Liver International最新文献

{"title":"Increased IgG Levels at Diagnosis Are Associated With Worse Prognosis of Patients With Primary Biliary Cholangitis","authors":"Eirini I. Rigopoulou,&nbsp;Vassiliki Lygoura,&nbsp;Stella Gabeta,&nbsp;Nikolaos Gatselis,&nbsp;George Giannoulis,&nbsp;George N. Dalekos","doi":"10.1111/liv.70074","DOIUrl":"https://doi.org/10.1111/liv.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>A proportion of patients with primary biliary cholangitis (PBC) have increased IgG (I-IgG) levels at baseline, though not fulfilling the criteria of autoimmune hepatitis/PBC variant. Our aim was to evaluate whether I-IgG has prognostic significance in non-cirrhotic PBC patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective analysis of prospectively collected data from 675 PBC patients (592 non-cirrhotic) with available IgG levels at first evaluation was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among non-cirrhotic patients, 97 with I-IgG were more frequently females (<i>p</i> &lt; 0.05), having a higher frequency of concurrent autoimmune diseases (<i>p</i> = 0.01) and a higher frequency of PBC-specific ANA (<i>p</i> &lt; 0.001), sp100 (<i>p</i> &lt; 0.001) and gp210 (<i>p</i> = 0.029) compared to 495 with normal IgG (N-IgG). Patients with I-IgG were older (<i>p</i> &lt; 0.001) and had lower albumin (<i>p</i> &lt; 0.001) and higher AST (<i>p</i> &lt; 0.001), ALT (<i>p</i> = 0.005), ALP (<i>p</i> = 0.006), γGT (<i>p</i> = 0.038) and IgM (<i>p</i> &lt; 0.001) compared to those with N-IgG. I-IgG patients had a higher probability of cirrhosis development (Breslow <i>p</i> &lt; 0.001; log-rank <i>p</i> = 0.05) and liver-related death (Breslow <i>p</i> = 0.034; log-rank <i>p</i> &lt; 0.05) compared to N-IgG patients. IgG &gt; 1.5xULN was the highest risk factor for cirrhosis development (HR = 9.507, 95% CI: 1.221–74.038, <i>p</i> = 0.032) and liver-related death (HR = 27.140, 95% CI: 3.111–236.783; <i>p</i> = 0.003); IgG normalisation after 1 year of UDCA treatment had a favourable effect on disease outcome. Ν-IgG was associated with a higher probability of liver stiffness regression (<i>p</i> = 0.025).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This long-term study demonstrates that I-IgG levels characterise a subgroup of non-cirrhotic PBC patients with faster disease progression and increased probability of liver-related death. Normalisation of IgG levels during UDCA treatment seems to improve prognosis and therefore, these patients could benefit from stricter follow-up and earlier add-on second-line treatments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690113","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":"Evaluating the Macroeconomic Burden of Hepatitis B and the Gains From Timely Coverage Investments in China","authors":"Yun Bao,&nbsp;Ying Chen,&nbsp;Huajie Jin,&nbsp;Chi Zhang,&nbsp;Lingli Zhang,&nbsp;Bin Wu","doi":"10.1111/liv.70054","DOIUrl":"10.1111/liv.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hepatitis B (HBV) continues to pose a significant public health challenge in China. This study aimed to assess the macroeconomic burden of HBV and its impact on gross domestic product (GDP) in China and estimate the potential benefits of early and enhanced interventions between 2023 and 2050.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A compartmental model was employed to simulate HBV transmission, progression, and patient care. The model was structured by age and sex to calculate the costs and benefits associated with achieving World Health Organisation (WHO) coverage targets by 2030, 2040, and 2050. The macroeconomic burden was estimated using a health-augment model, based on a counterfactual scenario. All costs were reported in 2023 US dollars.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The estimated macroeconomic burden of HBV in China from 2023 to 2050 is projected to reach $2.52 trillion, representing 0.33% of the country's total GDP. Achieving the WHO HBV diagnosis and treatment coverage targets by 2030 could, over the same period, reduce cumulative CHB incidence by 0.27(95% UI 0.24–0.30) million, prevent 1.08(95% UI 0.91–1.24) million HCC cases, avert 2.98(95% UI 2.83–3.14) million HBV-related deaths, and contribute an additional $0.85 trillion (95% UI $0.78–$0.93 trillion) to GDP by 2050.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings underscore the importance of early and increased interventions in the diagnosis and treatment of HBV to mitigate the long-term impact of CHB, HCC, and HBV-related deaths. Achieving WHO coverage targets not only optimises disease burden but also promotes economic growth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674228","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":"Unravelling the Role of PANoptosis in Liver Diseases: Mechanisms and Therapeutic Implications","authors":"Wanyuan Xiong,&nbsp;Junfeng Li,&nbsp;Aiping Tian,&nbsp;Xiaorong Mao","doi":"10.1111/liv.70000","DOIUrl":"10.1111/liv.70000","url":null,"abstract":"<p>PANoptosis is a multimodal form of cell death that involves inflammatory, apoptotic, and necroptotic pathways, playing a key role in the development of liver diseases. This article first outlines the definition and characteristics of PANoptosis, and then explores its mechanisms of action in different types of liver diseases, including acute liver injury, liver failure, metabolic dysfunction-associated fatty liver disease, and hepatocellular carcinoma. Furthermore, this article analyses the molecular regulatory network of PANoptosis and potential therapeutic targets. Finally, this article summarises the current research on PANoptosis in liver diseases and future research directions, and it reviews the role of the emerging cell death mechanism of PANoptosis in liver diseases.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674301","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":"The Global and Regional Burden of Gallbladder and Biliary Tract Cancer and Attributable Risk Factors: Trends and Predictions","authors":"Shuping Qiu,&nbsp;Wanting Zeng,&nbsp;Jilin Zhang,&nbsp;Jianfeng Xie,&nbsp;Xiaoping Chen","doi":"10.1111/liv.70025","DOIUrl":"10.1111/liv.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gallbladder and biliary tract cancer (GBTC) is a serious disease burden. A comprehensive assessment of the disease burden is essential for improving prevention and treatment strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The estimated annual percentage change, Joinpoint regression analysis and age-period-cohort model (APCM) were used to comprehensively evaluate the current status and trend of GBTC burden from 1990 to 2021 from the Global Burden of Disease Study. From the perspective of deep learning, a hierarchical weighted long short-term memory network model (SW-LSTM) is proposed for trend prediction to overcome the shortcomings of traditional models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The global GBTC burden increased non-linearly with age, which was higher in women than in men. With the increase of SDI, the gender difference showed a decreasing trend. Significant period and cohort effects were observed for the indicators in the remaining regions except for some indicators in the low-and low-middle-SDI regions. Age-standardised indicators in the high, high-middle and middle SDI regions showed a downward trend, while the remaining regions showed an upward trend. The proportion of age-standardised mortality rate attributable to high BMI increased with the increase of SDI. The prediction results showed that the SW-LSTM model outperformed the APCM and ARIMA models in prediction accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The SW-LSTM model proposed in this paper can provide more accurate prediction information to assist in the development of more targeted prevention strategies. In view of the impact of GBTC on global health, especially among women and the elderly, effective measures should be taken to reverse the increasing trend of GBTC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674243","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":"Farnesoid X Receptor: Bridging the Gaps in Organ-Specific Metabolic Regulation","authors":"Muhammad Khubaib Iftikhar,&nbsp;Qurat ul ain Iftikhar,&nbsp;Mirza Muhammad Ali Baig","doi":"10.1111/liv.70071","DOIUrl":"10.1111/liv.70071","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674232","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":"STING Activation in Various Cell Types in Metabolic Dysfunction-Associated Steatotic Liver Disease","authors":"JingJing Wang,&nbsp;Yue Guo,&nbsp;Jing Hu,&nbsp;Jinghua Peng","doi":"10.1111/liv.70063","DOIUrl":"10.1111/liv.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>During the hepatic histological progression in metabolic dysfunction-associated steatotic liver disease (MASLD), the immunological mechanisms play a the pivotal role, especially when progressing to metabolic dysfunction-associated steatohepatitis (MASH). The discovery of the stimulator of interferon genes (STING) marked a significant advancement in understanding the immune system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched literature on STING involved in MASLD in PubMed to summarise the role of intrahepatic or extrahepatic STING signal pathways and the potential agonists or inhibitors of STING in MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Besides inflammation and type I interferon response induced by STING activation in the intrahepatic or extrahepatic immune cells, STING activation in hepatocytes leads to protein aggregates and lipid deposition. STING activation in hepatic macrophages inhibits autophagy in hepatocytes and promotes hepatic stellate cells (HSCs) activation. STING activation in HSCs promotes HSC activation and exacerbates liver sinusoidal endothelial cells (LSECs) impairment. However, it was also reported that STING activation in hepatic macrophages promotes lipophagy in hepatocytes and STING activation in HSCs leads to HSC senescence. STING activation in LSEC, inhibits angiogenesis. For extrahepatic tissue, STING signalling participates in the regulation of the intestinal permeability, intestinal microecology and insulin action in adipocytes, which were all involved in the pathogenesis of MASLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There're plenty of STING ligands in MASLD. How STING activation affects the intercellular conversation in MASLD deserves thorough investigation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674236","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":"Technical Considerations on Sex Matching in Liver Transplantation for Hepatocellular Carcinoma","authors":"Chenxi Wang,&nbsp;Jin Shang,&nbsp;Huichuan Tian","doi":"10.1111/liv.16221","DOIUrl":"https://doi.org/10.1111/liv.16221","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646257","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":"Development of Liver-Heart Score for Early Detection of Myocardial Contractile Dysfunction in Cirrhosis by Strain Imaging","authors":"Marcel Razpotnik,&nbsp;Simona Bota,&nbsp;Philipp Wimmer,&nbsp;Peter Hofer,&nbsp;Michael Hackl,&nbsp;Matthias Fürstner,&nbsp;Hannes Alber,&nbsp;Raphael Mohr,&nbsp;Alexander Wree,&nbsp;Nirbaanjot Walia,&nbsp;Cornelius Engelmann,&nbsp;Münevver Demir,&nbsp;Frank Tacke,&nbsp;Markus Peck-Radosavljevic","doi":"10.1111/liv.70062","DOIUrl":"https://doi.org/10.1111/liv.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Cirrhotic cardiomyopathy is characterised by myocardial dysfunction in patients with cirrhosis in the absence of other cardiac conditions. We aimed to develop and validate a scoring system to identify patients at high risk for reduced global longitudinal strain, a newly proposed marker of myocardial dysfunction in the updated diagnostic criteria for cirrhotic cardiomyopathy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospectively recruited patients with cirrhosis in the training and validation groups underwent identical hepatological and cardiological evaluations, including strain echocardiography. Risk factors for myocardial dysfunction were identified using logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In a cohort of 452 consecutive patients, 278 were excluded due to non-cirrhotic cardiomyopathy or conditions potentially affecting strain measurements. The prevalence of reduced global longitudinal strain was 9.8% (13/133) in the training group and 19.5% (8/41) in the validation group. Multivariate logistic regression revealed BMI ≥ 28 kg/m² (OR 7.02), CAP &gt; 260 dB/m (OR 8.53), and age &gt; 57 years (OR 4.68) as independent predictors of reduced myocardial contractility. These variables were combined and weighted based on their beta coefficients to develop the Liver-heart score (CAP &gt; 260 dB/m [2 pts], BMI ≥ 28 kg/m² [2 pts], age &gt; 57 years [1 pt]). The AUC-ROC was 0.84 in the training and 0.83 in the validation cohort. A Liver-heart score of 5 points was associated with increased mortality, observed at 2 years (44.4% vs. 17.3%) and the end of the follow-up period (66.7% vs. 37.7%, HR 1.3, <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Liver-heart score can accurately rule out reduced myocardial contractility and may be useful for risk stratification in cirrhotic patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646191","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":"Large Language Models in MASLD: The New Era of Generative Artificial Intelligence-Augmented Clinical Practice","authors":"Nicola Pugliese,&nbsp;Mauro Giuffrè,&nbsp;Jörn M. Schattenberg","doi":"10.1111/liv.16162","DOIUrl":"10.1111/liv.16162","url":null,"abstract":"&lt;p&gt;In a rapidly transforming healthcare landscape, generative artificial intelligence (GenAI) is rapidly emerging as a powerful ally, especially in the management of complex diseases such as metabolic dysfunction-associated steatotic liver disease (MASLD) [&lt;span&gt;1&lt;/span&gt;]. At the core of this revolution are large language models (LLMs), such as OpenAI's GPT-4 or Meta's Llama-3, which are showing the potential to reshape how healthcare professionals interact with patients and their data [&lt;span&gt;1, 2&lt;/span&gt;] (Figure 1). These tools have unprecedented potential, not only to improve the accuracy of diagnosis, but also to reach patients in underserved areas and provide accessible, timely, and patient-centred support [&lt;span&gt;1, 2&lt;/span&gt;]. In particular, the field of digestive diseases has been very prolific in terms of LLM-oriented research, with a recent systematic review defining baseline ChatGPT accuracy ranging from 6.4% to 91.4% when applied to gastroenterology and hepatology queries in the form of simple text-comprehension and response-generation tasks without the use of real-world patient data [&lt;span&gt;3&lt;/span&gt;]. However, the recent study by Wu et al. represents a step forward in LLM-oriented clinical research, demonstrating the potential role of OpenAI's GPT (i.e., GPT-3.5, GPT-4, and GPT-4 Vision) in diagnosing MASLD using real-world patient data, including both electronic health records and ultrasound images, and showing comparable diagnostic accuracy to established tools such as the fatty liver index (FLI) and the United States FLI (USFLI) [&lt;span&gt;4&lt;/span&gt;]. Therefore, with further refinement, LLMs could quickly and accurately assess patients, ultimately accelerating diagnosis and enabling healthcare providers to make faster, more informed decisions. This potential is further supported by previous validations in machine learning, where algorithms have already demonstrated their capacity to enhance diagnostic processes, streamlining patient assessments and decision-making with impressive accuracy [&lt;span&gt;5&lt;/span&gt;]. In addition, we can envision LLMs acting as virtual companions for MASLD patients, guiding them through lifestyle adjustments and answering questions in plain language [&lt;span&gt;6, 7&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In addition to textual interactions, LLMs have demonstrated the ability to process and analyse sophisticated medical data, including images of liver biopsy specimens. A recent exploratory study demonstrated the potential of LLMs for histological diagnosis and fibrosis staging in metabolic dysfunction-associated steatohepatitis (MASH) [&lt;span&gt;8&lt;/span&gt;]. In particular, ChatGPT-4 has demonstrated superior performance in the interpretation of histological images, achieving an accuracy of 87.5% compared to 38.3% for Google Bard [&lt;span&gt;8&lt;/span&gt;]. The results of this preliminary study suggest that ChatGPT-4, which is accessible even in low- and middle-income countries, could significantly improve cost-effectiveness and resource allocation by aiding in th","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.16162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663784","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":"Identification of Clinically Significant Portal Hypertension in cACLD Individuals With Spleen Stiffness Measurement","authors":"Xiaofeng Zhang,&nbsp;Ling Zhou,&nbsp;Weihao Liang,&nbsp;Xiao Cheng,&nbsp;Qinjun He,&nbsp;Hui Li,&nbsp;Wenfan Luo,&nbsp;Jing Huang,&nbsp;Junying Li,&nbsp;Weibin Wang,&nbsp;Minghan Tu,&nbsp;Haiyu Wang,&nbsp;Pengcheng Ou,&nbsp;Biao Wen,&nbsp;Lushan Xiao,&nbsp;Damei Zhou,&nbsp;Vincent Wai-Sun Wong,&nbsp;Jinjun Chen","doi":"10.1111/liv.16241","DOIUrl":"https://doi.org/10.1111/liv.16241","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>The Baveno VII consensus recommends spleen stiffness measurement (SSM) for the detection of clinically significant portal hypertension (CSPH) in patients with compensated advanced chronic liver disease (cACLD). We aimed to evaluate the performance of SSM-based algorithms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive cACLD individuals who underwent hepatic venous pressure gradient measurement, liver stiffness measurement (LSM), and SSM measured with the dedicated 100-Hz probe by vibration-controlled transient elastography were prospectively enrolled.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From July 2021 to August 2024, a total of 395 patients were screened, and 185 cACLD cases were enrolled, of which 101 patients had CSPH. An SSM &gt; 50 kPa demonstrated a positive predictive value (PPV) of 98.0% and a specificity of 98.8% for ruling in CSPH, correctly identifying 47.5% (48/101) of CSPH cases. Sensitivity analysis revealed that in 60 patients with aetiology removal or suppression, SSM &gt; 50 kPa achieved both a PPV and specificity of 100%. Among the 125 patients with ongoing aetiologies, the PPV and specificity were 96.4% and 98.3%, respectively. Across HBV (with or without viral suppression) and non-HBV subgroups, the PPV and specificity consistently exceeded 90%. In decision curve analysis, SSM &gt; 50 kPa provided the highest net benefit compared with other elastography-based algorithms when threshold probabilities exceeded 0.8.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We prospectively validated that SSM &gt; 50 kPa, measured using the spleen-dedicated probe, is sufficient for identifying CSPH in individuals with cACLD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>NCT04820166</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646256","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}