Canadian Journal of Gastroenterology and Hepatology最新文献

{"title":"Tumor Budding and E-Cadherin Loss as Robust Prognostic Markers in Pancreatic Ductal Adenocarcinoma: A Study in a Turkish Patient Cohort.","authors":"Tevhide Bilgen Özcan, Esra Pasaoglu, Osman Bilgin Gülçiçek","doi":"10.1155/cjgh/9097621","DOIUrl":"10.1155/cjgh/9097621","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the prognostic significance of tumor budding and its association with E-cadherin expression in pancreatic ductal adenocarcinoma (PDAC) with a focus on a Turkish patient cohort.</p><p><strong>Methods: </strong>A total of 76 patients who had undergone resection of PDAC were analyzed. Tumor budding was assessed according to Tumor Budding Consensus Conference (ITBCC) guideline and classified as low (1-4 buds), medium (5-9 buds), or high (≥ 10 buds). E-cadherin expression was assessed by immunohistochemistry and categorized as low, moderate, or high. The correlations between tumor budding, clinicopathological factors, and survival were statistically analyzed and examined, and <i>p</i> < 0.05 was considered significant.</p><p><strong>Results: </strong>Tumor budding was detected in 42.1% of patients, significantly associated with advanced tumor stage (<i>p</i> < 0.001), perineural invasion (<i>p</i> = 0.015), and lymphatic invasion (<i>p</i> = 0.005). Reduced E-cadherin expression was strongly correlated with tumor budding, which occurred in 83.3% of patients with weak (+) expression. Kaplan-Meier survival analysis demonstrated a median survival of 7.03 months in patients with tumor budding, compared to 21.7 months in those without tumor budding (<i>p</i> < 0.001). Multivariate analysis confirmed tumor budding as an independent prognostic factor (HR = 6.594, 95% CI: 1.825-23.818, <i>p</i> = 0.004).</p><p><strong>Conclusions: </strong>Tumor budding is a reliable prognostic marker in PDAC, demonstrating significant associations with poor clinical outcomes, including advanced tumor stage and reduced survival. These findings support the integration of tumor budding into clinical guidelines to enhance prognostic precision and guide treatment decision-making.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"9097621"},"PeriodicalIF":2.3,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12618180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Interplay Between CA19-9 and the Lewis Blood Group System: Implications for the Diagnosis of Gallbladder Cancer.","authors":"Yuhan Liu, Jiamao Zhang, Zitong Zheng, Wenjuan Zheng, Lu Fang, Fan Zhou, Bo Liang","doi":"10.1155/cjgh/8465615","DOIUrl":"10.1155/cjgh/8465615","url":null,"abstract":"<p><p>CA19-9 is one of the most widely applied tumor markers in clinical oncology, particularly in the diagnosis and prognostic evaluation of biliary tract and pancreatic cancers. However, its clinical utility is limited by biological variability, most notably the influence of the Lewis blood group system, which may result in false-negative findings. The Lewis system is composed of three major phenotypes, Le(a+b-), Le(a-b+), and Le(a-b-), with the less frequent Le(a+b+) also reported in certain populations. Current evidence indicates that CA19-9 expression occurs predominantly in Le(a+b-) or Le(a-b+) individuals, whereas it is largely absent in Le(a-b-) individuals. Insufficient consideration of this factor in clinical settings reduces diagnostic accuracy and complicates interpretation of CA19-9 results. This review summarizes the current understanding of the relationship between CA19-9 and the Lewis system, critically evaluates recent clinical studies, highlights existing limitations, and discusses the potential role of combined CA19-9 and Lewis typing in improving the diagnostic value of gallbladder cancer.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"8465615"},"PeriodicalIF":2.3,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12616487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Microwave Ablation in Patients With Hepatocellular Carcinoma With Decompensated Liver Cirrhosis: A Retrospective Study.","authors":"Jihua Xue, Yuting Gu, Ji Li, Junfei Zhang, Tingting Bian, Zhongsong Zhou, Yufeng Gao","doi":"10.1155/cjgh/4859487","DOIUrl":"10.1155/cjgh/4859487","url":null,"abstract":"<p><strong>Objective: </strong>Except for liver transplantation, no definitive treatment exists for hepatocellular carcinoma (HCC) in individuals suffering from decompensated liver cirrhosis. This research evaluated the feasibility and outcomes of microwave ablation (MWA) treatment in this patient population.</p><p><strong>Methods: </strong>This research involved individuals diagnosed with HCC and decompensated cirrhosis who underwent MWA between 2019 and 2022. The analysis examined complications associated with the procedure, the effectiveness of treatment, patient survival rates, and the variations in blood test results and liver function reserves before and after MWA.</p><p><strong>Results: </strong>The 62 enrolled patients were predominantly male (<i>n</i> = 48), and the average age was 59.06 years. Fifty-one patients were diagnosed with HBV-related cirrhosis. The tumor characteristics varied: 47 patients had single lesions with diameters ranging from 8 to 57 mm. Following the MWA procedure, there was a notable rise in the levels of alanine transaminase, aspartate transaminase, total bilirubin, prothrombin time, and the Child-Pugh, albumin-bilirubin, and model for end-stage liver disease scores (<i>p</i> < 0.05). Analysis of survival data indicated that tumor diameter < 3 cm, complete response (CR), meeting the Milan criteria, and Barcelona Clinic Liver Cancer (BCLC) Stage 0-A were linked to a more favorable prognosis. Multivariable Cox regression analysis identified achieving a CR as the strongest independent predictor for improved overall survival (HR = 0.25, 95% CI [0.09, 0.66], <i>p</i> = 0.005). Furthermore, the Milan criteria were independently associated with reduced risk of tumor progression in both univariate and multivariate analyses.</p><p><strong>Conclusion: </strong>MWA is a safe procedure for individuals with HCC and decompensated liver cirrhosis. CR is associated with a better prognosis.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"4859487"},"PeriodicalIF":2.3,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12611878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Rabdosia rubescens</i> Inhibits CYP7A1 Expression and Induces Autophagy to Reduce Alcohol-Induced Liver Damage in Mice.","authors":"Xi Zou, Wei Chen, Yidan Shao, Tingting Shi, Yunling Ke","doi":"10.1155/cjgh/9507266","DOIUrl":"10.1155/cjgh/9507266","url":null,"abstract":"<p><strong>Objective: </strong>Investigating the antialcoholic liver injury properties of <i>Rabdosia rubescens</i> and its effect on the expression of CYP7A1 and levels of autophagy.</p><p><strong>Materials and methods: </strong>Male C57BL/6 mice were randomly divided into three groups, namely, the control group (Lieber-DeCarli standard diet), model group (Lieber-DeCarli ethanol diet), and treatment group (<i>Rabdosia rubescens</i> at concentrations of 50 mg/kg, 100 mg/kg, and 200 mg/kg). The mice were fed their respective diets for 10 days, with the treatment group receiving the corresponding concentration of <i>Rabdosia rubescens</i>. On the 11th day, all the mice except those in the control group were given 30% EtOH. Nine hours later, the mice were sacrificed and their blood serum and liver tissue were collected for analysis. The effect of <i>Rabdosia rubescens</i> on alcohol-induced liver damage was evaluated by testing serum biochemical indicators, liver bile acid content, liver tissue histopathological changes, liver LC3 and p62 immunohistochemical staining, liver inflammatory factors, and CYP7A1, SREBP, FAS, LC3, Beclin-1, ATG7, and p62 expressions.</p><p><strong>Results: </strong>Compared with the model group, <i>Rabdosia rubescens</i> was found to significantly reduce the levels of ALT, AST, TG, TC, and TBA in the serum of mice with alcoholic liver injury (<i>p</i> < 0.05 or <i>p</i> < 0.01). <i>Rabdosia rubescens</i> was found to significantly reduce the level of apoptosis in H&E-stained liver tissue sections. <i>Rabdosia rubescens</i> also significantly reduced the levels of TNF-α and IL-1β in the livers of mice (<i>p</i> < 0.001). <i>Rabdosia rubescens</i> was found to induce the expression of LC3, Beclin-1, and ATG7 proteins and mRNA, while inhibiting the expression of CYP7A1, SREBP, FAS, and p62 proteins and mRNA (<i>p</i> < 0.05 or <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong><i>Rabdosia rubescens</i> has been shown to relieve alcohol-induced liver damage in mice by reducing levels of CYP7A1, alleviating cholestasis and reducing inflammation. It can also reduce alcohol-induced liver damage by decreasing fat synthesis and inducing autophagy.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"9507266"},"PeriodicalIF":2.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12512039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micronutrient Deficiencies as Early Signs of Celiac Disease: Exemplified by Two Cases.","authors":"Thea Skov Nielsen, Signe Ulfbeck Schovsbo, Allan Linneberg, Line Lund Kårhus","doi":"10.1155/cjgh/7256866","DOIUrl":"10.1155/cjgh/7256866","url":null,"abstract":"<p><p>Celiac disease is an important yet often overlooked condition that, when left untreated, can lead to intestinal villous atrophy, resulting in malabsorption and nutritional deficiencies. The clinical presentation of celiac disease varies greatly and is not limited to gastrointestinal symptoms. The diverse clinical picture and nonspecific manifestations can lead to difficulties in the diagnostic process and a delay in diagnosis. In this article, we discuss two cases in which the diagnosis was established-but very late. The first case presents a woman who experienced symptoms for more than 10 years and was initially suspected of having cancer before finally receiving the correct diagnosis of celiac disease. The second case describes a former general practitioner who, at the age of 55 years, underwent transglutaminase antibody testing for celiac disease and only then realized that he could feel differently. Both cases presented early signs of micronutrient deficiencies and/or weight loss, despite maintaining an adequate dietary energy intake. These cases illustrate the challenges with diagnostic delay.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"7256866"},"PeriodicalIF":2.3,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12475928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TSPAN7 Functions as an Antitumor Agent Through the STK11/AMPK/mTOR Axis in Colorectal Cancer.","authors":"Tao Weng, Fenfen Hong","doi":"10.1155/cjgh/5209381","DOIUrl":"10.1155/cjgh/5209381","url":null,"abstract":"<p><p><b>Background:</b> Tetraspanin 7 (<i>TSPAN7</i>), a quadruple transmembrane glycoprotein, is involved in the growth, development, and energy metabolism of cells, particularly in tumor cells. Despite its recognized significance, the role of <i>TSPAN7</i> in colorectal cancer (CRC) remains unexplored. The purpose of this study is to explore the antitumor activity of <i>TSPAN7</i> through the STK11/AMPK/mTOR pathway. <b>Methods:</b> Analysis of differential genes in normal colon and CRC tissues was conducted using the Gene Expression Omnibus (GEO) database. Ten potential genes, including <i>TSPAN7</i>, were also identified through the database screening. <b>Results:</b> Assessment of <i>TSPAN7</i> alterations in both CRC tissues as well as cell lines revealed reduced expression as compared to normal colon tissues. Based on the findings, modulation of <i>TSPAN7</i> expression was performed through overexpression and downregulation in vitro within CRC cells. The findings indicated that <i>TSPAN7</i> exerted a negative regulatory influence on the migration and proliferation of CRC cells. An examination of AMPK and mTOR phosphorylation levels revealed that <i>TSPAN7</i> affected the phosphorylation of these proteins via STK11. <b>Conclusion:</b> In CRC, <i>TSPAN7</i> exerts antitumor effects through the STK11/AMPK/mTOR axis.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"5209381"},"PeriodicalIF":2.3,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of and Risk Factors for Migration of Biliary Plastic Stents After Stone Removal With Endoscopic Retrograde Cholangiopancreatography.","authors":"Longping Chen, Yanfang Lin, Linfu Zheng, Chuanshen Jiang, Zhiping Chen, Jin Zheng, Dazhou Li, Wen Wang","doi":"10.1155/cjgh/9996501","DOIUrl":"10.1155/cjgh/9996501","url":null,"abstract":"<p><p><b>Background and Aims:</b> Biliary plastic stents frequently detach or migrate from the duodenal papilla, leading to recurrent biliary tract infections or intestinal perforations. This study aimed to investigate the incidence and risk factors associated with migration of biliary plastic stents following endoscopic retrograde cholangiopancreatography (ERCP). <b>Methods:</b> The study analyzed a population of patients who underwent ERCP for bile duct stone removal and placement of biliary plastic stents between March 2018 and December 2022, and analyzed the risk factors for biliary stent migration in the enrolled patients. <b>Results:</b> A total of 836 patients (60.40 ± 15.58 years, 511 males) were included in the analysis. Among them, 105 patients experienced stent migration, comprising 91 (10.9%) patients with distal biliary plastic stent migration and 14 (1.7%) patients with proximal biliary plastic stent migration. Multivariate logistic regression analysis revealed that the risk of stent migration was significantly higher in patients with duodenal diverticula (odds ratio [OR] = 2.367, <i>p</i> = 0.005), duodenal sphincter incision (OR = 3.638, <i>p</i> = 0.007), and longer stent lengths (OR = 0.423, <i>p</i> < 0.001). The Christmas tree plastic stent exhibited a significantly lower propensity for migration compared to the straight-type biliary plastic stent (OR = 2.654, <i>p</i> = 0.034). In addition, the risk of proximal biliary stent migration increased significantly with the degree of balloon dilation (OR = 2.708, <i>p</i> = 0.043) and the presence of diverticula in the descending part of the duodenum (OR = 6.412, <i>p</i> = 0.002). <b>Conclusion:</b> Duodenal diverticulum, duodenal sphincterotomy, longer biliary stents, and straight biliary stents are independent risk factors for stent migration. In addition, balloon dilation greater than 1 cm and the presence of diverticula in the descending part of the duodenum are independent risk factors for proximal biliary stent migration. Consequently, patients with risk factors for stent migration should be closely monitored.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"9996501"},"PeriodicalIF":2.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major Depression as a Catalyst for Nonalcoholic Fatty Liver Disease: Insights From a Comprehensive Mendelian Randomization Study.","authors":"Yinshi Su, Shuangzhe Lin, Ling She, Jingping Xiong, Yongnian Ding, Yan Zhang, Yuanwen Chen","doi":"10.1155/cjgh/6632867","DOIUrl":"10.1155/cjgh/6632867","url":null,"abstract":"<p><p><b>Background:</b> This study aimed to investigate the causal association between mental disorders and nonalcoholic fatty liver disease (NAFLD; now termed metabolic dysfunction-associated steatotic liver disease, MASLD) using Mendelian randomization (MR). <b>Methods:</b> A bidirectional two-sample MR approach was employed to evaluate the causal relationship between NAFLD and eight mental disorders: major depression, anxiety, bipolar disorder, schizophrenia, autism, post-traumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD), and eating disorders. The inverse-variance weighted (IVW) method was utilized to estimate causal effects, supported by MR-CAUSE and other sensitivity analyses to address pleiotropy and heterogeneity. Instrumental variables from genome-wide association studies were applied, and initial associations were examined using linkage disequilibrium score (LDSC) regression analysis. Furthermore, mediation analysis was conducted to identify potential mediators. <b>Results:</b> The MR analysis revealed significant positive associations between NAFLD occurrence and major depression (odds ratio [OR] = 1.294, <i>p</i> = 0.003), bipolar disorder (OR = 0.895, <i>p</i> = 0.004), and autism (OR = 1.118, <i>p</i> = 0.005). However, only the putative causal association of major depression on NAFLD remained statistically significant in further validation, including MR-CAUSE and sensitivity analyses, and was not attributable to linkage disequilibrium. No causal effect of NAFLD on mental disorders was found in reverse MR analysis. In LDSC regression, significant positive associations with NAFLD occurrence were observed for major depression (Rg = 0.538, <i>p</i> = 1.36<i>E</i> - 07), ADHD (Rg = 0.798, <i>p</i> = 1.10<i>E</i> - 08), and PTSD (Rg = 0.579, <i>p</i> = 0.009). Mediation analysis identified body mass index (39.33%, <i>p</i> = 0.017), waist-to-hip ratio (8.09%, <i>p</i> = 0.026), triglycerides (39.33%, <i>p</i> = 0.017), and serum concentration of large very low-density lipoprotein (VLDL) particles (8.76%, <i>p</i> = 0.032) as mediators of the causal effect of major depression on NAFLD occurrence. <b>Conclusion:</b> This study suggests a potential causal link between major depression and the development of NAFLD, underscoring the importance of considering major depression in the management of NAFLD patients.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"6632867"},"PeriodicalIF":2.3,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"The Relationship between <i>Helicobacter pylori</i> Infection of the Gallbladder and Chronic Cholecystitis and Cholelithiasis: A Systematic Review and Meta-Analysis\".","authors":"","doi":"10.1155/cjgh/9835917","DOIUrl":"10.1155/cjgh/9835917","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1155/2021/8886085.].</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"9835917"},"PeriodicalIF":2.3,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Outcomes of Acute-on-Chronic Liver Failure in Nonelective Cirrhotic Patients Admitted to a Brazilian ICU: A Single-Center Retrospective Study.","authors":"Maria Eduarda Chaves Soares, Liana Codes, Bianca Sampaio de Carvalho, Amanda Caroline Silveira E Silva, Myriam Sofia Angeli Guimarães de Oliveira, Fabiola Santos Sousa, Mariana Rebouças de Calasans, Jade de Oliveira Santana, Lucas Celes Dominguez, Paulo Lisboa Bittencourt","doi":"10.1155/cjgh/9728104","DOIUrl":"10.1155/cjgh/9728104","url":null,"abstract":"<p><p><b>Introduction:</b> Acute-on-chronic liver failure (ACLF) is a severe complication of cirrhosis characterized by acute decompensation (AD), organ failure(s), and high mortality. <b>Aims:</b> To investigate the frequency and the clinical course of ACLF in intensive care unit (ICU) patients at different time points, using CLIF-C and NACSELD criteria as well as to assess their influence on mortality. <b>Methods:</b> Patients admitted with AD with and without ACLF were retrospectively evaluated. <b>Results:</b> 595 patients (443 males, mean age: 66.6 ± 12.0 years) were admitted due to AD (<i>n</i> = 381) or ACLF (<i>n</i> = 214). According to the CLIF-C criteria, 119 patients (20%) had ACLF Grade I, 63 (10.6%) had ACLF Grade II, and 32 (5.4%) had ACLF Grade III at admission. Using the NACSELD, 155 patients (26.1%) had ACLF at admission. Infection was the main factor associated with ACLF at admission (<i>n</i> = 57; 27%, <i>p</i> = 0.001). In total, 104 (17.5%) patients died during hospitalization. ACLF grade at admission (OR: 4.6; 95% CI: 2.45-8.67; NS: 0.0001), use of vasopressors (OR: 3.83; 95% CI: 1.15-12.7; NS: 0.02), and CLIF-C ACLF (OR: 1.12; 95% CI: 1.06-1.19; NS: 0.0001) were independently associated with in-hospital mortality. The improvement in organ dysfunction after 7 days of intensive care was associated with a reduction in the risk of in-hospital mortality compared to the 3-day period (OR: 0.098; 95% CI: 0.047-0.204 vs. 0.253; 95% CI: 0.127-0.504; <i>p</i> < 0.00001, respectively). <b>Conclusion:</b> ACLF is associated with significant mortality in ICU patients, the CLIF-C criteria appear to be more effective for prognostic assessment than NACSELD, and 7 days of intensive care may improve clinical outcomes.</p>","PeriodicalId":48755,"journal":{"name":"Canadian Journal of Gastroenterology and Hepatology","volume":"2025 ","pages":"9728104"},"PeriodicalIF":2.3,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}