American Journal of Gastroenterology最新文献

{"title":"Predominant serrated molecular signature in postcolonoscopy colorectal cancer: A systematic review and meta-analysis.","authors":"Jen-Hao Yeh, Sin-Hua Moi, Chia-Chi Chen, Chao-Wen Hsu, Wen-Shuo Yeh, Tzu-Ning Tseng, Chuan-Pin Lin, Yu-Peng Liu, Jaw-Yuan Wang","doi":"10.14309/ajg.0000000000003658","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003658","url":null,"abstract":"<p><strong>Introduction: </strong>Postcolonoscopy colorectal cancers (PCCRCs) are an adverse outcome associated with missed lesions and incomplete polypectomy. However, their molecular features have not been systematically reviewed.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane Library databases from inception to April 2024. Studies examining the molecular characteristics of PCCRCs, including microsatellite instability (MSI), CpG island methylator phenotype (CIMP), genetic mutations, and chromosomal alterations were regarded as eligible.</p><p><strong>Results: </strong>In total, 15 studies encompassing 11 cohorts, with 2,143 PCCRC and 19,036 sporadic colorectal cancer (SCRC) cases, were analyzed. Compared with SCRC, PCCRC was associated with older age (standardized mean difference 0.29, 95% confidence interval [CI] 0.20-0.38) and more proximal lesions (odds ratio [OR] 2.08, 95% CI 1.91-3.63). Molecularly, PCCRCs were more likely to exhibit MSI (OR 2.28, 95% CI 1.69-3.08), CIMP (OR 2.10, 95% CI 1.39-3.18), and BRAF mutations (OR 1.74, 95% CI 1.22-2.49) but were less likely to exhibit KRAS mutations (OR 0.63, 95% CI 0.45-0.87). Furthermore, MSI was strongly correlated with BRAF mutation (OR 9.36, 95% CI 5.11-17.16) and proximal lesions (OR 6.16, 95% CI 3.74-10.16) in a pooled analysis. Although the pooled 5-year overall survival rate was similar between PCCRC and SCRC cases (hazard ratio 1.03, 95% CI 0.64-1.66), PCCRCs exhibited worse survival compared with screening-detected ones (hazard ratio 1.65, 95% CI 1.46-1.86).</p><p><strong>Conclusion: </strong>Clinical and molecular features indicate that PCCRCs are more likely to be associated with the serrated pathway than with SCRC. Enhancing the detection of clinically significant serrated lesions may improve the efficacy of CRC screening.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Liao and Lai.","authors":"Phuc Le, Michael B Rothberg, Srinivasan Dasarathy","doi":"10.14309/ajg.0000000000003568","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003568","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Dai et al.","authors":"Yannick Hoffert, Erwin Dreesen","doi":"10.14309/ajg.0000000000003597","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003597","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spectrum of Interstitial Cell of Cajal Deficits in Chronic Gastroduodenal Disorders: Systematic Review and Meta-Analysis.","authors":"Chris Varghese, Pankaj J Pasricha, Thomas L Abell, Henry P Parkman, Christopher N Andrews, Daniel Keszthelyi, Armen A Gharibans, Gianrico Farrugia, Greg O'Grady","doi":"10.14309/ajg.0000000000003646","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003646","url":null,"abstract":"<p><strong>Background and aims: </strong>Chronic neurogastroduodenal disorders are heterogeneous and thought to lie on a spectrum of disease encompassing both sensory and neuromuscular pathologies. Abnormalities of interstitial cells of Cajal (ICC), a subset of which generate pacemaker signals and subsequently motility, have been implicated in their pathophysiology. We systematically reviewed the literature to pool ICC deficits observed in chronic neurogastroduodenal disorders.</p><p><strong>Methods: </strong>Studies quantifying gastric ICC from the corpus or antrum, in adult patients with gastroparesis, functional dyspepsia (FD) or chronic nausea and vomiting syndromes (CNVS) were analysed (PROSPERO: CRD42024613226). MEDLINE, Embase and CENTRAL databases were searched systematically. Random effects meta-analyses were used to compare ICC counts by disorder group with subgroup analysis by quantification methodology.</p><p><strong>Results: </strong>2158 studies were screened and 22 included. Comparative studies (n=12) showed patients with chronic neurogastroduodenal disorders (n=167 with gastroparesis, n=19 with FD±CNVS) had lower ICC counts than non-diabetic controls (n=130); standardised mean difference -1.58, 95% confidence interval -2.09 to -1.07, p<0.0001, with more severe deficits in gastroparesis compared to FD±CNVS (SMD -0.44, p=0.048). A spectrum of ICC deficits was evident in a subgroup of studies using gold-standard methods with c-KIT antibody and DAPI-stained nuclei confirmation (7 studies, 246 patients: mean ICC counts 2.29 in gastroparesis vs 3.49 in FD±CNVS, and 5.27 in controls; p<0.001 all comparisons). Most studies were at high risk of bias (n=21).</p><p><strong>Conclusion: </strong>Marked depletion of ICC is a consistent finding in neurogastroduodenal disorders. A spectrum of disease is revealed, with greater depletion associated with delayed emptying. Techniques for clinically defining ICC-driven gastric neuromuscular dysfunction should be prioritized.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Improvement of Mental Health is Associated with Long-term Disease Remission in Ulcerative Colitis.","authors":"Jieqi Zheng, Pinwei Huang, Ruiqi Feng, Li Li, Minhu Chen, Rirong Chen, Shenghong Zhang","doi":"10.14309/ajg.0000000000003638","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003638","url":null,"abstract":"<p><strong>Background and aims: </strong>Emerging evidence highlight the critical role of mental health in the management of ulcerative colitis (UC). We investigated the relationship between early mental health improvement and long-term disease remission.</p><p><strong>Methods: </strong>This study utilized data from the SELECTION trial involving 381 patients treated with filgotinib. Mental health was assessed using the mental health subscale of the 36-item Short-Form Survey. Endoscopic, clinical, and histologic outcomes were assessed at week 58. Adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) were calculated using multivariate logistic regression. Receiver operating characteristic curves, combined with bootstrap resampling, were used to define the mental health response threshold.</p><p><strong>Results: </strong>Early mental health improvements at week 10 were significantly associated with disease remission at week 58. Patients who showed a mental health response (subscale score changes of ≥7.85) exhibited greater odds of achieving endoscopic remission (aOR 2.67, 95% CI: 1.43-5.25), clinical remission (aOR 1.91, 95% CI: 1.22-2.99), histologic remission (aOR 1.98, 95% CI: 1.27-3.12), and disease clearance (aOR 3.48, 95% CI: 1.74-7.50). Additionally, incorporating mental health response assessment along with clinical remission significantly enhanced outcome predictions. Specifically, individuals with only clinical remission at week 10 were approximately half as likely to reach week-58 endoscopic remission (aOR 0.45, 95% CI: 0.21-0.91) compared to those who attained both mental health response and clinical remission.</p><p><strong>Conclusion: </strong>Early mental health improvements independently predicted long-term disease remission. Integrating mental health assessments into UC management strategies may provide valuable insights beyond physical symptoms.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACG Clinical Guideline Update: Preventive Care in Inflammatory Bowel Disease.","authors":"Francis A Farraye, Gil Y Melmed, Gary R Lichtenstein, Edward L Barnes, Berkeley N Limketkai, Freddy Caldera, Sunanda Kane","doi":"10.14309/ajg.0000000000003541","DOIUrl":"10.14309/ajg.0000000000003541","url":null,"abstract":"<p><p>Patients with inflammatory bowel disease (IBD) often consider their gastroenterologist to be the primary provider of care. To improve the care delivered to patients with IBD, health maintenance issues need to be addressed by the gastroenterology team. In particular, documentation and recommendation for vaccinations are crucial because more than 70% of patients with IBD will at some time be on immune-modifying therapies that may increase the risk for infections, many of which are preventable with vaccinations. Health maintenance recommendations addressed in this guideline include the safety and appropriate timing of vaccinations, screening for osteoporosis, cervical cancer, melanoma and non-melanoma skin cancer and screening for depression, anxiety, and need for smoking cessation. To accomplish these health maintenance goals, coordination among the primary care provider, gastroenterology team, and other specialists is necessary.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":"120 7","pages":"1447-1473"},"PeriodicalIF":8.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Dell'Unto et al.","authors":"Andre Jove, Robert J Huang","doi":"10.14309/ajg.0000000000003578","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003578","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor.","authors":"Cong Dai, Yu-Hong Huang, Min Jiang","doi":"10.14309/ajg.0000000000003556","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003556","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Macias et al.","authors":"Griffith B Perkins, Amanda H Lim, Pravin B Hissaria, Nam Q Nguyen","doi":"10.14309/ajg.0000000000003553","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003553","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Zhang and Fang.","authors":"Gian Paolo Caviglia, Elisabetta Bugianesi","doi":"10.14309/ajg.0000000000003566","DOIUrl":"https://doi.org/10.14309/ajg.0000000000003566","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}