{"title":"Sarcopenia is risk factor for prognosis of patients with biliopancreatic diseases.","authors":"Tomoya Emori, Reiko Ashida, Masayuki Kitano","doi":"10.1016/j.hbpd.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.09.005","url":null,"abstract":"<p><p>The prevalence of sarcopenia tends to be high in patients with biliopancreatic disease. Sarcopenia is a risk factor of poor prognosis in patients with acute and chronic pancreatitis and biliary tract and pancreatic cancer. Several studies have suggested that sarcopenia may be a risk factor for perioperative complications and decreased recurrence-free or overall survival in patients with biliary tract and pancreatic cancer after surgery. Sarcopenia in biliary tract and pancreatic cancer may also increase chemotherapy-induced toxicities and worsen quality of life and survival in neoadjuvant or palliative chemotherapy. Moreover, sarcopenia is a risk factor for biliary stent occlusion in patients with malignant biliary obstruction, predictors of the efficacy of endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) for pain relief, EUS-guided drainage, and endoscopic necrosectomy for walled-off necrosis (WON). Diagnosis of sarcopenia prior to the treatment of biliopancreatic diseases and endoscopy may predict treatment efficacy, and appropriate nutritional and exercise therapy improve therapeutic outcomes of patients with biliopancreatic diseases.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310071","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}
Bo Peng, Kai Liu, Xu-Yu Xiang, Yu-Fei Zhang, Hao Li, Peng-Peng Zhang, Jun-Hui Li, Ying-Zi Ming
{"title":"Soluble TREM2 is a novel diagnostic and prognostic biomarker of acute-on-chronic liver failure in patients receiving liver transplantation.","authors":"Bo Peng, Kai Liu, Xu-Yu Xiang, Yu-Fei Zhang, Hao Li, Peng-Peng Zhang, Jun-Hui Li, Ying-Zi Ming","doi":"10.1016/j.hbpd.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.06.009","url":null,"abstract":"<p><strong>Background: </strong>Acute-on-chronic liver failure (ACLF) is a severe syndrome with high short-term mortality. Triggering receptor expressed on myeloid cells-2 (TREM2) is highly expressed in the livers of patients with ACLF, but the role of its soluble form, soluble TREM2 (sTREM2), in ACLF is not clear.</p><p><strong>Methods: </strong>We enrolled 96 consecutive patients receiving liver transplantation (LT), including 40 ACLF patients and 56 non-ACLF patients, and collected plasma at pre-LT and day 3, 7 and 14 after LT. We also enrolled 22 healthy controls (HC). The plasma sTREM2 level was detected using the enzyme-linked immunosorbent assay. The expression of TREM2 in the livers was examined using quantitative polymerase chain reaction.</p><p><strong>Results: </strong>The pre-LT sTREM2 of the ACLF group was significantly higher than that of the non-ACLF group (13.4 ng/mL vs. 2.6 ng/mL, P < 0.001) and the HC group (13.4 ng/mL vs. 0.57 ng/mL, P < 0.001), but sTREM2 did not correlate with the grades of ACLF. The level of sTREM2 was positively correlated with the expression of TREM2 in the livers and had tight correlations with liver function and liver failure-related scores. To diagnose ACLF, sTREM2 showed an area under the receiver operating characteristic curve (AUROC) of 0.863 (P < 0.001). When the cut-off value was 6.5 ng/mL, the sensitivity was 74.3% and the specificity was 93.0%. sTREM2 levels tested at day 7 and 14 after LT were associated with mortality [hazard ratio (HR): 1.187 and 1.078, P < 0.001 and P = 0.043, respectively], and sTREM2 tested at day 3 after LT was a risk factor for early allograft dysfunction (EAD) [odds ratio (OR): 1.060, P = 0.023].</p><p><strong>Conclusions: </strong>sTREM2 was a good biomarker for liver injury. Pre-LT sTREM2 could be used to diagnose ACLF and persistently high levels of sTREM2 after LT predicted poor survival and incidence of EAD.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214476","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}
Chang-Yi Ji, Meng-Meng Gu, Lan Huang, Jian Wu, Hong-Tao Wang
{"title":"Chronic hepatitis E: The neglected liver killer.","authors":"Chang-Yi Ji, Meng-Meng Gu, Lan Huang, Jian Wu, Hong-Tao Wang","doi":"10.1016/j.hbpd.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.09.006","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis E virus (HEV) may induce acute self-limiting illnesses or persistent infections. Chronic hepatitis E frequently occurs in immunocompromised persons, including organ transplant recipients, HIV-positive patients, and those with hematological malignancies. It poses a risk of liver fibrosis and cirrhosis.</p><p><strong>Data sources: </strong>Relevant articles published till September 2024 were located using PubMed searches. The further search terms utilized were: \"immunocompromised\", \"solid organ transplant\", \"HIV\", \"hematological malignancy\", and \"hepatitis E virus\". A manual search of references from pivotal articles extended further publications. The search parameters encompass publications in English.</p><p><strong>Results: </strong>The epidemiology, clinical manifestations, diagnostic measures, and therapeutic modalities of chronic hepatitis E were discussed. Immunocompromised individuals who are infected with HEV are at an increased risk of developing chronic infections, which may progress to liver fibrosis and cirrhosis. Current understanding of HEV is still limited, and there is no medicine that specifically targets hepatitis E. Consequently, the prevention and management of hepatitis E continue to present a significant challenge.</p><p><strong>Conclusions: </strong>Chronic hepatitis E patients need special attention in clinical practice. The relevant risk factors must be identified to facilitate accurate diagnosis and the implementation of more effective preventive measures, thereby enhancing the monitoring, treatment, and prevention of immunocompromised individuals.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228708","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":"Efficacy of regorafenib following first-line immune checkpoint inhibitor failure in patients with advanced hepatocellular carcinoma: A multicenter study.","authors":"Yuan Cheng, Jun-Ying Wang, You Lu, Yong-Xiang Xia, Hui Zhao, Qi Wang, Xiao-Li Zhu, Qing-Quan Zu, Hui-Kai Li, Zhong Chen, Xiang-Cheng Li","doi":"10.1016/j.hbpd.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.09.004","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) remains a significant global health challenge. While first-line treatments with immune checkpoint inhibitors (ICIs) have improved patient outcomes, the selection of effective second-line therapies remains unclear. This study evaluated the efficacy and safety of regorafenib as a second-line option in advanced HCC patients post-progression on ICI-based therapies.</p><p><strong>Methods: </strong>Advanced HCC patients from eight hospitals in China who received regorafenib after progression on first-line ICI therapies, alone or combined with ICIs were enrolled. Clinical data were collected, and propensity score matching (PSM) was used to ensure comparability between treatment groups. The primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events. The study was registered at www.chictr.org.cn (ChiCTR2400091318).</p><p><strong>Results: </strong>A total of 149 patients were included: 113 in the combination therapy group (Rego-ICI group) and 36 in the regorafenib monotherapy group (Rego group). After PSM, the Rego-ICI group showed significantly improved and OS [19.0 vs. 11.0 months, hazard ratio (HR) = 0.426, 95% confidence interval (CI): 0.235-0.772, P = 0.005] and PFS (4.0 vs. 3.0 months, HR = 0.539, 95% CI: 0.337-0.863, P = 0.010) compared to the Rego group. Differences in ORR and DCR were not statistically significant (ORR: 19.4% vs. 9.7%, P = 0.226; DCR: 64.2% vs. 48.4%, P = 0.139), but the Rego-ICI group showed better disease control. Regorafenib plus ICI improved both OS and PFS with no new safety signals.</p><p><strong>Conclusions: </strong>The combination of ICIs and regorafenib significantly enhances OS in advanced HCC patients post-progression on first-line ICI treatments. These findings support the potential of regorafenib plus ICIs as an effective second-line therapy.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281819","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}