Journal of Gastroenterology最新文献

{"title":"Comment on \"A novel artificial intelligence-based endoscopic ultrasonography diagnostic system for diagnosing the invasion depth of early gastric cancer\".","authors":"Sudhakar Polasi, Kavitha Ramachandran, Aniket Gokhale","doi":"10.1007/s00535-026-02470-w","DOIUrl":"https://doi.org/10.1007/s00535-026-02470-w","url":null,"abstract":"","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate prediction of post-ERCP pancreatitis: a novel approach using serum trypsin.","authors":"Takashi Tamura, Seiji Fujigaki, Tsuyoshi Sanuki, Tetsuya Ikeda, Satoshi Sugimori, Tsukasa Ikeura, Shinji Nakayama, Tomoya Emori, Kazuhiro Fukatsu, Yasutaka Ishii, Shiro Oka, Kenji Ikezawa, Ryoji Takada, Masanori Asada, Ayana Kishibuchi, Takeshi Ogura, Nobu Nishioka, Masaaki Shimatani, Masataka Kano, Arata Sakai, Kae Nagao, Shuhei Shintani, Osamu Inatomi, Masayuki Kitano","doi":"10.1007/s00535-026-02472-8","DOIUrl":"https://doi.org/10.1007/s00535-026-02472-8","url":null,"abstract":"<p><strong>Background: </strong>As trypsin activation occurs early in the pathogenesis of pancreatitis, evaluating serum trypsin (TRY) may allow immediate prediction of post-ERCP pancreatitis (PEP). This study aims to evaluate the diagnostic performance of TRY measurement for predicting PEP.</p><p><strong>Methods: </strong>This multicenter prospective observational study was conducted at 12 tertiary centers in Japan. Serum TRY, amylase (AMY), pancreatic-type AMY (P-AMY), and lipase (LIP) were measured before ERCP, immediately post-procedure (0 h), and 2 h post-procedure. Predictive performances of pancreatic enzymes for PEP were evaluated using receiver operating characteristic (ROC) analysis, Youden's index, and DeLong's test.</p><p><strong>Results: </strong>PEP was identified in 48 of the 463 patients analyzed (10.3%). The optimal 0-h TRY cut-off was 2043 ng/mL, yielding an area under the ROC curve (AUC) of 0.83 (68.7% sensitivity, 84.6% specificity), significantly higher than those of 0-h AMY (AUC 0.74, p = 0.002), 0-h P-AMY (0.78, p = 0.007), or 0-h LIP (0.80, p = 0.048). At 2-h, TRY showed an AUC of 0.89, superior to 2-h AMY (0.84) and comparable to 2-h P-AMY (0.89) and 2-h LIP (0.90). When cutoffs were set as 2 × , 2.5 × and 3 × of the upper limit of normal, TRY consistently showed higher sensitivity than AMY or P-AMY. TRY showed the earliest and steepest post-procedural increase among all enzymes in patients with PEP.</p><p><strong>Conclusions: </strong>TRY measured immediately after ERCP provides significantly better early prediction of PEP than conventional enzymes. Rapid measurement of TRY may enable immediate risk stratification, potentially improving clinical outcomes.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced COMP expression induced by Helicobacter pylori drives gastric cancer progression by NOTCH2/SMAD3 pathway.","authors":"Zhaotian Feng, Muhua Luan, Wenshuai Zhu, He Qi, Yuanxin Xing, Xiaoli Ma, Yunshan Wang, Yanfei Jia","doi":"10.1007/s00535-026-02462-w","DOIUrl":"https://doi.org/10.1007/s00535-026-02462-w","url":null,"abstract":"<p><strong>Background: </strong>The main risk factor for gastric carcinogenesis is infection with Helicobacter pylori (H. pylori) that injects the bacterial oncoprotein cytotoxin-associated gene A (CagA). Aberrant cartilage oligomeric protein (COMP) expression is implicated in tumorigenesis and cancer development. However, the critical mediators participating in regulation of COMP and how COMP contributes to the progression of gastric cancer (GC) have not been elucidated.</p><p><strong>Methods: </strong>To evaluate H. pylori-mediated transcriptional changes, RNA-seq was performed. The clinical relevance and prognostic potential of COMP in GC were examined via Western blot and IHC assays. Functional roles of COMP were further probed using in vitro cellular models and in vivo animal studies. Putative mechanistic networks were elucidated through chromatin immunoprecipitation (ChIP) and co-immunoprecipitation (Co-IP) experiments.</p><p><strong>Results: </strong>In GC cell lines and mouse models, both H. pylori colonization and its virulence factor CagA upregulated COMP at transcriptional and translational levels. COMP expression is markedly elevated in H. pylori-related GC and is associated with poor prognosis. The inhibition of COMP curtailed the pro-proliferative, metastatic, and epithelial-mesenchymal transition (EMT) capacities of the CagA in GC cells. H. pylori infection enhances COMP expression via the activation of KLF5. COMP binding to NOTCH2 and JAG1 facilitates the interaction between NOTCH2 and JAG1, hence activating downstream SMAD3, which promotes EMT in GC.</p><p><strong>Conclusions: </strong>H. pylori infection depends on CagA/KLF5 to induce COMP expression and highlights the COMP/NOTCH2/SMAD3/EMT axis in modulating GC progression, which may reveal actionable targets for GC therapy.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct phenotype of primary sclerosing cholangitis-associated inflammatory bowel disease.","authors":"Haruka Okada, Shinya Sugimoto, Atsuto Kayashima, Yohei Mikami, Takanori Kanai, Nobuhiro Nakamoto","doi":"10.1007/s00535-026-02388-3","DOIUrl":"10.1007/s00535-026-02388-3","url":null,"abstract":"<p><p>Primary sclerosing cholangitis (PSC) is frequently accompanied by colitis with clinicopathologic features that differ from conventional inflammatory bowel disease (IBD). Accumulating evidence indicates that PSC-associated IBD (PSC-IBD) often presents as extensive colitis with a right-sided predominant distribution and characteristic endoscopic features, such as rectal sparing and backwash ileitis. Beyond endoscopic appearance, PSC-IBD also appears to have distinct biological underpinnings, including shared genetic susceptibility, dysregulated bile acid signaling, altered gut microbial communities, and immune crosstalk along the gut-liver axis. These mechanisms may contribute not only to intestinal inflammation but also to PSC-related clinical outcomes. From a long-term perspective, patients with PSC and colitis are consistently classified as a high-risk group for colorectal neoplasia, warranting early and intensive colonoscopic surveillance. In parallel, surveillance for hepatobiliary malignancies remains central in PSC care, although risk stratification continues to evolve. Therapeutic management generally follows established IBD algorithms, yet the extent to which colitis-directed therapies modify PSC outcomes remains uncertain, with heterogeneous findings across cohorts and endpoints. In this review, we summarize current knowledge on the clinical phenotype, mechanistic framework, and outcome-driven management of PSC-IBD, and highlight future directions toward precision surveillance and mechanism-based interventions targeting bile acid-microbiota-immune interactions.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"863-879"},"PeriodicalIF":5.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147485722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological features of localized-type IgG4-related cholecystitis: a nationwide multicenter study in Japan.","authors":"Itaru Naitoh, Takahiro Nakazawa, Kenji Notohara, Dai Inoue, Takahiro Komori, Yujiro Kawakami, Masaki Kuwatani, Tsukasa Ikeura, Takanori Sano, Kazuro Chiba, Hiroyuki Matsubayashi, Takuya Ishikawa, Atsushi Kanno, Atsuhiro Masuda, Masahiro Shiokawa, Ami Hosoi, Masaomi Ichinokawa, Fumihiro Okumura, Mitsuhiro Kawano, Terumi Kamisawa, Atsushi Masamune","doi":"10.1007/s00535-026-02353-0","DOIUrl":"10.1007/s00535-026-02353-0","url":null,"abstract":"<p><strong>Background: </strong>Immunoglobulin G4 (IgG4)-related cholecystitis represents gallbladder involvement in IgG4-related disease (IgG4-RD). However, localized-type IgG4-related cholecystitis is rare and remains poorly characterized. We conducted a nationwide, multicenter study to clarify the clinicopathological features of localized-type IgG4-related cholecystitis in Japan.</p><p><strong>Methods: </strong>We collected clinical information, imaging data, and tissue slides from suspected cases of IgG4-related cholecystitis for central review, and evaluated their clinicopathological features.</p><p><strong>Results: </strong>Fifteen patients were diagnosed with localized-type IgG4-related cholecystitis. The incidence of localized-type IgG4-related cholecystitis was 0.59% (15/2560) among all IgG4-related gastroenterological diseases across 30 institutions. The median age was 62 years (range, 54-70 years), and 10 patients were men. Elevated serum IgG4 levels and other IgG4-RD lesions were observed in all 15 patients. Imaging findings demonstrated subepithelial lesions (SELs) of the gallbladder in all patients, and cystic lesions within SELs suggestive of adenomyomatosis (ADM) in nine patients. Among the 11 patients with available histopathological analyses, two distinct types of mass-forming lesions (inflammatory pseudotumors) characterized by storiform fibrosis and obliterative phlebitis were identified: ADM-type in six cases and mural hypertrophy-type in three cases. Eleven patients underwent surgery and four received glucocorticoids therapy. Within 2-4 weeks of initiating glucocorticoid therapy, complete resolution was achieved in one patient, and partial improvement in three patients.</p><p><strong>Conclusion: </strong>Localized-type IgG4-related cholecystitis is characterized by imaging findings of SELs. It shares histopathological features of IgG4-RD, and often has unique lesions centered around ADM. It responds to glucocorticoid therapy.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"1016-1028"},"PeriodicalIF":5.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to \"Increasing age at diagnosis raises malignancy risk and aminosalicylate intolerance influences therapeutic strategies in ulcerative colitis\".","authors":"Buyuan Dong, Liyue Hou","doi":"10.1007/s00535-026-02378-5","DOIUrl":"10.1007/s00535-026-02378-5","url":null,"abstract":"","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"1034"},"PeriodicalIF":5.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Dependence-related screening positivity among regular stimulant-laxative users with chronic constipation: a multicenter prospective observational study\".","authors":"Ruoyi Xu","doi":"10.1007/s00535-026-02477-3","DOIUrl":"10.1007/s00535-026-02477-3","url":null,"abstract":"","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional differences for the risk of in-hospital mortality after pancreaticoduodenectomy: a cross-sectional study analyzing data from a Japanese nationwide database including 86,339 patients.","authors":"Teruchika Koyama, Nobutoshi Nawa, Hisaaki Nishimura, Mariko Hanafusa, Keiichi Akahoshi, Hiroki Ueda, Kiyohide Fushimi, Takeo Fujiwara","doi":"10.1007/s00535-026-02357-w","DOIUrl":"10.1007/s00535-026-02357-w","url":null,"abstract":"<p><strong>Background: </strong>Pancreaticoduodenectomy is the only curative treatment for pancreatic cancer, though it is an invasive procedure, with a high perioperative mortality rate, which may differ by region. The objectives of this study are to 1) investigate the risk of in-hospital mortality after pancreaticoduodenectomy in urban and rural hospitals, and 2) investigate its differences, stratified by age groups and hospital volume.</p><p><strong>Methods: </strong>This study analyzed data from 86,339 patients who underwent pancreaticoduodenectomy from a Japanese nationwide database between 2010 and 2021. Hospitals were classified as urban if located in cities with ≥ 500,000 residents or in municipalities where ≥ 1.5% of residents commute to such cities, and all others were classified as rural. The primary outcome was in-hospital mortality within 90 days after pancreaticoduodenectomy. Logistic regression was applied.</p><p><strong>Results: </strong>The risk for in-hospital mortality within 90 days after pancreaticoduodenectomy was significantly higher for patients in rural hospitals than those in urban hospitals (OR 1.17 [1.04-1.31]). Stratified analysis by age groups showed rural location was a significantly higher risk for patients ≧80 years old (OR 1.41 [1.11-1.80]), whereas there was no significant difference among patients aged ≤ 79 years. Stratified analysis by hospital volume and age groups showed that rural location was a significantly higher risk for patients ≧80 years old in low-volume hospitals (OR 1.43 [1.09-1.87]), whereas that was not significant for patients in high-volume hospitals.</p><p><strong>Conclusions: </strong>The risk for in-hospital mortality was higher for rural hospitals than urban. Patients aged ≥ 80 years old in low-volume rural hospitals represented the highest-risk subgroup.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"1003-1015"},"PeriodicalIF":5.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accounting for resumption timing in evaluating the safety of oral anticoagulants following upper gastrointestinal endoscopic submucosal dissection.","authors":"Chikamasa Ichita, Tadahiro Goto, Sayuri Shimizu","doi":"10.1007/s00535-026-02365-w","DOIUrl":"10.1007/s00535-026-02365-w","url":null,"abstract":"","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":"1029-1030"},"PeriodicalIF":5.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Dependence-related screening positivity among regular stimulant-laxative users with chronic constipation: a multicenter prospective observational study\".","authors":"Wenqiang Cheng","doi":"10.1007/s00535-026-02478-2","DOIUrl":"10.1007/s00535-026-02478-2","url":null,"abstract":"","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":5.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}