Scandinavian Journal of Gastroenterology最新文献

{"title":"An indication-based analysis of the yield and findings of esophageal high-resolution manometry.","authors":"Amir Mari, Sari Cohen, Jamelah Abo Amer, Mohammed Hijazi, Basem Hijazi, Fadi Abu Baker, Edoardo Savarino, Atallah Mansour, Daniela Malkin, Haim Shirin, Daniel L Cohen","doi":"10.1080/00365521.2025.2475083","DOIUrl":"10.1080/00365521.2025.2475083","url":null,"abstract":"<p><strong>Background: </strong>High-resolution manometry (HRM) is the gold standard for the diagnosis of esophageal motility disorders. While studies have previously reported on HRM findings in patients with dysphagia and/or chest pain, we sought to compare the yield and findings of HRM based on different indications for motility testing.</p><p><strong>Methods: </strong>A retrospective study was performed including all successful HRM studies performed at two tertiary medical centers between 2018 and 2023. The indication was categorized as either: (1) dysphagia; (2) GERD evaluation; (3) non-cardiac chest pain; (4) epigastric pain; (5) regurgitation/vomiting; or (6) prior to esophageal surgery. Motility disorders were diagnosed as per the Chicago Classification, version 4.0.</p><p><strong>Results: </strong>A total of 768 patients were included (mean age 55.5 +/- 17.3; 56.2% female). The most common indications were dysphagia (368, 47.9%) and prior to reflux testing (267, 34.8%). Normal motility was found in 417 (54.3%) patients while a motility disorder was diagnosed in 351 (45.7%) subjects. A major motility disorder was found in 178 (23.2%) cases, with achalasia in 82 (10.7%) patients. HRM diagnoses significantly differed based on the indication for testing (<i>p</i> < 0.001), with major motility disorders and achalasia being most commonly diagnosed when performed for dysphagia and recurrent regurgitation/vomiting. The indication affected the likelihood of having any motility disorder (<i>p</i> = 0.010), a major motility disorder (<i>p</i> < 0.001), a disorder of EGJ Outflow (<i>p</i> < 0.001), and achalasia (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The indication for HRM testing affects the likelihood of having a motility disorder including achalasia. The highest yield is in patients being evaluated for dysphagia and regurgitation/vomiting.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"368-374"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress of MUC family in esophageal mucosal barrier of gastroesophageal reflux disease.","authors":"Xue Jia, Hai-Qing Hu","doi":"10.1080/00365521.2025.2479566","DOIUrl":"10.1080/00365521.2025.2479566","url":null,"abstract":"<p><p>Gastroesophageal reflux disease (GERD) is a prevalent chronic digestive disorder with a rising incidence rate, profoundly affecting patients' quality of life. The condition is marked by recurrent episodes of acid reflux and heartburn, which can compromise the esophageal mucosal barrier and trigger inflammatory responses in the esophagus. Mucins (MUC), essential components of the mucus gel layer, play a vital role in protecting the esophageal mucosa and may serve as potential biomarkers for GERD diagnosis and treatment. This review provides a comprehensive overview of the MUC family's structure, types, and physiological functions, highlighting their significance in maintaining the esophageal mucosal barrier. By exploring the role of MUC in GERD, this paper aims to contribute to a deeper understanding of the disease's pathophysiological mechanisms and inform advancements in its diagnosis and treatment.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"375-385"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting colorectal adenoma recurrence: the role of systemic inflammatory markers and insulin resistance.","authors":"Zhiqiang Li, Danyun Zhao, Chunyan Zhu","doi":"10.1080/00365521.2025.2469801","DOIUrl":"10.1080/00365521.2025.2469801","url":null,"abstract":"<p><strong>Background: </strong>Colorectal adenomas (CRA) exhibit high recurrence rates following endoscopic resection. Insulin resistance (IR) and chronic inflammation, increasingly prevalent due to unhealthy lifestyles, are key factors in CRA development. This study aimed to evaluate the predictive power of combining the inflammation score with the triglyceride-glucose (TyG) index for CRA recurrence.</p><p><strong>Methods: </strong>We conducted a comprehensive analysis of the clinical characteristics of 847 CRA patients who underwent endoscopic resection. Postoperative recurrence of CRA was assessed using logistic regression analyses to determine odds ratios (ORs) and 95% confidence intervals (CIs). The receiver operating characteristic (ROC) curve analysis was utilized to predict the risk of CRA recurrence based on the inflammation score and TyG index.</p><p><strong>Results: </strong>Among the 847 CRA included in the study, 126 experienced recurrences. Logistic regression analysis identified NLR (OR 2.641, 95% CI 1.982-3.549), TyG (OR 1.494, 95% CI 1.146-1.956), three or more adenomas (OR 2.182, 95% CI 1.431-3.322) and CRA larger than 10 mm (OR 1.917, 95% CI 1.267-2.921) as independent risk factors for CRA recurrence. ROC curves demonstrated the efficacy of NLR (AUC 0.701, 95% CI 0.652-0.750) and TyG (AUC 0.607, 95% CI 0.553-0.660) in predicting CRA recurrence. The combination of NLR, TyG and adenoma characteristics showed improved performance in predicting CRA recurrence (AUC 0.762, 95% CI 0.718-0.805).</p><p><strong>Conclusions: </strong>Elevated NLR and TyG were associated with an increased risk of CRA recurrence. The integration of NLR and TyG with CRA characteristics significantly enhanced the predictive power for CRA recurrence.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"300-306"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of periampullary diverticulum morphology on ERCP cannulation and clinical results.","authors":"Yavuz Cagir, Muhammed Bahaddin Durak, Cem Simsek, Ilhami Yuksel","doi":"10.1080/00365521.2025.2469121","DOIUrl":"10.1080/00365521.2025.2469121","url":null,"abstract":"<p><strong>Aim: </strong>Periampullary diverticulum (PAD) is a common anatomical variant that can potentially impact the technical difficulty and outcomes of endoscopic retrograde cholangiopancreatography (ERCP), necessitating a comprehensive understanding of its effects on the procedure. To evaluate the effect of PAD subtypes and diameter on ERCP cannulation success and clinical outcomes.</p><p><strong>Materials and methods: </strong>The study included patients with PAD and papilla-naïve patients undergoing ERCP for suspected common bile duct stones or distal benign strictures (due to PAD compression). PAD subtyping was based on Lobo and Li-Tanaka classifications. Diverticulum size was categorized as small (<1 cm), medium (1-2 cm), and giant (≥2 cm).</p><p><strong>Results: </strong>Of the 907 patients analyzed, 164 (18%) had PAD with a median age of 63 years. PAD patients were significantly older than non-PAD patients and had more comorbidities. The most frequent PAD type was 2B (34.1%) based on the Li-Tanaka classification. Subgroup analysis of PAD types 1, 2, 3, and 4 showed no statistically significant differences in cannulation time, success, total procedure time, or adverse events (AEs). Overall cannulation success rates were similar between PAD and non-PAD groups (99.4% vs 99.6%). Analysis based on diverticulum size revealed higher probabilities of giant stones and procedure-related AEs in giant diverticula. The risk of post-ERCP pancreatitis was notably low at 1.8% in the PAD group.</p><p><strong>Conclusion: </strong>Diverticulum size, rather than PAD subtype, may be more closely associated with cannulation success and procedure-related AEs in ERCP. Individualized management considering diverticulum size may improve outcomes in PAD patients undergoing ERCP.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"292-299"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the validity of pancreatoduodenectomy for octogenarian patients with biliary tract carcinoma from the perspective of recurrence.","authors":"Wataru Izumo, Hiromichi Kawaida, Ryo Saito, Yuuki Nakata, Hidetake Amemiya, Yudai Higuchi, Takashi Nakayama, Suguru Maruyama, Koichi Takiguchi, Katsutoshi Shoda, Kensuke Shiraishi, Shinji Furuya, Yoshihiko Kawaguchi, Daisuke Ichikawa","doi":"10.1080/00365521.2025.2469123","DOIUrl":"10.1080/00365521.2025.2469123","url":null,"abstract":"<p><strong>Objective: </strong>To clarify the short- and long-term validity of pancreatoduodenectomy in octogenarian patients with biliary tract carcinoma.</p><p><strong>Methods: </strong>We compared 23 and 141 patients aged ≥80 and <80 years, who underwent pancreatoduodenectomy for biliary tract carcinoma (distal cholangiocarcinomas and ampullary carcinomas) and evaluated the relationship between age, clinicopathological factors, and surgical and oncological outcomes, especially in terms of recurrence.</p><p><strong>Results: </strong>Median overall survival time of distal cholangiocarcinoma and ampullary carcinoma was 92 and 109 months (<i>p</i> = 0.13). Postoperative complications, mortality, and adjuvant chemotherapy rates did not differ between the groups. Although the 5-year recurrence-free survival rate was similar, the 5-year disease-specific survival and overall survival rate were significantly shorter in octogenarians (≥80 years: 43.5, 47.1, and 35.3%; <80 years: 54.1, 69.2, and 63.0%; <i>p</i> = 0.41, 0.016, and 0.034, respectively). The median time from recurrence to death for octogenarian patients was significantly shorter than that of younger patients (3.3 <i>vs.</i> 16.1 months, <i>p</i> < 0.001). At recurrence, the serum albumin level, prognostic nutritional index, controlling nutritional status score, and treatment rate for recurrence were lower in octogenarians. The multivariate analysis identified age ≥80 years (hazard ratio: 3.8), low prognostic nutritional index (hazard ratio: 2.9), high serum carbohydrate antigen 19-9 (hazard ratio: 2.6), and failure to implement treatment after recurrence (hazard ratio: 3.0) as independent risk factors for a short time from recurrence to death. Furthermore, age ≥80 years (odds ratio 0.09) was an independent risk factor for treatment implementation after recurrence.</p><p><strong>Conclusions: </strong>Octogenarians had a shorter survival time after recurrence, resulting from low nutritional indices and a reduced rate of treatment implementation at the time of recurrence.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"312-321"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of novel biomarkers for gastric adenocarcinoma through two-sample Mendelian randomization analysis of the human plasma proteome.","authors":"Jingjing Tian, Qingrui Cai, Shiying Li, Zhanfei Guo, Yanbao Liu, Zhiwei Zhang, Zhongchao Huo","doi":"10.1080/00365521.2025.2472198","DOIUrl":"10.1080/00365521.2025.2472198","url":null,"abstract":"<p><strong>Background: </strong>Papillary gastric adenocarcinoma (PGC), a histological subtype of gastric cancer (GC), is characterized by malignant potential and poor prognosis. Therefore, identifying novel biomarkers is urgently needed to enhance PGC diagnosis and treatment outcomes.</p><p><strong>Methods: </strong>This study utilized two-sample Mendelian randomization (MR) to explore potential causal relationships between human blood plasma proteins and GC. Heterogeneity testing, pleiotropy assessment, and directionality analyses were performed to evaluate identified plasma proteins. Additionally, pathway enrichment analysis was conducted to elucidate the molecular mechanisms underlying the causal associations between plasma proteins and GC development.</p><p><strong>Results: </strong>MR analysis of 4,907 plasma proteins related to GC risk identified 90 proteins with potential causal relationships. The findings revealed that DNAJB9, CHCHD10, and suppressor of cytokine signaling 3 exhibited protective effects against GC, while Syntaxin-8, alcohol dehydrogenase 7, and UDP-glucose 4-epimerase were associated with increased GC risk at the genetic level.</p><p><strong>Conclusion: </strong>In the present study, the six plasma proteins identified through comprehensive MR analysis may serve as potential biomarkers for GC, offering new insights for future molecular diagnosis and therapeutic strategies.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"394-404"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selected comorbidities increases the likelihood of an incomplete colonoscopy during colorectal cancer screening.","authors":"Camilla Thorndal, Birgitte Skau, Issam Al-Najami, Lasse Kaalby, Gunnar Baatrup, Anastasios Koulaouzidis, Ulrik Deding","doi":"10.1080/00365521.2025.2465623","DOIUrl":"10.1080/00365521.2025.2465623","url":null,"abstract":"<p><strong>Objective: </strong>The risk of incomplete colonoscopy is associated with demographic factors and general comorbidity. However, focus on specific comorbidities is limited. This study aimed to investigate the association between selected comorbidities and incomplete colonoscopy in colorectal cancer (CRC) screening.</p><p><strong>Methods: </strong>This register-based study included 71,973 Danish screening participants, undergoing colonoscopy after positive fecal immunochemical test. The selected comorbidities were divided into hematological disease, endocrine disease (nondiabetes), endocrine disease (diabetes related), upper gastrointestinal (GI) disease, lower GI disease, other diseases of digestive system, hepatobiliary and pancreatic (HBP) disease, CRC, intraabdominal cancer (except CRC), and mental disease. Outcomes were incomplete colonoscopy due to poor bowel preparation and other reasons. Multivariate logistic regression models were applied.</p><p><strong>Results: </strong>Of 5,428 (7.5%) incomplete colonoscopies, 2,625 (3.6%) were due to poor bowel preparation and 2,803 (3.9%) due to other reasons. Individuals with specific comorbidities were compared to those without, exhibiting varying odds ratios (OR) for incomplete colonoscopy. For poor bowel preparation, ORs were 1.20 (95%CI: 1.04;1.39), 1.43 (95%CI: 1.30;1.56), 1.86 (95%CI: 1.66;2.09), 1.27 (95%CI: 1.12;1.43), and 1.64 (95%CI: 1.47;1.83) for hematological, endocrine (nondiabetes), endocrine (diabetes related), HBP, and mental disease, respectively, and 1.29 (95%CI: 1.09;1.52) for intraabdominal cancer (except CRC). Incomplete colonoscopies due to other reasons showed ORs of 1.24 (95%CI: 1.08;1.43), 1.18 (95%CI: 1.03;1.36), 1.19 (95%CI: 1.05;1.35), and 1.30 (95%CI: 1.15;1.47) for hematological, endocrine (diabetes related), HBP, and mental disease, respectively, and 1.35 (95%CI: 1.15;1.60) for intra-abdominal cancer (except CRC).</p><p><strong>Conclusion: </strong>Participants with specific comorbidities had significantly higher probability of having an incomplete colonoscopy, suggesting that certain comorbidities could be used prospectively as a predictive factor.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"283-291"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic yield of second-line aetiological workup in patients with presumed idiopathic acute pancreatitis: a retrospective cohort study.","authors":"Ida Saksenborg Kølle, Andreas Svenstrup Hesthaven, Line Davidsen, Rasmus Hagn-Meincke, Asbjørn Mohr Drewes, Inge Søkilde Pedersen, Per Ejstrud, Stine Dam Henriksen, Søren Schou Olesen","doi":"10.1080/00365521.2025.2485135","DOIUrl":"https://doi.org/10.1080/00365521.2025.2485135","url":null,"abstract":"<p><strong>Background: </strong>After an aetiological (first-line) workup, the cause of acute pancreatitis remains unidentified in a significant proportion of cases, a condition known as idiopathic acute pancreatitis (IAP).</p><p><strong>Methods: </strong>Retrospective cohort study involving patients with presumed IAP referred for second-line aetiological workup. The completion of first-line aetiological evaluations was assessed upon referral, and the diagnostic outcomes of second-line investigations were evaluated. Over a one-year follow-up period, we documented acute pancreatitis recurrence and patient mortality. Recurrence risk was analysed using an age-adjusted Cox regression model, stratified by treatable versus non-treatable aetiologies.</p><p><strong>Results: </strong>We identified 161 patients with presumed IAP, among whom 81 (50%) had recurrent acute pancreatitis. In total, 115 patients (71%) had a complete first-line aetiological workup. The overall diagnostic yield of the second-line aetiological workup was 25% (95% confidence interval [CI] 18-32%). Among second-line tests, the highest diagnostic yield was found for endoscopic ultrasound (34%, 95% CI 20-50%) and genetic testing (37%, 95% CI 22-53%). The most frequent aetiologies identified were biliary pancreatitis (16 patients [10%]) and pancreatitis with a genetic mutation (15 patients [9%]). Neoplasia was identified in two patients. A treatable aetiology was associated with a numerically reduced pancreatitis recurrence risk (Hazard Ratio 0.50, 95% CI 0.07-3.85, <i>p</i> = 0.51). No patient died during the follow-up period.</p><p><strong>Conclusion: </strong>A second-line aetiological workup can identify the aetiology in 25% of patients with presumed IAP. The most frequent aetiologies are biliary pancreatitis and pancreatitis with a genetic mutation.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PD-1 inhibitors improve the efficacy of tyrosine kinase inhibitors combined with transcatheter arterial chemoembolization in advanced hepatocellular carcinoma: a meta-analysis and trial sequential analysis.","authors":"Jiahui Yu, Yong Li, Yuting Yang, Hao Guo, Yimiao Chen, Pengsheng Yi","doi":"10.1080/00365521.2025.2479193","DOIUrl":"https://doi.org/10.1080/00365521.2025.2479193","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis and trial sequential analysis (TSA) aimed to evaluate the efficacy and safety of triple therapy with tyrosine kinase inhibitors (TKIs) combined with transcatheter arterial chemoembolization (TACE) plus programmed death 1 (PD-1) inhibitors (T-T-P) and dual therapy with TKIs combined with TACE (T-T) for the treatment of advanced unresectable hepatocellular carcinoma (uHCC).</p><p><strong>Methods: </strong>Literature related to the efficacy of TKIs combined with TACE plus PD-1 inhibitors in uHCC was searched using the Embase, PubMed, and Cocrane libraries. TSA was used to reduce false positive results due to random error.</p><p><strong>Results: </strong>Seventeen articles were included in this meta-analysis, including 2,561 patients. In the T-T-P group, OS [HR 0.45, 95% confidence interval (CI) 0.39-0.52; <i>p</i> = 0.000], PFS [HR 0.43, 95% CI 0.38 - 0.48; <i>p</i> = 0.000], were significantly prolonged compared to those in the T-T group; ORR (RR 1.59 [95% CI 1.39-1.81]; <i>p</i> = 0.000) and DCR (RR 1.26 [95% CI 1.15-1.37]; <i>p</i> = 0.000) were significantly higher. TSA analysis showed early results without further testing. Prognostic factor analysis demonstrated that portal vein tumor thrombus (PVTT) and extrahepatic metastasis were common independent risk factors for OS and PFS. Regarding grade 3/4 adverse events results showed no statistically significant differences in any of them.</p><p><strong>Conclusions: </strong>Compared with T-T treatment group, the T-T-P treatment group exhibited a notable improvement in OS and PFS, particularly in cases of PVTT and extrahepatic metastasis. Furthermore, it can markedly enhance the ORR and DCR in patients with uHCC.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-13"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asymptomatic small gastric subepithelial lesions arising from the muscularis propria: outcomes and surveillance in a medical center.","authors":"Pei-Huan Ho, Chun-Jung Lin, Chao-Wei Hsu, Cheng-Yu Lin, Mu-Hsien Lee, Wey-Ran Lin, Ming-Ling Chang, Tse-Ching Chen, Cheng-Tang Chiu","doi":"10.1080/00365521.2025.2480679","DOIUrl":"https://doi.org/10.1080/00365521.2025.2480679","url":null,"abstract":"<p><p><b>Background and aims</b>: Gastric subepithelial lesions (SELs) are frequently identified incidentally during endoscopy, with those originating from the muscularis propria (MP) layer posing diagnostic and management challenges. The optimal surveillance duration for these lesions remains debated. This study aimed to assess size changes in SELs from the MP layer and recommend appropriate surveillance intervals.</p><p><p><b>Methods</b>: We retrospectively reviewed asymptomatic gastric SELs (≤2 cm) diagnosed <i>via</i> endoscopic ultrasound (EUS) from 2013 to 2018, with follow-up data and no excision within 1 year. Significant progression was defined as <i>a</i> > 20% increase in diameter during EUS surveillance. Lesion-related adverse outcomes, size changes, and histological findings were analyzed.</p><p><p><b>Results</b>: A total of 561 patients (median surveillance duration: 80 months) were included. One lesion-related adverse outcome (0.2%), liver metastasis from a gastrointestinal stromal tumor, occurred after 62 months. Among the EUS subgroup (<i>n</i> = 313), no differences were observed in progression rates (22.6% vs. 25%) or size increase rates (0.3 mm/year vs. 0.9 mm/year) between micro-SELs (<10 mm) and mini-SELs (10-20 mm). Progressive lesions exhibited faster growth (2.6 mm/year) and more heterogeneous echotexture (43.8%). Most excised lesions were gastrointestinal stromal tumors or leiomyomas.</p><p><p><b>Conclusions</b>: Over a mean surveillance period of 25.5 months, 13 lesions grew beyond 20 mm. No lesion-related adverse outcomes occurred within the first three years. Histological diagnosis remains the gold standard, but when tissue acquisition is unfeasible, EUS surveillance may be an alternative. Our findings suggest that for asymptomatic micro-SELs (<10 mm) from the MP layer without high-risk features, the surveillance interval can be safely extended to two years.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}