Gastroenterology Report最新文献

{"title":"Primary solitary fibrous tumor of the liver: an uncommon neoplasm.","authors":"Shu Sasaki, Luis Veloza, Christine Sempoux, Didier Sarazin, Emilie Uldry, Nermin Halkic, Ismail Labgaa","doi":"10.1093/gastro/goaf012","DOIUrl":"10.1093/gastro/goaf012","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf012"},"PeriodicalIF":3.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Micro-environmental changes indicate potential for subclinical intestinal tissue damage in early-age-onset colorectal cancer patients.","authors":"Sean G Kraus, Katherine A Johnson, Philip B Emmerich, Linda Clipson, Cheri A Pasch, Wei Zhang, Kristina A Matkowskyj, Dustin A Deming","doi":"10.1093/gastro/goaf015","DOIUrl":"10.1093/gastro/goaf015","url":null,"abstract":"<p><strong>Background: </strong>While improved screening rates have contributed to an overall decrease in the incidence of colorectal cancer (CRC), the incidence of early-age-onset CRC (EAO CRC; age <50 years) has increased. Here, we characterize the genetic alterations and tumor microenvironment (TME) for EAO and later-age-onset (LAO) CRCs to identify relevant biological differences that might point to etiologic factors.</p><p><strong>Methods: </strong>A cohort of EAO (<i>n </i>=<i> </i>60) and LAO (<i>n </i>=<i> </i>93) CRC patients were evaluated for mutations by using targeted DNA sequencing and for TME differences by using immunohistochemistry and immunofluorescence. The Cancer Genome Atlas (TCGA) PanCancer Atlas colorectal adenocarcinoma cohort was evaluated for transcriptional changes between EAO (<i>n </i>=<i> </i>82) and LAO (<i>n </i>=<i> </i>510) patients.</p><p><strong>Results: </strong><i>KRAS</i> and <i>BRAF</i> mutations were less frequent in EAO CRCs. Gene-set enrichment analysis of TCGA data revealed the downregulation of immune-related pathways in EAO CRCs. Both age cohorts had similar numbers of CD8⁺ tumor-infiltrating lymphocytes (TILs), although LAO patients had more CD4⁺ TILs and Th1-polarized CD4s. While significant associations between immune subsets and versican (VCAN), versikine, and alpha-smooth muscle actin (αSMA) were found, none of these trends differed between age cohorts. EAO patients trended towards greater VCAN accumulation in adjacent normal tissue, lower rates of VCAN proteolysis, and decreased αSMA accumulation vs LAO patients.</p><p><strong>Conclusions: </strong>Overall, established EAO cancers are similar to LAO cancers in mutational profile and key TME features. High VCAN and αSMA expression in adjacent normal colon indicates a presence of factors that are associated with increased intestinal subclinical inflammation. Future mechanistic studies will be conducted to better understand the importance of these findings and related processes should be prioritized as potential etiologic factors for EAO tumorigenesis.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf015"},"PeriodicalIF":3.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk-stratified hepatocellular carcinoma surveillance in non-cirrhotic patients with MASLD.","authors":"Ke Mi, Tingdan Ye, Lin Zhu, Calvin Q Pan","doi":"10.1093/gastro/goaf018","DOIUrl":"10.1093/gastro/goaf018","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is rapidly emerging as the leading global liver disorder and is poised to become the primary cause of hepatocellular carcinoma (HCC). Research indicates that nearly 50% of HCC cases in MASLD patients occur without cirrhosis, often presenting with more advanced and larger tumors. Despite this, current guidelines primarily focus on HCC screening in cirrhotic patients, with limited guidance for non-cirrhotic MASLD individuals. This narrative review seeks to identify key risk factors for HCC development, consolidate available screening methods, and propose a practical, risk-stratified algorithm for HCC surveillance in non-cirrhotic MASLD patients. We conducted a comprehensive review of studies published between 2017 and 2023 using PubMed, Embase, and CNKI, focusing on HCC risk factors and emerging screening strategies for non-cirrhotic MASLD cohorts. Key risk factors for HCC development in these patients include male sex, age over 65, hypertension, diabetes, mild alcohol consumption, smoking, dyslipidemia, elevated alanine aminotransferase levels, and a platelet count ≤ 150 × 10⁹/L. Among the screening methods evaluated, circulating free DNA, alpha-fetoprotein (AFP) combined with protein induced by vitamin K absence or antagonist-II (PIVKA-II), and the GALAD score (incorporating Glypican-3, AFP, alpha-1-Antitrypsin, and des-gamma-carboxy prothrombin) demonstrated the highest performance. Based on these findings, we proposed a risk-stratified HCC surveillance algorithm that integrates GALAD and PIVKA-II into the existing sonography and AFP screening protocols. This review aims to provide clinicians with actionable recommendations for HCC screening in non-cirrhotic MASLD patients.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf018"},"PeriodicalIF":3.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coexisting steatotic liver disease is not associated with long-term liver-related events in patients with chronic hepatitis B.","authors":"Navavee Uman, Apichat Kaewdech, Pimsiri Sripongpun, Naichaya Chamroonkul, Teerha Piratvisuth","doi":"10.1093/gastro/goaf013","DOIUrl":"10.1093/gastro/goaf013","url":null,"abstract":"<p><p>Steatotic liver disease (SLD) is an emerging liver disease, whereas chronic viral hepatitis is the renowned cause of chronic liver disease leading to cirrhosis and hepatocellular carcinoma (HCC). The impact of coexisting SLD in chronic hepatitis B (CHB) on liver-related events (LREs) in the long term is still debated. This study aims to compare all-cause mortality and LRE between CHB patients with and without SLD. This retrospective study included CHB patients who underwent transient elastography between 2014 and 2021 at a tertiary-care hospital. Exclusion criteria were those without controlled attenuated parameter (CAP) results, interquartile range/median of liver stiffness measurement (LSM) > 30%, follow-up time < 6 months, and without hepatitis B virus DNA data during follow-up. SLD was defined as CAP ≥ 248 dB/m, significant liver fibrosis (SF) as LSM ≥ 7 kPa, and cirrhosis as LSM ≥11 kPa or imaging evidence. LRE was defined as the development of HCC and/or cirrhosis complications. Among 532 patients (median follow-up 4.3 years), SLD was present in 161 (30.2%) patients, SF was found in 186 (34.5%) patients, and 104 (19.6%) patients had cirrhosis at baseline. SF was insignificantly more common in SLD patients (40.1% vs 32.4%, <i>P </i>=<i> </i>0.068). Long-term outcomes showed SF, not SLD, was independently associated with higher LRE development with an adjusted HR of 13.85 (95% confidence interval [CI]: 3.06-62.76, <i>P </i><<i> </i>0.001), while the adjusted HR of SLD was 0.49 (95% CI: 0.16-1.53, <i>P </i>=<i> </i>0.22). In conclusion, SLD commonly coexists with CHB patients. CHB patients with SLD were more likely to have SF at baseline, albeit not significantly. Long-term HCC and cirrhosis complications development are associated with SF but not SLD status.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf013"},"PeriodicalIF":3.8,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaps and disparities in the treatment of chronic hepatitis B infection in the USA.","authors":"Robert J Wong","doi":"10.1093/gastro/goaf016","DOIUrl":"10.1093/gastro/goaf016","url":null,"abstract":"<p><p>Chronic hepatitis B (CHB) infection affects nearly 300 million individuals worldwide and is a leading cause of hepatocellular carcinoma and liver-related mortality. However, major gaps in the CHB cascade of care persist, with the majority of individuals with CHB not diagnosed and not linked to care and treatment. Even among individuals with known CHB, existing studies report on major gaps and disparities in timely linkage to care and timely access to CHB therapies. While the momentum to expand and simplify CHB treatment guidelines is promising, access to treatment still relies on individuals being effectively engaged in clinical care and liver disease monitoring. The contributing factors to the observed gaps and disparities in the CHB cascade of care are complex and multifactorial, and there is no one-size-fits-all solution than can be easily applied across all global regions. However, any serious approach towards addressing the existing gaps in the CHB cascade of care to improve patient outcomes requires a concerted investment from healthcare institutions, governments, policymakers, and industry partners to provide the necessary resources to be able to achieve this goal. Anything less than a comprehensive and collaborative approach that engages all stakeholders to invest effort and resources into tackling the global epidemic of CHB will continue to fall short in making progress towards global viral hepatitis elimination goals.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf016"},"PeriodicalIF":3.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Odevixibat as a possible rescue therapy in a pediatric patient with vanishing bile ducts syndrome associated with ethosuximide-induced DILI-DRESS.","authors":"Silvio Veraldi, Luca Della Volpe, Valerio Cecinati, Paola Francalanci, Giuseppe Maggiore, Andrea Pietrobattista","doi":"10.1093/gastro/goaf014","DOIUrl":"10.1093/gastro/goaf014","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf014"},"PeriodicalIF":3.8,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11802463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The safety and feasibility of a novel cap-assisted endoscopic resection device for rectal tissue resection: a pilot study (with videos).","authors":"Xuelian Gao, Jing Wang, Jiaming He, Panpan Liu, Haiyan Hu, Jun He, Side Liu, Yue Li","doi":"10.1093/gastro/goaf003","DOIUrl":"10.1093/gastro/goaf003","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf003"},"PeriodicalIF":3.8,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of vagus nerve stimulation in gastrointestinal disorders: a systematic review.","authors":"Fleur Veldman, Kimberly Hawinkels, Daniel Keszthelyi","doi":"10.1093/gastro/goaf009","DOIUrl":"10.1093/gastro/goaf009","url":null,"abstract":"<p><p>Dysfunction of the vagus nerve has been suggested as a contributing factor in various gastrointestinal disorders, prompting interest in vagus nerve stimulation (VNS) as a non-pharmacological therapy. We performed a systematic review to determine the efficacy of invasive and non-invasive VNS in gastrointestinal disorders, including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation, gastroesophageal reflux disease, and gastroparesis. We applied a systematic search of the literature in the PubMed, Embase, Web of Science, and Cochrane Library databases in order to identify studies comparing VNS with an adequate control condition (sham stimulation) in patients with gastrointestinal disorders. The primary outcome was adequate symptom relief. Methodological quality was evaluated using the revised Cochrane risk-of-bias tool. Meta-analyses were not performed due to study heterogeneity. Seven randomized controlled trials investigating non-invasive VNS were included, with a total of 644 patients: FD (<i>n </i>=<i> </i>426), IBD (<i>n </i>=<i> </i>22), IBS (<i>n </i>=<i> </i>92), and abdominal pain-related functional gastrointestinal disorder (<i>n </i>=<i> </i>104), with a mean age ranging from 15 to 65 years. Non-invasive VNS significantly improved symptoms across all subsets of patients, as measured differently according to disease type, compared with sham stimulation. Adverse events, if reported, were low, with no serious complications. Putative mechanisms of action were assumed to be related to anti-inflammatory and anti-nociceptive effects. Non-invasive VNS holds promise as a safe therapy for diverse gastrointestinal disorders. However, these findings are derived from studies with small sample sizes and provide preliminary insights. Further research is warranted to define its exact position within the therapeutic arsenal.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf009"},"PeriodicalIF":3.8,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of intrahepatic cholangiocarcinoma: a review for clinicians.","authors":"Matteo Colangelo, Marcello Di Martino, Michela Anna Polidoro, Laura Forti, Nastassja Tober, Alessandra Gennari, Nico Pagano, Matteo Donadon","doi":"10.1093/gastro/goaf005","DOIUrl":"10.1093/gastro/goaf005","url":null,"abstract":"<p><p>Intrahepatic cholangiocarcinoma (iCCA) is an aggressive liver malignancy that arises from second-order biliary epithelial cells. Its incidence is gradually increasing worldwide. Well-known risk factors have been described, although in many cases, they are not identifiable. Treatment options are continuously expanding, but the prognosis of iCCA remains dismal. R0 liver resection remains the only curative treatment, but only a limited number of patients can benefit from it. Frequently, major hepatectomies are needed to completely remove the tumour. This could contraindicate surgery or increase postoperative morbidity in patients with chronic liver disease and small remnant liver volume. In cases of anticipated inadequate future liver remnant, regenerative techniques may be used to expand resectability. The role and extent of lymphadenectomy in iCCA are still matters of debate. Improvements in iCCA diagnosis and better understanding of genetic profiles might lead to optimized surgical approaches and drug therapies. The role of neoadjuvant and adjuvant therapies is broadening, gaining more and more acceptance in clinical practice. Combining surgery with locoregional therapies and novel drugs, such as checkpoint-inhibitors and molecular-targeted molecules, might improve treatment options and survival rates. Liver transplantation, after very poor initial results, is now receiving attention for the treatment of patients with unresectable very early iCCA (i.e. <2 cm) in cirrhotic livers, showing survival outcomes comparable to those of hepatocellular carcinoma. Ongoing prospective protocols are testing the efficacy of liver transplantation for patients with unresectable, advanced tumours confined to the liver, with sustained response to neoadjuvant treatment. In such a continuously changing landscape, the aim of our work is to review the state-of-the-art in the surgical and medical treatment of iCCA.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf005"},"PeriodicalIF":3.8,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From chelation to transplantation: lessons from a progressive familial intrahepatic cholestasis type 3 case initially managed as Wilson's disease.","authors":"Ali Emre Bardak, Tuğba Kalaycı, Bilger Çavuş, Aslı Çifçibaşı Örmeci, Kadir Demir","doi":"10.1093/gastro/goaf017","DOIUrl":"10.1093/gastro/goaf017","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 ","pages":"goaf017"},"PeriodicalIF":3.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}