Gastroenterology Report最新文献

{"title":"Postpartum hepatitis flares in mothers with chronic hepatitis B infection.","authors":"Shi OuYang, Yawen Geng, Gongqin Qiu, Yueying Deng, Haitao Deng, Calvin Q Pan","doi":"10.1093/gastro/goae091","DOIUrl":"https://doi.org/10.1093/gastro/goae091","url":null,"abstract":"<p><p>Postpartum elevation of alanine aminotransferase (ALT) in mothers with chronic hepatitis B (CHB) presents a significant clinical challenge. However, the existing literature demonstrates inconsistencies regarding its incidence and predictors in mothers infected with the hepatitis B virus (HBV). Recent advancements in antiviral prophylaxis against mother-to-child transmission of HBV and postpartum cessation of antiviral therapy further complicate this issue. Our literature review, spanning PubMed, and two Chinese-language databases (CNKI and Wanfang) from 1 January 2000 to 31 December 2023 aimed to consolidate and analyse available data on the frequency and severity of postpartum ALT flares, identify risk factors, and propose a management algorithm. Data from 23 eligible studies involving 8,077 pregnant women revealed an overall incidence of postpartum ALT elevation: 25.7% for mild cases, 4.4% for moderate cases, and 1.7% for severe cases. In the subgroup of mothers who were HBeAg-positive and on antiviral prophylaxis for preventing mother-to-child transmission, postpartum intermediate and severe ALT elevations were reported with pooled rates of 5.9% and 0.8%, respectively. Importantly, none resulted in mortality or necessitated liver transplantation. Identified risk factors for postpartum ALT flares in mothers with CHB included HBV DNA levels, ALT levels during pregnancy, postpartum cessation of antiviral treatment, and HBeAg status. By leveraging this evidence and recent data on predictors of intermediate or severe postpartum ALT flares, we propose a risk-stratified algorithm for managing postpartum ALT elevation and selecting therapy in mothers with CHB, tailoring different approaches for treatment-naive vs treatment-experienced populations. These recommendations aim to provide guidance for clinical decision-making and enhance patient outcomes.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae091"},"PeriodicalIF":3.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512944","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":"HCV elimination: is the bulk of the iceberg being missed?","authors":"Eric Kalo, Asma Baig, Alison Derrett, Scott Read, Golo Ahlenstiel","doi":"10.1093/gastro/goae093","DOIUrl":"https://doi.org/10.1093/gastro/goae093","url":null,"abstract":"","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae093"},"PeriodicalIF":3.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480725","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":"Active role of the immune system in metabolic dysfunction-associated steatotic liver disease.","authors":"Taizo Mori, Sachiyo Yoshio, Eiji Kakazu, Tatsuya Kanto","doi":"10.1093/gastro/goae089","DOIUrl":"https://doi.org/10.1093/gastro/goae089","url":null,"abstract":"<p><p>Non-alcoholic fatty liver disease, recently renamed metabolic dysfunction-associated steatotic liver disease (MASLD), is a complex multifactorial disease that progresses from steatohepatitis (MASH) to liver cirrhosis and liver cancer. Recent research has revealed that crosstalk between innate immune cells and hepatic parenchymal and non-parenchymal cells is involved in the pathogenesis of liver disease in MASLD/MASH. Of particular importance, novel inflammatory mechanisms, including macrophage diversity, neutrophil NETosis, B-cell biology, auto-reactive T cells, unconventional T cells, and dendritic cell-T cell interactions, are considered key drivers for disease progression. These mechanisms and factors are potential targets for the therapeutic intervention of MASLD/MASH. In this review, we focus on recent discoveries related to liver inflammation and discuss the role of innate immune cell subsets in MASLD/MASH.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae089"},"PeriodicalIF":3.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11479709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480723","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":"Correction to: Noninvasive tests for liver fibrosis in 2024: are there different scales for different diseases?","authors":"","doi":"10.1093/gastro/goae096","DOIUrl":"https://doi.org/10.1093/gastro/goae096","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/gastro/goae024.].</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae096"},"PeriodicalIF":3.8,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11481166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480724","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":"A predictive model and rapid multi-dynamic algorithm developed based on tumor-stroma percentage in gastric cancer: a retrospective, observational study.","authors":"Yitian Xu, Yan Yang, Feichi Cheng, Zai Luo, Yuan Zhang, Pengshan Zhang, Jiahui Qiu, Zhengjun Qiu, Chen Huang","doi":"10.1093/gastro/goae083","DOIUrl":"https://doi.org/10.1093/gastro/goae083","url":null,"abstract":"<p><strong>Background: </strong>Tumor-stroma percentage (TSP) is a prognostic risk factor in numerous solid tumors. Despite this, the prognostic significance of TSP in gastric cancer (GC) remains underexplored. Through the development of a personalized predictive model and a semi-automatic identification system, our study aimed to fully unlock the predictive potential of TSP in GC.</p><p><strong>Methods: </strong>We screened GC patients from Shanghai General Hospital (SGH) between 2012 and 2019 to develop and validate a nomogram. Univariate and multivariate Cox proportional hazards regression analyses were employed to identify independent prognostic factors influencing the prognosis for GC patients. The nomogram was further validated externally by using a cohort from Bengbu Medical College (BMC). All patients underwent radical gastrectomy, with those diagnosed with locally advanced GC receiving adjuvant chemotherapy. The primary outcome measured was overall survival (OS). The semi-automatic identification of the TSP was achieved through a computer-aided detection (CAD) system, denoted as TSP-cad, while TSP identified by pathologists was labeled as TSP-visual.</p><p><strong>Results: </strong>A total of 813 GC patients from SGH and 59 from BMC were enrolled in our study. TSP-visual was identified as an adverse prognostic factor for OS in GC and was found to be associated with pathological Tumor Node Metastasis staging system (pTNM) stage, T stage, N stage, perineural invasion (PNI), lymphovascular invasion (LVI), TSP-visual, tumor size, and other factors. Multivariate Cox regression using the training cohort revealed that TSP-visual (hazard ratio [HR], 2.042; 95% confidential interval [CI], 1.485-2.806; <i>P </i><<i> </i>0.001), N stage (HR, 2.136; 95% CI, 1.343-3.397; <i>P </i>=<i> </i>0.010), PNI (HR , 1.791; 95% CI, 1.270-2.526; <i>P </i>=<i> </i>0.001), and LVI (HR, 1.482; 95% CI, 1.021-2.152; <i>P </i>=<i> </i>0.039) were independent predictors. These factors were incorporated into a novel nomogram, which exhibited strong predictive accuracy for 5-year OS in the training, internal validation, and external validation cohorts (area under the curve = 0.744, 0.759, and 0.854, respectively). The decision curve analysis of the nomogram and concordance indexes across the three cohorts outperformed the traditional pTNM (<i>P </i><<i> </i>0.05). Additionally, TSP-cad assessment using a rapid multi-dynamic algorithm demonstrated good agreement with TSP-visual.</p><p><strong>Conclusions: </strong>The novel nomogram based on TSP could effectively identify individuals at risk of a poor prognosis among patients with GC. TSP-cad is anticipated to enhance the evaluation process of TSP.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae083"},"PeriodicalIF":3.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480722","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":"Analysis of actionable gene fusions in a large cohort of Chinese patients with colorectal cancer.","authors":"Fu-Rong Kou, Jian Li, Zheng-Hang Wang, Ting Xu, Juan-Juan Qian, En-Li Zhang, Li-Jun Zhang, Lin Shen, Xi-Cheng Wang","doi":"10.1093/gastro/goae092","DOIUrl":"10.1093/gastro/goae092","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of gene fusion is extremely low in unselected patients with colorectal cancer (CRC). Published data on gene fusions are limited by relatively small sample sizes, with a primary focus on Western populations. This study aimed to analyse actionable gene fusions in a large consecutive Chinese CRC population.</p><p><strong>Methods: </strong>This study included 5,534 consecutive CRC patients from the Genecast database. Genomic profiling was performed using a panel of 769 cancer-related genes. Data for 34 CRC patients with actionable gene fusions were also collected from cBioPortal and ChimerSeq.</p><p><strong>Results: </strong>Among 5,534 CRC patients, 54 (0.98%) had actionable gene fusions, with <i>NTRK1/2/3</i> being the most common fusion (0.38%), accounting for 38.9% (21/54) of those with fusions. Actionable gene fusion enrichment was higher in patients with microsatellite instability-high (MSI-H) (6.7% vs. 0.5%, <i>P </i><<i> </i>0.001), <i>RAS/BRAF</i> wildtype (2.0% vs. 0.2%, <i>P </i><<i> </i>0.001) and <i>RNF43</i> mutation (7.7% vs. 0.4%, <i>P </i><<i> </i>0.001) than in patients with microsatellite stability/MSI-low, <i>RAS/BRAF</i> mutation and <i>RNF43</i> wildtype, respectively. When these markers were combined, the fusion detection rate increased. Among patients with <i>RAS/BRAF</i> wildtype and MSI-H, fusions were detected in 20.3% of patients. The fusion detection rate further increased to 37.5% when <i>RNF43</i> mutation was added. The fusion detection rate was also higher in colon cancer than in rectal cancer. No significant differences in clinical or molecular features were found in patients with actionable gene fusions between the Genecast, cBioPortal, and ChimerSeq databases.</p><p><strong>Conclusions: </strong>Approximately 1% of the unselected Chinese CRC population carries actionable gene fusions, mostly involving <i>NTRK</i>. Actionable gene fusions are more prevalent in MSI-H, <i>RAS/BRAF</i> wildtype, or <i>RNF43</i>-mutated CRC, as well as in colon cancer. Mapping of these molecular markers can markedly increase the fusion detection rate, which can help clinicians select candidates for fusion testing and targeted therapy.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae092"},"PeriodicalIF":3.8,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11464618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401958","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 clinical efficacy of \"water-jet\" hemostasis in gastrointestinal endoscopic submucosal dissection.","authors":"Ran Chen, Qingyong Zhang, Shiya Hong, Fengying Chen, Xiaoqing Huang, Xiongfei Bao, Zhi Ni, Rongchun Zhang","doi":"10.1093/gastro/goae088","DOIUrl":"https://doi.org/10.1093/gastro/goae088","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the safety and efficacy of \"water-jet\" hemostasis during endoscopic submucosal dissection.</p><p><strong>Methods: </strong>In this prospective single-arm clinical study, 10 patients aged 18-60 years with gastric or intestinal mucosal lesions who were admitted to Fujian Medical University Xiamen Humanity Hospital (Xiamen, P. R. China) between June 2022 and June 2023 and met the absolute indications for endoscopic treatment were finally analyzed. The primary outcomes of this study are the incidence rates of adverse events and R0 resection, and the secondary outcomes are length of hospital stay and short- and long-term outcomes.</p><p><strong>Results: </strong>Successful hemostasis was achieved in all the included cases. In one case, the \"water-jet\" hemostasis failed to stop bleeding in one blood vessel, so the hemostatic forceps were used instead. No adverse events occurred in all cases. Pathologic results showed R0 resection in all samples.</p><p><strong>Conclusion: </strong>The \"water-jet\" method is safe and feasible for hemostasis in endoscopic submucosal dissection.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae088"},"PeriodicalIF":3.8,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11427691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332344","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":"New perspectives in hepatocellular carcinoma surveillance after hepatitis C virus eradication.","authors":"Calvin Q Pan, Andrew J Park, James S Park","doi":"10.1093/gastro/goae085","DOIUrl":"https://doi.org/10.1093/gastro/goae085","url":null,"abstract":"<p><p>Achieving a sustained virologic response (SVR) through direct-acting antivirals for hepatitis C virus (HCV) infection significantly reduces the long-term risk of hepatocellular carcinoma (HCC), particularly in patients with advanced fibrosis (F3) or cirrhosis (F4). However, despite this improvement, the risks associated with HCC and the optimal surveillance strategies for patients who have achieved SVR remain topics of debate. This controversy is compounded by challenges in reliably staging liver fibrosis non-invasively, especially at advanced fibrosis (F3), and the unclear cost-effectiveness, modality, frequency, and duration of HCC surveillance in individuals with SVR but without cirrhosis. These factors contribute to significant variations in surveillance guidelines recommended by different professional societies. Therefore, there is a pressing need for an optimal surveillance strategy that is both simplified and cost-effective to facilitate wider adoption by clinicians. This review article evaluates the existing data, addresses ongoing controversies, and aims to provide new perspectives on HCC surveillance strategies for patients who have achieved SVR from HCV.</p>","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"12 ","pages":"goae085"},"PeriodicalIF":3.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332343","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":"Strain- and sex-specific differences in intestinal microhemodynamics and gut microbiota composition.","authors":"Sunjing Fu,Mengting Xu,Bing Wang,Bingwei Li,Yuan Li,Yingyu Wang,Xueting Liu,Hao Ling,Qin Wang,Xiaoyan Zhang,Ailing Li,Xu Zhang,Mingming Liu","doi":"10.1093/gastro/goae087","DOIUrl":"https://doi.org/10.1093/gastro/goae087","url":null,"abstract":"BackgroundIntestinal microcirculation is a critical interface for nutrient exchange and energy transfer, and is essential for maintaining physiological integrity. Our study aimed to elucidate the relationships among intestinal microhemodynamics, genetic background, sex, and microbial composition.MethodsTo dissect the microhemodynamic landscape of the BALB/c, C57BL/6J, and KM mouse strains, laser Doppler flowmetry paired with wavelet transform analysis was utilized to determine the amplitude of characteristic oscillatory patterns. Microbial consortia were profiled using 16S rRNA gene sequencing. To augment our investigation, a broad-spectrum antibiotic regimen was administered to these strains to evaluate the impact of gut microbiota depletion on intestinal microhemodynamics. Immunohistochemical analyses were used to quantify platelet endothelial cell adhesion molecule-1 (PECAM-1), estrogen receptor α (ESR1), and estrogen receptor β (ESR2) expression.ResultsOur findings revealed strain-dependent and sex-related disparities in microhemodynamic profiles and characteristic oscillatory behaviors. Significant differences in the gut microbiota contingent upon sex and genetic lineage were observed, with correlational analyses indicating an influence of the microbiota on microhemodynamic parameters. Following antibiotic treatment, distinct changes in blood perfusion levels and velocities were observed, including a reduction in female C57BL/6J mice and a general decrease in perfusion velocity. Enhanced erythrocyte aggregation and modulated endothelial function post-antibiotic treatment indicated that a systemic response to microbiota depletion impacted cardiac amplitude. Immunohistochemical data revealed strain-specific and sex-specific PECAM-1 and ESR1 expression patterns that aligned with observed intestinal microhemodynamic changes.ConclusionsThis study highlights the influence of both genetic and sex-specific factors on intestinal microhemodynamics and the gut microbiota in mice. These findings also emphasize a substantial correlation between intestinal microhemodynamics and the compositional dynamics of the gut bacterial community.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"201 1","pages":"goae087"},"PeriodicalIF":3.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hiatal hernia: risk factors, and clinical and endoscopic aspects in gastroscopy","authors":"Naim Abu-Freha, Revital Guterman, Ruhama Elhayany, Avraham Yitzhak, Shira Sophie Hudes, Alexander Fich","doi":"10.1093/gastro/goae086","DOIUrl":"https://doi.org/10.1093/gastro/goae086","url":null,"abstract":"Background Hiatal hernia (HH) is a common finding in gastroscopy. The aim of the present study was to investigate the frequency rate of HH among patients who underwent esophagogastroduodenoscopy (EGD) according to their age, gender, and procedural indication. Methods A multicenter, retrospective study including all EGDs was conducted across seven endoscopy departments between 2016 and 2021. Demographic information, procedural indications, and findings from the initial EGD were collected. Results Of the 162,608 EGDs examined, 96,369 (59.3%) involved female patients. HH was identified in 39,619 (24.4%) of all EGDs performed, comprising small HH in 31,562 (79.6%) and large HH in 3,547 (9.0%). The frequency of HH was 16.5% in the age group of ≤50 years and 37.3% in those aged ≥81 years. HH was diagnosed in 38.7% (11,370) of patients with heartburn/reflux symptoms, 31.5% of those with dysphagia, 28.5% of those with positive fecal occult blood tests, and 24.3% of those who would undergo bariatric surgery. Age (odds ratio 1.030), female gender (odds ratio 1.309), reflux symptoms (odds ratio 2.314), and dysphagia (odds ratio 1.470) were identified as predictors for HH. Conclusions Risk factors for HH diagnosed by EGD in symptomatic patients were shown to be advanced age, female gender, and the presence of heartburn or dysphagia.","PeriodicalId":54275,"journal":{"name":"Gastroenterology Report","volume":"13 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142254004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}