Hepatology最新文献

{"title":"Deep learning analysis of magnetic resonance imaging accurately detects early-stage perihilar cholangiocarcinoma in patients with primary sclerosing cholangitis","authors":"Yashbir Singh, John E. Eaton, Sudhakar K. Venkatesh, Christopher L. Welle, Byron Smith, Shahriar Faghani, Mette Vesterhus, Tom H. Karlsen, Kristin K. Jorgensen, Trine Folseraas, Kosta Petrovic, Anne Negard, Ida Bjoerk, Andreas Abildgaard, Aliya F. Gulamhusein, Kartik Jhaveri, Gregory J. Gores, Sumera I. Ilyas, Timucin Taner, Julie K. Heimbach, Ty S. Diwan, Nicholas F. LaRusso, Konstantinos N. Lazaridis, Bradley J. Erickson","doi":"10.1097/hep.0000000000001314","DOIUrl":"https://doi.org/10.1097/hep.0000000000001314","url":null,"abstract":"Background and aims: Among those with primary sclerosing cholangitis (PSC), perihilar CCA (pCCA) is often diagnosed at a late-stage and is a leading source of mortality. Detection of pCCA in PSC when curative action can be taken is challenging. Our aim was to create a deep learning model that analyzed magnetic resonance imaging (MRI) to detect early-stage pCCA and compare its diagnostic performance with expert radiologists. Approach and results: We conducted a multicenter, international, retrospective cohort study involving adults with large duct PSC who underwent contrast-enhanced MRI. Senior abdominal radiologists reviewed the images. All patients with pCCA had early-stage cancer and were registered for liver transplantation. We trained a 3D DenseNet-121 model, a form of deep learning, using MRI images and assessed its performance in a separate test cohort. The study included 398 patients (training cohort n=150; test cohort n=248). pCCA was present in 230 individuals (training cohort n=64; test cohort n=166). In the test cohort, the respective performances of the model compared to the radiologists were: sensitivity 87.9% versus 50.0%, <jats:italic toggle=\"yes\">p</jats:italic>&lt;0.001; specificity 84.1% versus 100.0%, <jats:italic toggle=\"yes\">p</jats:italic>&lt;0.001; area under receiving operating curve 86.0% versus 75.0%, <jats:italic toggle=\"yes\">p</jats:italic>&lt;0.001. Even when a mass was absent, the model had a higher sensitivity for pCCA than radiologists (91.6% vs. 50.6%, <jats:italic toggle=\"yes\">p</jats:italic>&lt;0.001) and maintained good specificity (84.1%). Conclusion: The 3D DenseNet-121 MRI model effectively detects early-stage pCCA in PSC patients. Compared to expert radiologists, the model missed fewer cases of cancer.","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"3 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher level of Hepatitis B Surface antigen associated with delayed development of hepatocellular carcinoma in immune-tolerant patients","authors":"Tai-Chung Tseng, Tetsuya Hosaka, Mei-Hung Pan, Chun-Jen Liu, Fumitaka Suzuki, Chien-Jen Chen, Tung-Hung Su, Hiromitsu Kumada, Wan-Ting Yang, Hung-Chih Yang, Chen-Hua Liu, Pei-Jer Chen, Hwai-I. Yang, Jia-Horng Kao","doi":"10.1097/hep.0000000000001313","DOIUrl":"https://doi.org/10.1097/hep.0000000000001313","url":null,"abstract":"Background: Active viral replication in patients with chronic HBV infection is a major risk factor for hepatocellular carcinoma (HCC). However, the HCC risk in highly viremic patients, such as immune-tolerant patients, remains unclear. This study aimed to investigate the relationship between viral factors and HCC risk in patients with chronic HBV infection, focusing on immune-tolerant patients. Patients and Methods: A total of 6,139 non-cirrhotic Taiwanese patients with chronic HBV infection were enrolled, comprising 2,666 patients from ERADICATE-B study and 3,473 patients from REVEAL-HBV study. The primary endpoint was HCC development. The relationships between viral factors and HCC risk in HBeAg-positive and HBeAg-negative patients were analyzed separately. Results: Over a median 21.7-year follow-up, 547 patients developed HCC. The relationship between viral factors and HCC risk varied depending on HBeAg status. HCC risk increased with viral load and plateaued at ≥5 log<jats:sub>10</jats:sub> IU/mL in HBeAg-negative patients, while showing limited correlation in HBeAg-positive patients. Conversely, HBsAg levels were positively associated with HCC risk in HBeAg-negative patients but negatively associated in HBeAg-positive patients. Further investigation focusing on HBeAg-positive immune-tolerant patients showed that HBsAg levels ≥10,000 IU/mL (vs. &lt;10,000 IU/mL) were associated with delayed HCC development, which was validated both internally through various subgroup analyses and externally by an independent Japanese cohort. Conclusion: Predictive roles of HBV DNA and HBsAg levels in HCC development differ between HBeAg-negative and HBeAg-positive patients. Particularly, among immune-tolerant patients, HBsAg levels ≥10,000 IU/mL showed delayed development of HCC, suggesting HBsAg as a biomarker to define genuine immune-tolerant patients.","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"54 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CAD-Driven pathways in hepatocellular carcinoma metastasis","authors":"Carmen Chak-Lui Wong, Chun-Ming Wong","doi":"10.1097/hep.0000000000001315","DOIUrl":"https://doi.org/10.1097/hep.0000000000001315","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"25 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population perspectives on benefits and harms of screening for metabolic dysfunction-associated steatotic liver disease","authors":"Alina M. Allen, W. Ray Kim, Patrizia Carrieri, Rachel Canning, Fang-Shu Ou, Joanne Benson, Jessica L. Olson, Sudhakar K. Venkatesh, Jiahui Li, Meng Yin, Maysa Eslami, Richard L. Ehman, Jennifer Hunter Berg, Jeffrey V. Lazarus","doi":"10.1097/hep.0000000000001311","DOIUrl":"https://doi.org/10.1097/hep.0000000000001311","url":null,"abstract":"Screening for diseases can have psychological impacts, such as anxiety, and requires acceptability from the population to be effective. This study examined the perspectives on the benefits and harms of screening for metabolic dysfunction-associated steatotic liver disease (MASLD) among the general population to optimize screening practices. A survey was sent to participants enrolled between 2020-2024 in a prospective MASLD screening study in Olmsted County, MN. The survey assessed participants’ perceived anxiety, stigma, quality of life, preferred screening methods, financial concerns, and lifestyle impacts following screening and diagnosis. Of the 461 participants, 342 (74%) completed the survey. Overall, 14% of participants reported screening-related anxiety and 14% were concerned about disclosing a potential MASLD diagnosis to others. Among those without a MASLD diagnosis, 99% felt reassured about their liver health, 48% reported an improved quality of life, and 25% made lifestyle changes pertaining to their diet, alcohol use, and physical activity. Of the 77 participants diagnosed with MASLD, 52% experienced some anxiety about their new diagnosis; however, 95% and 97% considered it important to receive an early MASLD diagnosis to mitigate the risk for cirrhosis and cardiovascular disease, respectively. Notably, 79% of diagnosed participants found the diagnosis beneficial in adopting healthier habits, with 30% achieving a &gt;10% weight loss after screening. Conclusion: This population-based survey demonstrates that the perceived benefits of proactive MASLD screening, such as increased awareness, lifestyle changes, and early diagnosis, outweigh the harms. These findings highlight the importance of early screening through patient-centered protocols to improve health outcomes.","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"183 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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: The divergences in the efficacy of adjuvant transarterial chemoembolization for hepatocellular carcinoma: In-depth analysis and enlightenments","authors":"Shuanggang Chen, Lujun Shen, Weijun Fan","doi":"10.1097/hep.0000000000001310","DOIUrl":"https://doi.org/10.1097/hep.0000000000001310","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"7 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Niche Discovery: Spatial Mapping of Therapeutic Targets in Biliary Atresia","authors":"Jack W. Sample","doi":"10.1097/hep.0000000000001247","DOIUrl":"https://doi.org/10.1097/hep.0000000000001247","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"214 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resmetirom: Steatosis Down, Fibrosis Out, Peace of Mind In","authors":"Prowpanga Udompap","doi":"10.1097/hep.0000000000001245","DOIUrl":"https://doi.org/10.1097/hep.0000000000001245","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"69 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AKI Alert: Anakinra + Zinc, and the Renal Rollercoaster","authors":"Vinay Jahagirdar, Juan Pablo Arab","doi":"10.1097/hep.0000000000001248","DOIUrl":"https://doi.org/10.1097/hep.0000000000001248","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"14 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Frail to Free: How Liver Transplantation Defies Frailty’s Limits","authors":"Guneet Sidhu","doi":"10.1097/hep.0000000000001246","DOIUrl":"https://doi.org/10.1097/hep.0000000000001246","url":null,"abstract":"","PeriodicalId":177,"journal":{"name":"Hepatology","volume":"183 1","pages":""},"PeriodicalIF":13.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HLA-DQB1*03:01 and risk of Hepatitis B virus-related hepatocellular carcinoma.","authors":"Ting Zhang, Chih-Jen Huang, Hai-Tao Chen, Yu-Han Huang, Mei-Hung Pan, Mei-Hsuan Lee, Mathias Viard, Allan Hildesheim, Ruth M Pfeiffer, Mary Carrington, Chien-Jen Chen, Bin Zhu, Tobias L Lenz, Deke Jiang, Hwai-I Yang, Zhiwei Liu","doi":"10.1097/HEP.0000000000001307","DOIUrl":"https://doi.org/10.1097/HEP.0000000000001307","url":null,"abstract":"<p><strong>Background aims: </strong>The human leukocyte antigen (HLA) locus is implicated in hepatocellular carcinoma (HCC) among chronic hepatitis B virus (HBV) carriers. We investigated associations of HLA variants, amino acid polymorphisms, zygosity, and evolutionary divergence (HED) with HBV-related HCC in Han Chinese and explored biological mechanisms.</p><p><strong>Approach results: </strong>We examined the associations of HLA variants (imputed 4-digit classical alleles and amino acid polymorphisms), zygosity, and HED with HBV-related HCC in a discovery set (706 HBV-related HCC cases, 6,197 chronic HBV carriers in Taiwan). Significant signals were validated in independent set (636 cases, 560 controls in Qidong, PR China). We used logistic regression adjusted for sex, age, and top 10 genetic principal components, with a Bonferroni-correction for multiple testing (p<1.6×10-4). We evaluated predicted peptide-binding affinities and control of viral load, viral population diversity, and inflammatory markers for significant signals. HLA-DQB1*03:01 was most significantly associated with HBV-related HCC in discovery and validation sets (ORmeta-analysis=1.33, Pmeta-analysis=2.6×10-8). Three amino acids within DQβ1 peptide-binding region, HLA-DQβ1Ala13, HLA-DQβ1Tyr26, and HLA-DQβ1Glu45, were positively associated with HCC. HLA-DQB1*03:01 was associated with lower binding affinity of HBV nucleocapsid antigen and higher HBV DNA load and serum soluble programmed cell death 1 (sPD-1) (P<0.05). HLA-DQB1 heterozygosity was inversely associated with HCC independent of HLA-DQB1*03:01 (Pmeta-analysis=3.3×10-3).</p><p><strong>Conclusions: </strong>HLA-DQB1*03:01 and its three key amino acids are associated with an increased HBV-related HCC risk. This association may be explained by the low binding affinity to HBV antigen, resulting in poor control of viral load and increased inflammation, as evidenced by sPD-1 levels.</p>","PeriodicalId":177,"journal":{"name":"Hepatology","volume":" ","pages":""},"PeriodicalIF":12.9,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}