Huei Tseng, Ying-Nan Tsai, Ming-Tsung Hsieh, Chi-Yang Chang","doi":"10.1111/jgh.16992","DOIUrl":"https://doi.org/10.1111/jgh.16992","url":null,"abstract":"<p><strong>Background and aim: </strong>With rising rates of esophageal adenocarcinoma (EAC) in Western countries, Barrett's esophagus (BE) has become a growing concern. The increasing prevalence of chronic gastroesophageal reflux disease (GERD) in Taiwan suggests a potential rise in BE cases as well. A 2007 large-scale study reported a BE prevalence of 1.06% in Taiwan. Our multicenter prospective study aims to evaluate the current prevalence of BE and identify key risk factors in this region.</p><p><strong>Method: </strong>We assessed outpatients undergoing upper gastrointestinal endoscopy for various symptoms, obtaining biopsies from endoscopically suspected esophageal metaplasia (ESEM) at least 1 cm above the gastroesophageal junction. Quadrant biopsies were taken every 2 cm, with BE confirmed by histological evidence of specialized intestinal metaplasia.</p><p><strong>Results: </strong>Among 8697 subjects, the prevalence of BE was 2.6%. GERD symptoms, erosive esophagitis (EE), and hiatal hernia (HH) were present in 52.5%, 27.3%, and 7.85% of subjects, respectively. Of 751 with ESEM, 228 were diagnosed with BE, predominantly short-segment BE (78.1%). Multivariate analysis identified significant risk factors for BE: age > 50 (OR = 1.59), male gender (OR = 2.27), alcohol consumption (OR = 1.70), GERD symptoms (OR = 1.45), EE (OR = 1.94), and HH (OR = 2.49) (all p < 0.01).</p><p><strong>Conclusion: </strong>The prevalence of BE was identified as 2.6%, representing a significant increase compared with 2007. Significant risk factors include age more than 50, male gender, alcohol use, GERD symptoms, EE, and HH.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988563","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":"Integration of Machine Learning Algorithms and Single-Cell Sequencing Analysis Reveals the Efferocytosis-Related Molecular Subtype and Prognostic Scoring Index in Colon Adenocarcinoma.","authors":"Kun Ju, Xiaolei Liu, Qian Wang, Xichun Liu, Dalue Li, Bin Tan","doi":"10.1111/jgh.16985","DOIUrl":"https://doi.org/10.1111/jgh.16985","url":null,"abstract":"<p><strong>Background: </strong>Colon adenocarcinoma (COAD) is a leading cause of cancer-related mortality, with limited therapies for advanced stages. Efferocytosis, the clearance of apoptotic cells, modulates tumor immunity and progression. We investigated efferocytosis-related genes (ERRGs) in COAD through multiomics integration.</p><p><strong>Methods: </strong>We analyzed multiomics data from public databases to identify differentially expressed ERRGs and their molecular subtypes. An ERRG score index was developed using integrated machine learning algorithms to evaluate its predictive capacity. Single-cell sequencing and in vitro functional assays were performed to validate key findings.</p><p><strong>Results: </strong>Among 162 ERRGs, 22 were dysregulated in COAD. Three molecular subtypes exhibited distinct prognoses, immune profiles, and therapy responses. The ERRG score system accurately predicted clinical outcomes, with low scores correlating with improved survival and sensitivity to certain drugs. Single-cell analysis highlighted TIMP1 as a key regulator, confirmed by its knockdown suppressing tumor proliferation and migration in vitro.</p><p><strong>Conclusion: </strong>ERRGs demonstrate prognostic and therapeutic relevance in COAD, providing insights into molecular subtyping and immunotherapy prediction. TIMP1 emerges as a potential therapeutic target, warranting further clinical validation.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029295","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":"Unraveling the Role of Programmed Cell Death Gene Signature and THBS1 in Gastric Cancer Progression and Therapy Response.","authors":"Min Wang, YinChao Guo, YiNing Xu, Yan Yu, Jia Lin, Yao Lin, LiLin Ge, Yitong Zhang, LiangJie Chi, FangQin Xue, QingShui Wang","doi":"10.1111/jgh.16987","DOIUrl":"https://doi.org/10.1111/jgh.16987","url":null,"abstract":"<p><strong>Background: </strong>Programmed cell death (PCD) genes play crucial roles in cancer progression and response to therapies, yet their impact on gastric cancer remains inadequately elucidated. This study aimed to create a prognostic cell death signature (PCDs) for gastric cancer, providing insights into potential therapeutic targets and survival predictors.</p><p><strong>Methods: </strong>We utilized TCGA-STAD and five GEO datasets, representing thousands of gastric cancer samples, for a comprehensive analysis of PCD genes. Differential gene expression, functional enrichment, survival, and machine learning analyses were conducted to construct a PCD-based prognostic model.</p><p><strong>Results: </strong>A total of 249 differentially expressed PCD genes were identified between cancerous and noncancerous gastric tissues. Subsequently, a PCD signature based on seven genes was developed and cross-validated across multiple cohorts. The high-PCD subtype correlated with poorer survival outcomes, lower tumor mutational burden, higher infiltration of M2 macrophages, lower levels of immune checkpoint expression, and decreased response to immunotherapy. A nomogram incorporating the PCDs provided accurate survival rate predictions. Additionally, nine machine learning algorithms were implemented for recurrence prediction, with the random forest model displaying high effectiveness. In this model, thrombospondin 1 (THBS1) showed the highest weight, and its knockdown significantly reduced gastric cancer cell proliferation and invasion.</p><p><strong>Conclusion: </strong>This study underscores the significance of PCD genes, particularly THBS1, in gastric cancer progression and highlights their value as potential therapeutic targets. The predictive models developed here can aid in assessing patient prognosis and tailoring personalized treatment strategies.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971607","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 METTL14-YTHDF1-SAP30 Axis Promotes Glycolysis and Oxaliplatin Resistance in Colorectal Adenocarcinoma via m6A Modification.","authors":"Haoran Zhang, Xunxin Wu, Jinlin Nie, Xiaofeng Li, Cheng Li, Hailiang Li","doi":"10.1111/jgh.16988","DOIUrl":"https://doi.org/10.1111/jgh.16988","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is a prevalent cancer with a poor prognosis, especially in advanced metastatic stages. This study identifies SAP30 as a significantly upregulated gene in COAD, linking high SAP30 expression to reduced overall survival. Experimental validation revealed elevated SAP30 levels in CRC cell lines (SW480, RKO, HT29, and HCT15), with the highest expression in oxaliplatin-resistant sublines (HT29-OxR and HCT15-OxR). SAP30 knockdown in oxaliplatin-resistant cells reduced glycolytic activity, glucose consumption, and glycolytic enzyme expression (LDHA, HK1, HK2, GLUT1, and GLUT4), while SAP30 overexpression enhanced glycolysis, partially reversed by the GLUT1 inhibitor WZB117. SAP30 also promoted cell proliferation, inhibited apoptosis, and enhanced migration and invasion in resistant CRC cells. Mechanistically, METTL14, an m6A methyltransferase, upregulates SAP30 mRNA via m6A modification, stabilized by the m6A reader protein YTHDF1. This METTL14-YTHDF1-SAP30 axis sustains SAP30 expression, promoting glycolysis and oxaliplatin resistance. In vivo studies confirmed that SAP30 knockout impairs tumor growth and reduces proliferation and glycolysis markers. This study highlights the METTL14-YTHDF1-SAP30 axis in glycolysis and chemoresistance in CRC, suggesting SAP30 as a potential target to overcome oxaliplatin resistance and improve patient outcomes.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014307","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":"Head-to-Head Comparison of Long-Term HCC Risk of Antivirals-Treated Versus Untreated Low-Level Viremia in HBV-Compensated Cirrhosis","authors":"Nobuharu Tamaki,&nbsp;Daniel Q. Huang,&nbsp;Hyung Woong Lee,&nbsp;Soo Young Park,&nbsp;Yu Rim Lee,&nbsp;Dong Hyun Sinn,&nbsp;Tae Seop Lim,&nbsp;Hiroyuki Marusawa,&nbsp;Seng Gee Lim,&nbsp;Hironori Ochi,&nbsp;Masahiko Kondo,&nbsp;Yasushi Uchida,&nbsp;Haruhiko Kobashi,&nbsp;Koichiro Furuta,&nbsp;Masayuki Kurosaki,&nbsp;Beom Kyung Kim","doi":"10.1111/jgh.16986","DOIUrl":"10.1111/jgh.16986","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Among patients with hepatitis B virus (HBV)-infected compensated cirrhosis and low-level viremia, there are limited data for comparative outcomes between those treated with oral nucleos(t)ide analogs versus those not. We conducted a large, multi-ethnic, multi-center study to examine the impact of antiviral treatment (AVT) on long-term hepatocellular carcinoma (HCC) risk for compensated cirrhosis and low-level viremia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with compensated cirrhosis and low-level viremia (serum HBV-DNA 20–2000 IU/mL) at baseline or before AVT were screened for eligibility from 19 hospitals in South Korea, Singapore, and Japan. The primary outcome was HCC development, compared between those receiving AVT versus those untreated throughout follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 848 patients (mean age 55.7 years and 66.9% male), AVT (<i>n</i> = 233) was associated with significantly lower annual HCC incidence compared to non-AVT (<i>n</i> = 615); 1.72/100 versus 2.99/100 person-years (PY), respectively (<i>p</i> = 0.033). Multivariable Cox-regression analyses determined that AVT was associated with significantly lower HCC risk, compared to non-AVT (adjusted HR [HR] 0.514, 95% confidence interval [CI] 0.271–0.976; <i>p</i> = 0.042). In a landmark analysis, HCC incidence was similar between two groups until 18 months, but after this landmark, the treated group had the significantly lower HCC risk compared to untreated group (<i>p</i> = 0.012). Furthermore, propensity score-matching analysis consistently showed that AVT was associated with significantly lower HCC risk, compared to non-AVT; the annual HCC incidence of 1.45/100 PYs versus 2.73/100 PY, respectively (<i>p</i> = 0.043).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with compensated cirrhosis and low-level viremia may benefit from long-term AVT, highlighting appropriate amendment of reimbursement guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1595-1601"},"PeriodicalIF":3.7,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967789","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":"Effect of Potassium-Competitive Acid Blockers on Upper Gastrointestinal Bleeding in Patients on Dual Antiplatelet Therapy After Percutaneous Coronary Intervention: A Nationwide Cohort Study.","authors":"Minyoul Baik, Jimin Jeon, Joonsang Yoo, Jinkwon Kim","doi":"10.1111/jgh.16989","DOIUrl":"https://doi.org/10.1111/jgh.16989","url":null,"abstract":"<p><strong>Background and aim: </strong>Proton pump inhibitors (PPIs) are the drug of choice to prevent upper gastrointestinal (UGI) bleeding in patients receiving dual antiplatelet therapy (DAPT); however, unmet needs remain. Potassium-competitive acid blockers (P-CABs) are novel acid-suppressive drugs that have emerged as potential alternatives. We evaluated the effectiveness of P-CAB in reducing the risk of UGI bleeding in patients receiving DAPT after percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>This retrospective cohort study included patients with PCI on DAPT between January 2019 and January 2023 using the Korean nationwide health claims database. The primary outcome was admission for UGI bleeding within 6 months of PCI. A multivariate Cox regression model was used to evaluate UGI bleeding risk based on PPIs and P-CAB use.</p><p><strong>Results: </strong>Of the 210 447 patients who underwent PCI on DAPT (mean age, 65.5 years; 74.7% men), 4.6% and 47.5% patients were prescribed P-CABs and PPIs, respectively. Overall, 0.3% of patients experienced UGI bleeding within 6 months of PCI. P-CAB users had a reduced risk of UGI bleeding (adjusted hazard ratio, 0.59; 95% confidence interval, 0.38-0.92; p = 0.019) compared with patients not receiving P-CAB or PPI. No significant difference was observed between the P-CAB and PPI users (p > 0.05).</p><p><strong>Conclusions: </strong>Among Korean patients undergoing PCI with DAPT, P-CABs reduced UGI bleeding comparably to PPIs. These findings suggest that P-CABs are potential alternatives to PPIs for preventing UGI bleeding.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Hepatocellular Carcinoma Decreases After Antiviral Therapy-Induced HBsAg Seroclearance.","authors":"Han Ah Lee, Hyun Woong Lee, Yeon Seok Seo, Dong Hyun Sinn, Sang Hoon Ahn, Beom Kyung Kim, Seung Up Kim","doi":"10.1111/jgh.16973","DOIUrl":"https://doi.org/10.1111/jgh.16973","url":null,"abstract":"<p><strong>Background: </strong>Antiviral therapy (AVT) reduces the risk of hepatitis B virus-related hepatocellular carcinoma (HCC).</p><p><strong>Aims: </strong>The difference in risk of HCC after hepatitis B surface antigen (HBsAg) seroclearance to the AVT status was explored.</p><p><strong>Methods: </strong>Patients with chronic hepatitis B who achieved HBsAg seroclearance were retrospectively evaluated. The primary outcome was the development of HCC after HBsAg seroclearance.</p><p><strong>Results: </strong>Of the study population, 1280 (84.2%) and 241 (15.8%) patients achieved HBsAg seroclearance without (spontaneous clearance group) and with AVT (AVT-induced clearance group), respectively. HCC cumulative incidence was comparable between the two groups (hazard ratio [HR] = 0.461; log-rank test, p = 0.197), whereas it was significantly lower in the AVT-induced HBsAg clearance group than in the spontaneous HBsAg clearance group in inverse probability of treatment weighting analysis (HR = 0.442; log-rank test, p = 0.004). In multivariate analysis, spontaneous HBsAg clearance, albumin-bilirubin (ALBI) grade ≥ 2, cirrhosis, and platelet count < 50 × 10⁹/L were independently associated with the increased risk of HCC. The newly established antiviral therapy, cirrhosis, ALBI, and platelet count (ACAP) scores had a C-index of 0.765, and the time-dependent areas under the curve of HCC prediction at 5 and 8 years were 0774 and 0.823, respectively.</p><p><strong>Conclusion: </strong>The risk of HCC differed according to the AVT status after HBsAg seroclearance.</p>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983641","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}