世界胃肠病理生理学杂志(电子版)(英文版)最新文献

{"title":"Pathophysiological management of gastric varices: From hemodynamics to targeted therapies.","authors":"Suprabhat Giri, Ranjan K Patel, Tara Prasad Tripathy, Dibya Lochan Praharaj, Radhika Chavan","doi":"10.4291/wjgp.122115","DOIUrl":"10.4291/wjgp.122115","url":null,"abstract":"<p><p>Gastric varices (GV) are a distinct and clinically challenging manifestation of portal hypertension characterized by complex vascular anatomy and unique hemodynamic behavior. Unlike esophageal varices (EV), GVs arise from interactions between afferent portal inflow, large variceal reservoirs, and spontaneous portosystemic shunts, resulting in a low-pressure, high-flow system that often responds poorly to conventional pressure-reducing therapies. Consequently, management strategies extrapolated from EV are frequently inadequate. Advances in endoscopic ultrasound (EUS), cross-sectional imaging, and interventional radiology have facilitated a paradigm shift toward a pathophysiology-driven approach. Contemporary evaluation integrates endoscopic classification based on anatomical location (Sarin), EUS for assessment of feeding vessels and flow dynamics, and computed tomography/magnetic resonance imaging for mapping afferent and efferent pathways using Kiyosue and Saad-Caldwell classifications. These frameworks enable hemodynamic triage into shunt-dominant, pressure-dominant, and complex patterns, which directly inform therapeutic selection. Endoscopic therapies, including cyanoacrylate injection and EUS-guided coil ± glue embolization, target the variceal reservoir and inflow, providing effective local control. Radiologic interventions address systemic hemodynamics, with retrograde transvenous obliteration (Balloon-occluded retrograde transvenous obliteration/plug-assisted retrograde transvenous obliteration/coil-assisted retrograde transvenous obliteration) preferred for shunt-dominant varices and transjugular intrahepatic portosystemic shunt for pressure-driven disease. Surgical options remain relevant in selected conditions such as left-sided portal hypertension. Clinical modifiers, including hepatic reserve, encephalopathy, ascites, and portal vein patency, further refine treatment decisions. A multidisciplinary, mechanism-based strategy is essential to optimize outcomes. Future research should focus on integrated classification systems and prospective comparative studies to establish standardized, individualized management algorithms.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"17 3","pages":"122115"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbohydrate antigen 72-4 and tumor-associated glycoprotein 72 - tumor marker: Past, present and future.","authors":"Rui-Kyi Ng, Vishal G Shelat","doi":"10.4291/wjgp.125464","DOIUrl":"https://doi.org/10.4291/wjgp.125464","url":null,"abstract":"<p><p>Carbohydrate antigen 72-4 (CA72-4) is a serum tumor marker linked to tumor-associated glycoprotein 72 (TAG-72), a high-molecular-weight mucin-like antigen identified during the monoclonal-antibody era. Although developed later than CA19-9 and most closely associated with gastric cancer, CA72-4 has since attracted broader interest across gastrointestinal oncology, peritoneal disease, malignant effusions, cytology, benign false-positive states and TAG-72-directed translational research. This review examines the history, biology, clinical utility, diagnostic limitations and future applications of CA72-4 and TAG-72, using gastric cancer as the principal clinical anchor while considering wider esophagogastric, colorectal, appendiceal, pancreaticobiliary, peritoneal and fluid-based applications. Current evidence supports CA72-4 as an adjunctive biomarker rather than a population screening test or stand-alone diagnostic tool. Its most defensible clinical roles are in gastric cancer risk stratification, peritoneal disease assessment, selected multimarker panels and malignant effusion work-up. Looking ahead, TAG-72 may ultimately prove more clinically consequential than serum CA72-4 itself if imaging, cytology-based diagnostics and targeted therapeutic platforms continue to mature.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"17 3","pages":"125464"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of non-invasive tests for diagnosing liver fibrosis and steatosis: A systematic review.","authors":"Saurin R Shukla, Mirza Amer Ali Baig, Arika Pareek, Namita Johari, Yeshika Thapa, Beulah Blessy Kumpati, Shreya Mahesh Nirmal, Ifrah Ayesha Imdad, Durnave Azid, Eniola Aina, Alisha Lakhani","doi":"10.4291/wjgp.121790","DOIUrl":"https://doi.org/10.4291/wjgp.121790","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Liver fibrosis is a key determinant of prognosis and management in chronic liver diseases. Although liver biopsy is considered the gold standard for fibrosis assessment, its invasiveness, sampling variability, and associated risks have prompted increasing reliance on non-invasive tests. This systematic review evaluates the diagnostic accuracy and clinical applicability of non-invasive modalities for diagnosing liver fibrosis in adult patients with chronic liver diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To systematically evaluate the diagnostic accuracy, clinical utility, and applicability of non-invasive tests for detecting and staging liver fibrosis in adult patients with chronic liver diseases, using liver biopsy as the reference standard.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic literature search was conducted using predefined search terms combining liver fibrosis, chronic liver disease, non-invasive diagnostic tests, and diagnostic accuracy measures, with liver biopsy as the reference standard. Studies were selected based on a PICO (Population, Intervention, Comparison, Outcome) framework including adults (≥ 18 years) with chronic liver diseases such as hepatitis B, hepatitis C, non-alcoholic fatty liver disease, and alcohol-related liver disease. Eligible interventions included serum biomarkers (&lt;i&gt;e.g.&lt;/i&gt;, aspartate aminotransferase-to-platelet ratio index, fibrosis-4 index, enhanced liver fibrosis), imaging-based techniques (&lt;i&gt;e.g.&lt;/i&gt;, transient elastography, acoustic radiation force impulse, magnetic resonance imaging elastography), and combined diagnostic algorithms. Diagnostic accuracy outcomes including sensitivity, specificity, positive predictive value, and negative predictive value were extracted. Two independent reviewers performed abstract and full-text screening according to predefined inclusion and exclusion criteria, with disagreements resolved by consensus or a third reviewer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The included studies comprised prospective and retrospective cohort studies, randomized controlled trials, and cross-sectional studies. Elastography-based techniques consistently demonstrated high diagnostic accuracy for detecting significant and advanced fibrosis across multiple chronic liver disease etiologies. Serum biomarker panels showed variable performance but were effective as first-line screening tools due to their accessibility and cost-effectiveness. Heterogeneity was observed in study design, fibrosis staging systems, and cut-off values.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Non-invasive tests represent reliable and clinically applicable alternatives to liver biopsy for fibrosis assessment in chronic liver diseases. Elastography-based modalities, particularly transient elastography and two-dimensional shear wave elastography, demonstrated consistently high diagnostic accuracy for advanced fibrosis across included studies. Serum biomarker panels such as fibrosis-4 index and enhanc","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"17 3","pages":"121790"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cronkhite-Canada syndrome: An elusive gastrointestinal disorder with multisystem involvement-pathogenesis, diagnosis, and therapeutic strategies.","authors":"Araj Naveed Siddiqui, Rabia Hafsa, Vikash Kumar Karmani, Zainab Rehan, Rishi Chowdhary","doi":"10.4291/wjgp.121535","DOIUrl":"https://doi.org/10.4291/wjgp.121535","url":null,"abstract":"<p><p>Cronkhite-Canada syndrome (CCS) is a rare, non-hereditary gastrointestinal (GI) disorder characterized by diffuse polyposis in the GI tract, ectodermal abnormalities, and nutritional deficiencies. It is a multisystem disorder with a multifactorial origin, particularly autoimmune, with only about 500 cases reported from around the world. This narrative review aims to consolidate current knowledge on CCS, focusing on its epidemiology, clinical features, pathogenesis, diagnostic techniques, and treatment strategies. Clinically, patients with CCS present with chronic diarrhea, abdominal pain, protein-losing enteropathy, alopecia, onychodystrophy, and hyperpigmentation. These symptoms often overlap with other prevalent GI conditions like ulcerative colitis, leading to misdiagnosis of CCS in earlier stages of the disease. Diagnosis of CCS requires a combination of laboratory analyses facilitated with endoscopic visualization of characteristic polyps, histopathological evaluation, and exclusion of other polyposis syndromes. Treatment remains non-standardized, with corticosteroids being the mainstay of management. Other therapeutic regimens include immunosuppressants, biologic agents, non-steroidal anti-inflammatory drugs, and proton pump inhibitors, which are often used as adjunctive therapy with steroids and paired with nutritional supplementation. On the other hand, malignant polyps need to be surgically resected. The prognosis of CCS is improving owing to improved treatment strategies and better patient outcomes. Further research is crucial to enhance our understanding of the pathologic mechanisms of CCS, ultimately aiming to improve early detection and reduce long-term morbidity and mortality.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"17 3","pages":"121535"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intersections of gastrointestinal dysbiosis of the gut microbiome and aging.","authors":"Sara Shu, Benjamin K P Woo","doi":"10.4291/wjgp.124717","DOIUrl":"10.4291/wjgp.124717","url":null,"abstract":"<p><p>Geriatric syndromes such as frailty and sarcopenia are multidomain indicators of functional status in relation to the chronic disease burden of an aging adult. The human microbiota has gained increasing spotlight in regulating key aspects inherent of aging. In this review, we survey the current literature exploring the pathophysiological intersections of the gut microbiome and the aging process and associated geriatric syndromes that ultimately influence health span and lifespan. We discuss how intrinsic and extrinsic factors can influence age-related gut dysbiosis and propose areas of future directions for further research for identifying therapeutic targets to promote healthy aging.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"17 3","pages":"124717"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paradoxical nutrient hyperabsorption despite diarrhea: Insights from jejunal transcriptomic reanalysis in Linghu's obesity-diarrhea syndrome.","authors":"Xiao-Tong Niu, Xiang-Yao Wang, En-Qiang Linghu","doi":"10.4291/wjgp.121798","DOIUrl":"10.4291/wjgp.121798","url":null,"abstract":"<p><p>The transcriptomic changes in the jejunum involved in Linghu's obesity-diarrhea syndrome (ODS) are revealed in the previous study. In the present study, we performed a reanalysis of differentially expressed genes related to nutrient absorption from this dataset and found that gene sets involved in the digestion and absorption of three major nutrients - fats, carbohydrates, and proteins - were predominantly upregulated in the jejunal epithelium of patients with ODS. These changes specifically pertain to fat digestion and absorption, carbohydrate uptake and transport, and protein catabolism. These findings suggest that the jejunum of patients with ODS may exhibit a unique state of \"diarrhea-hyperabsorption\". In this article, we provide an in-depth discussion of this phenomenon and propose hypotheses, aiming to offer insights for the study of the pathological mechanisms underlying ODS and its clinical management.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"17 3","pages":"121798"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing the understanding of eosinophilic esophagitis: From pathogenesis to novel therapies.","authors":"Ashish Sharma, Angad Tiwari, Vishal Deshpande, Vishal Abhimutt Mahesh, Harendra Kumar, Anuj Shah, Ishita Ray, Rajvardhan Sisodia, Sneh Sonaiya, Saqr Alsakarneh, Hassam Ali, Dushyant Singh Dahiya","doi":"10.4291/wjgp.121571","DOIUrl":"https://doi.org/10.4291/wjgp.121571","url":null,"abstract":"<p><p>Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease characterized by inflammation in the esophagus, occurring in genetically predisposed individuals as a consequence of food antigen sensitization. EoE prevalence has increased exponentially in the last three decades to 40 per 100000 people worldwide, making it a common cause of dysphagia and food impaction in both children and adults. Diagnosis is made by esophageal biopsy showing eosinophilia (≥ 15 eosinophils per high-power field on biopsy). In children the presentation may be feeding intolerance, in adults a form of chronic solid food dysphagia. In EoE, in the absence of treatment, active inflammation inevitably progresses to fibrostenotic remodeling, highlighting the importance of early recognition and therapy. This review outlines the clinical criteria and pathophysiological mechanisms of EoE, biomarkers for the diagnosis of EoE, and the therapeutic strategies for EoE. EoE is characterized by epithelial barrier dysfunction, Th2 inflammation and eosinophil recruitment, with microbiome influences. Diagnosis is made by standard endoscopic biopsy, or by non-intrusive esophageal string test, Cytosponge, or by impedance planimetry. Treatment includes proton pump inhibitors, topical corticosteroids, dietary elimination therapy, endoscopic dilation, and the Food and Drug Administration approved biologic dupilumab. Emerging therapies such as precision medicine and artificial intelligence are also identified as areas for attention.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"17 3","pages":"121571"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microplastics and nanoplastics in inflammatory bowel disease: Mechanistic plausibility, human evidence and future research priorities.","authors":"Richard Hall, Michael Colwill, Kamal Patel, Sailish Honap, Andrew Poullis","doi":"10.4291/wjgp.122786","DOIUrl":"https://doi.org/10.4291/wjgp.122786","url":null,"abstract":"<p><p>Microplastics and nanoplastics (MNPs) are increasingly recognized as ubiquitous environmental contaminants with unavoidable human exposure through ingestion and inhalation. The gastrointestinal tract is an important interface between MNPs and the intestinal microbiota, epithelium and immune system. Interest in the effects of MNPs on human health has been increasing particularly in inflammatory bowel disease (IBD), a chronic immune-mediated disease in which environmental factors are thought to contribute to disease pathogenesis. Experimental studies have suggested that intestinal MNP exposure may promote several pathways relevant in IBD including dysbiosis, mucus disruption, impaired epithelial integrity, intestinal permeability and activation of immune pathways. Current evidence is largely translational and is dominated by experimental models that do not reflect real world human exposures. Human studies in IBD are currently limited to a small number of observational studies with data vulnerable to confounding and reverse causation. Despite increasing mechanistic plausibility, there is still no direct evidence that MNPs cause IBD or alter the disease course. In this narrative review we summaries the current knowledge on human MNPs exposures, we examine experimental evidence for biologically plausible pathways through which MNPs may influence intestinal inflammation and the emerging human evidence in IBD. We also explore the major analytical and methodological limitations in the field.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"17 3","pages":"122786"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gut barrier dysfunction and multidrug-resistant bacterial translocation in adult critical illness: Mechanistic insights from a systematic review.","authors":"Shree V Dhotre, Pradnya S Dhotre, Sachin S Mumbre, Basavraj S Nagoba","doi":"10.4291/wjgp.v17.i2.122029","DOIUrl":"10.4291/wjgp.v17.i2.122029","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The gastrointestinal tract plays an important role in host defence during critical illness. Disruption of epithelial integrity, microbiome imbalance, and immune dysregulation have all been linked to the translocation of multidrug-resistant (MDR) organisms from intestinal colonization to invasive infection. However, whether these associations reflect true causal mechanisms remains uncertain, and available human evidence has not been comprehensively synthesized using current methodological standards.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To systematically evaluate human evidence examining the relationship between intestinal barrier dysfunction, microbial colonization, and subsequent MDR infection in adult critical illness, with particular attention to study quality, heterogeneity, and potential confounding factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This systematic review was conducted in accordance with PRISMA guidelines. A structured literature search was performed in PubMed, EMBASE, and the Cochrane Library (2000-2025) using predefined Boolean combinations and Medical Subject Headings. Prospective and retrospective cohort studies involving intensive care units (ICU) adults were included if they evaluated intestinal colonization, biomarkers of barrier dysfunction (citrulline and intestinal fatty acid-binding protein), microbiome alterations, or endotoxemia. Study selection and data extraction were undertaken independently by two reviewers, with disagreements resolved through discussion. Risk of bias was assessed using the Newcastle-Ottawa Scale and ROBINS-I tool. Owing to methodological and clinical heterogeneity, findings were synthesized using a structured narrative approach rather than meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Across the included studies, intestinal colonization with carbapenem-resistant &lt;i&gt;Enterobacteriaceae&lt;/i&gt;, carbapenem-resistant &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt;, &lt;i&gt;Acinetobacter baumannii&lt;/i&gt;, and vancomycin-resistant &lt;i&gt;Enterococcus&lt;/i&gt; was consistently associated with an increased risk of subsequent bloodstream infection. However, progression rates varied considerably across cohorts, likely reflecting differences in patient characteristics, antimicrobial exposure, and ICU practices rather than a consistent effect size. Biomarker studies showed reduced citrulline levels and elevated intestinal fatty acid-binding protein concentrations in patients with gastrointestinal dysfunction; however, these markers indicate enterocyte injury rather than directly measuring intestinal permeability or bacterial translocation. Microbiome analyses demonstrated reduced diversity and impaired colonization resistance, although the extent and timing of these changes were not uniform across studies. Taken together, the evidence supports a biologically plausible link between epithelial injury, dysbiosis, and infection risk, but does not establish a direct causal relationship, largely due to the observational design of avai","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"17 2","pages":"122029"},"PeriodicalIF":0.0,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver stiffness at baseline as a marker of hepatocellular carcinoma in cirrhosis: A matched analysis.","authors":"Varun Mehta, Manjeet Kumar Goyal, Yogesh Kumar Gupta, Abhinav Gupta, Manisha Khubber, Tanisha Sehgal, Prabhav Mehta, Omesh Goyal","doi":"10.4291/wjgp.v17.i2.120603","DOIUrl":"10.4291/wjgp.v17.i2.120603","url":null,"abstract":"<p><strong>Background: </strong>Early hepatocellular carcinoma (HCC) detection in cirrhosis remains suboptimal despite semi-annual ultrasound and alpha-fetoprotein surveillance. Advanced fibrosis is a central driver of hepatocarcinogenesis, and liver stiffness measurement (LSM) is a non-invasive measure of liver stiffness that may be associated with HCC risk.</p><p><strong>Aim: </strong>To evaluate whether LSM by transient elastography (TE) is associated with the presence of HCC among patients with established cirrhosis.</p><p><strong>Methods: </strong>A retrospective, matched case-control study at a tertiary liver center including adults with cirrhosis and a valid TE (≥ 10 valid acquisitions, interquartile range < 30%, success rate > 60%) was conducted. Cirrhotic patients with diagnosed HCC per standard guidelines were frequency matched for age, sex, etiology, and Child-Pugh class with controls (cirrhotic patients without HCC). Multivariable logistic regression tested the association between LSM and HCC. Discrimination and cut-off points were assessed using receiver operating characteristic (ROC) analysis and Youden's index.</p><p><strong>Results: </strong>A total of 262 patients (133 with HCC; 129 controls) were enrolled. Median LSM was higher in the HCC cohort than in controls (31.7 kPa <i>vs</i> 22.6 kPa; <i>P</i> < 0.001). Multivariate regression analysis revealed that only LSM was significantly associated with HCC (adjusted odds ratio 1.09; 95%CI: 1.05-1.13; <i>P</i> = 0.0001). A cut-off of ≥ 47 kPa had excellent discriminatory power (area under the ROC curve: 0.88; 95%CI: 0.84-0.93).</p><p><strong>Conclusion: </strong>A liver stiffness threshold of approximately 47 kPa may serve as a marker associated with risk of HCC, justifying intensified screening in high-risk cirrhosis; prospective validation, integration with multivariable risk models, and cost-effectiveness analyses remain essential.</p>","PeriodicalId":68755,"journal":{"name":"世界胃肠病理生理学杂志(电子版)(英文版)","volume":"17 2","pages":"120603"},"PeriodicalIF":0.0,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}