BMC Gastroenterology最新文献

{"title":"Hepatocellular carcinoma patients with undetectable baseline hepatitis B viral DNA may benefit from immunotherapy.","authors":"Yan Jian, Sicong Jiang, Zhimin Qiu, Meijian Wang, Hanzhi Dong, Lin Zhou, Yu-An Qiu","doi":"10.1186/s12876-025-04043-2","DOIUrl":"10.1186/s12876-025-04043-2","url":null,"abstract":"<p><strong>Background: </strong>The relationship between hepatitis B virus (HBV) load and the survival or safety of immunotherapy in patients with advanced hepatocellular carcinoma (HCC) remains ambiguous.</p><p><strong>Methods: </strong>A multicenter study involving patients with advanced HCC who are treated with anti-PD-1 immunotherapy and entecavir from December 2019 to 2023 was conducted. Patients were categorized based on HBV-DNA levels to evaluate correlations with progression-free survival (PFS), overall survival (OS), and adverse events.</p><p><strong>Results: </strong>A total of 162 patients participated in the study. Among HCC patients with a positive hepatitis B surface antigen (HBsAg), median PFS was not significantly better for patients with HBV-DNA levels ≤ 2000 IU/ml compared to levels > 2000 IU/ml (4.60 months vs. 3.90 months, p = 0.17). Similarly, median OS did not differ between the two groups (10.53 months vs. 8.17 months, p = 0.14). Patients with undetectable baseline HBV-DNA had better PFS than those detectable (5.03 months vs. 3.70 months, p = 0.03), but there was no significant difference in OS (11.80 months vs. 8.00 months, p = 0.10). Furthermore, the incidence of hepatic impairment was not correlated with the baseline HBV - DNA load (6.1% vs. 7.9%, p > 0.05).</p><p><strong>Conclusions: </strong>The status of HBV DNA exerts an influence on the prognosis of HCC patients undergoing immunotherapy, and this influence is independent of the viral load. HCC patients with undetectable HBV DNA tend to have more favorable short - term survival outcomes. For patients who have received effective antiviral therapy, elevated levels of HBV DNA should not be used as an exclusion criterion for immunotherapy.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"456"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538625","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 influence of subjective well-being on anxiety, depression and quality of life in patients with functional dyspepsia.","authors":"Guizhen Yong, Xi Wang, Yan Xu, Guobin He","doi":"10.1186/s12876-025-04075-8","DOIUrl":"10.1186/s12876-025-04075-8","url":null,"abstract":"<p><strong>Background: </strong>Subjective well-being (SWB) encompasses both subjective happiness and objective factors. Anxiety and depression are increasingly recognized as contributing causes of functional dyspepsia (FD), yet the role of SWB in FD patients has been largely overlooked. This study aims to investigate the influence of SWB on anxiety, depression, symptom severity, and quality of life (QoL) in individuals with FD.</p><p><strong>Methods: </strong>A total of 374 patients with FD were selected according to Roman IV criteria. Satisfaction with life scale and affect balance scale, Generalized anxiety disorders-7, Patient healthy questionnaire-9, Dyspepsia symptoms severity(DSS)and Nepean dyspepsia index (NDI) were used to assess SWB, anxiety, depression, symptoms severity and QoL, respectively. The results were analyzed using one-way analysis, t-test, Pearson's correlation, and multiple linear regression.</p><p><strong>Results: </strong>Life satisfaction and emotional balance of FD patients were negatively correlated with DSS, anxiety, depression, and NDI for QoL(r=-0.148,-0.330,-0.325,-0.195, all p < 0.01), (r=-0.205,-0.545, -0.550, -0.357, all p < 0.001), respectively. Multiple linear regression showed that life satisfaction and emotional balance were influencing factors of anxiety (β= -0. 143, p = 0.001), (β= -0. 318, P < 0.001), and depression (β=-0. 122, p = 0.003), (β= -0. 287, p < 0.001), respectively. After removing anxiety and depression, life satisfaction and emotional balance were influencing factors of patients' DSS (β= -0.105, p = 0.049), (β= -0.180, p = 0.001), and QoL (β= -0.117, p = 0.023), (β= -0.329, p < 0.001), respectively.</p><p><strong>Conclusions: </strong>The SWB of FD patients is negatively associated with disease severity, anxiety, and depression, and positively associated with their quality of life. These results suggested that further strengthening SWB might help reduce symptom severity and improve the QoL of patients, which needs to be confirmed by future follow-up studies.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"490"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538568","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":"Clinical significance of contrast extravasation on computed tomography immediately after thermal ablation for hepatic tumors.","authors":"Dong Kyu Kim, Joon Ho Kwon, Kichang Han, Juil Park, Gyoung Min Kim, Man-Deuk Kim, Jong Yun Won","doi":"10.1186/s12876-025-04025-4","DOIUrl":"10.1186/s12876-025-04025-4","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the clinical significance of contrast extravasation observed on post-ablation computed tomography (CT) performed immediately following thermal ablation of hepatic tumors.</p><p><strong>Methods: </strong>Between October 2014 and December 2023, 1,274 patients with 1,745 primary or metastatic hepatic tumors underwent ablation, including radiofrequency ablation, microwave ablation, and cryoablation. Among them, 30 patients (median age: 66 years) with contrast extravasation observed on post-ablation CT scans were retrospectively analyzed. The pre- and post-ablation hemoglobin and hematocrit levels were measured. Local tumor progression-free survival (LTPFS) and overall survival (OS) rates were evaluated.</p><p><strong>Results: </strong>Among the 30 patients, angiography was performed in 6 patients. Contrast extravasation was observed on angiography in only two patients; contrast extravasation from the right inferior phrenic artery and intercostal artery was noted, and successful transarterial embolization was achieved. Conservative management was considered adequate without additional treatment in 28 of 30 patients. No significant differences were observed between the 1 day before and after ablation hemoglobin (12.9 g/dL; 12.0-13.8 g/dL vs. 12.5 g/dL; 11.5-13.8 g/dL, P = 0.102) and hematocrit (38.3%; 36.0-40.1% vs. 37.0%; 34.8-39.2%, P = 0.100) levels. During a mean follow up period of 23.3 ± 17.8 months, the LTPFS rates were 96.4% and 84.3% at 1 and 2 years, respectively. The OS rate after the procedure was 96.7%.</p><p><strong>Conclusion: </strong>The presence of contrast extravasation on post-ablation CT was not clinically significant, when extravasation confined to intrahepatic or venous origins. However, transarterial embolization is required if contrast extravasation is detected in the extrahepatic arteries.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"443"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538606","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":"Combining endoscopic variceal ligation and omeprazole sodium in treating upper gastrointestinal hemorrhage combined with liver cirrhosis.","authors":"Changfang Xie, Shilei Gong, Zhenfeng Zhao, Lu Liu, Lu Lu, Jin Zhou, Xiaohuan Yu, Ying Xiong","doi":"10.1186/s12876-025-04037-0","DOIUrl":"10.1186/s12876-025-04037-0","url":null,"abstract":"<p><strong>Background: </strong>Cirrhosis, a common chronic liver disease, leads to portal hypertension and complications like ascites and variceal bleeding. Endoscopic variceal ligation (EVL) is the preferred treatment for variceal bleeding. Post-EVL rebleeding due to mucosal irritation from gastric reflux significantly impacts patient prognosis. Omeprazole is an acid-suppressing medication to reduce mucosal damage and improve hemostasis. However, the effect of EVL combined with omeprazole in the treatment of esophageal variceal hemorrhage in cirrhosis remains exploring. Therefore, the present study aims to investigate the value of EVL + omeprazole in treating upper gastrointestinal hemorrhage combined with liver cirrhosis.</p><p><strong>Methods: </strong>One hundred patients with cirrhosis combined with upper gastrointestinal bleeding (January 2019-December 2022) were included as study subjects. Patients were categorized into observation (50 cases, omeprazole + endoscopic ligation) and control (50 cases, endoscopic ligation) groups. Clinical effects, hemostatic effects, portal venous blood flow, and stress indicators between the two groups were compared.</p><p><strong>Results: </strong>The blood transfusion volume, hospitalization time, hemostasis time and rebleeding rate of the observation group were statistically lower than control (P < 0.05). The portal vein blood flow and splenic vein blood flow in both groups after treatment were significantly lower than those before treatment (P < 0.05). The total effective rate of observation group was significantly higher than control (94.0% vs. 80.0%, P < 0.05). Also, the expression of serum amyloid A (SAA), IL-6, procalcitonin (PCT), cortisol (Cor), prostaglandin E2 (PGE2) and C-reactive protein (CRP) in observation group were significantly lower than control (P < 0.05).</p><p><strong>Conclusion: </strong>The combination of EVL and omeprazole effectively manages esophagogastric variceal hemorrhage in cirrhotic patients, enhancing hemostasis, reducing rebleeding, and improving portal hemodynamics.</p><p><strong>Trial registration: </strong>Not applicable.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"446"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538608","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":"Gastric cancer risk after Helicobacter pylori eradication in gastritis and peptic ulcer: a retrospective cohort study in Japan.","authors":"Kentaro Sugano, Chihiro Suzuki, Mihoko Ota, Ryuichi Iwakiri","doi":"10.1186/s12876-025-04034-3","DOIUrl":"10.1186/s12876-025-04034-3","url":null,"abstract":"<p><strong>Background: </strong>Helicobacter pylori infection is an important risk factor for gastric cancer. In Japan, national health insurance has covered eradication therapy for H. pylori infection-associated gastritis from 2013. However, gastric cancer was the fourth leading cause of cancer death in 2023. We aimed to investigate differences in gastric cancer risk among patients with gastritis, gastric ulcer, duodenal ulcer, and gastric ulcer and duodenal ulcer after H. pylori eradication.</p><p><strong>Methods: </strong>This retrospective cohort study used the JMDC Claims Database from February 21, 2013, to August 31, 2023. Patients who received first-line H. pylori eradication therapy and were diagnosed with H. pylori-associated gastritis, gastric ulcer, or duodenal ulcer in the same month or the month before the first eradication therapy prescription were included. Two antibacterial drugs and an acid secretion inhibitor or triple-drug blister-packaged product were prescribed. The primary outcome was gastric cancer incidence. A Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs). A propensity score approach was used to minimize the effect of confounding measures.</p><p><strong>Results: </strong>Of 17,245,330 beneficiaries, 148,489 were included. In the weighted cohort (after propensity matching), statistically significant differences were observed in HRs between H. pylori-associated gastritis and duodenal ulcer (HR using the latter as a reference [95% confidence interval]: 2.03 [1.31-3.13]; p = 0.001), and between gastric ulcer and duodenal ulcer (2.37 [1.52-3.71]; p < 0.001). The cumulative probabilities (95% confidence interval) per the median follow-up years (3.8 years for all) were 0.44% (0.39-0.48) for H. pylori-associated gastritis, 0.54% (0.46-0.63) for gastric ulcer, 0.22% (0.10-0.33) for duodenal ulcer, and 0.26% (0.08-0.50) for gastric ulcer and duodenal ulcer.</p><p><strong>Conclusions: </strong>Patients with H. pylori-associated gastritis and gastric ulcer had a higher risk of gastric cancer than patients with duodenal ulcer, indicating that gastric atrophy remains a risk factor after H. pylori eradication therapy. Careful monitoring, such as by endoscopic examination, is required after successful eradication of H. pylori in patients at higher risk.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"463"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538621","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 nomograph predicting the recurrence of Solid Pseudopapillary Neoplasm of the Pancreas: a study of the SEER database and a Chinese cohort.","authors":"Qidong Pei, Junzong Chen, Gang Deng, Dong Li, Yajun Tang, Jiaming Lai, Di Tang","doi":"10.1186/s12876-025-04076-7","DOIUrl":"10.1186/s12876-025-04076-7","url":null,"abstract":"<p><strong>Background: </strong>Solid pseudopapillary neoplasm of the pancreas (SPN) represents a rare form of low-grade malignant pancreatic cystic neoplasm. This study seeks to construct a predictive nomograph model for SPN recurrence.</p><p><strong>Methods: </strong>Data was collected from patients with SPN from the Surveillance, Epidemiology, and End Results (SEER) database in the United States from the years 2010 to 2021 as the training cohort. We collected data from our two hospitals as an external validation cohort from the years 2011 to 2021. Logistic regression analysis was used to analyze the related factors of recurrence, and a predictive nomograph model was established and verified. The calibration curve was plotted by the Bootstrap method, and the clinical efficacy of the model was evaluated by the decision curve analysis.</p><p><strong>Results: </strong>The SEER database included 455 patients. Five of them (1.10%) experienced recurrence, and the liver is the main recurrence site. There is a significant difference in tumor size (P = 0.001) between recurrent patients and the non-recurrent. Tumor size (P = 0.012) and regional nodes positive (P = 0.007) were independent predictors of relapse. We constructed a nomograph model based on them, the C-index 0.782 with a p-value 0.001. The C-index of the model in the external validation queue was 0.865 with a p-value 0.009. The calibration curve indicated that the model prediction probability is in well line with the actual observation probability, and decision clinical analysis showed a good net return.</p><p><strong>Conclusion: </strong>This constructed nomogram could well predict the possibility of SPN recurrence.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"482"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538569","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":"Development and clinical validation of deep learning-based immunohistochemistry prediction models for subtyping and staging of gastrointestinal cancers.","authors":"Junxiao Wang, Shiying Zhang, Jia Li, Mei Deng, Zhi Zeng, Zehua Dong, Fangfang Chen, Wen Liu, Lianlian Wu, Honggang Yu","doi":"10.1186/s12876-025-04045-0","DOIUrl":"10.1186/s12876-025-04045-0","url":null,"abstract":"<p><strong>Background: </strong>Immunohistochemistry (IHC) is a critical tool for tumor diagnosis and treatment, but it is time and tissue consuming, and highly dependent on skilled laboratory technicians. Recently, deep learning-based IHC biomarker prediction models have been widely developed, but few investigations have explored their clinical application effectiveness.</p><p><strong>Methods: </strong>In this study, we aimed to create an automatic pipeline for the construction of deep learning models to generate AI-IHC (Artificial Intelligence) output using H&E whole slide images (WSIs) and compared the pathology reports by pathologists on AI-IHC versus conventional IHC. We obtained 134 WSIs including H&E and IHC pairs, and automatically extracted 415,463 tiles from H&E slides for model construction based on the annotation transfer from IHC slides. Five IHC biomarker prediction models (P40, Pan-CK, Desmin, P53, Ki-67) were developed to support a range of clinically relevant diagnostic applications across various gastrointestinal cancer subtypes, including esophageal, gastric, and colorectal cancers. The Ki-67 proliferation index was quantitatively assessed using digital image analysis.</p><p><strong>Results: </strong>The AUCs of five IHC biomarker models ranged from 0.90 to 0.96 and the accuracies were between 83.04 and 90.81%. Additional 150 WSIs from 30 patients were collected to assess the effectiveness of AI-IHC through the multi-reader multi-case (MRMC) study. Each case was read by three pathologists, once on AI-IHC and once on conventional IHC with a minimum 2-week washout period. The results indicate that the consistency rates of pathologists in AI and conventional IHC cases were high in Desmin, Pan-CK and P40 (96.67-100%) while moderate in the P53 (70.00%). We also evaluated the T-stage through the staining of these IHC biomarkers and the consistency rate was 86.36%. Furthermore, the Ki-67 proliferation index, as reported by AI-IHC, showed a variability ranging from 17.35% ±16.2% compared to conventional IHC, with ICC of 0.415 (P = 0.015) between these two groups.</p><p><strong>Conclusions: </strong>Here, we leveraged automatic tile-level annotations from H&E slides to efficiently develop deep learning-based IHC biomarker models, achieving AUCs between 0.90 and 0.96. AI generated IHC showed substantial concordance with conventional IHC across most markers, supporting its potential as an assistive tool in routine diagnostics.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"494"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538612","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":"Diagnostic performances of adding transition and hepatobiliary phase to washout in gadoxetic acid-enhanced MRI for subcentimeter hepatocellular carcinoma.","authors":"Li Yang, Shengxiang Rao, Kaipu Jin, Lifang Wu, Mengsu Zeng, Ying Ding","doi":"10.1186/s12876-025-04071-y","DOIUrl":"10.1186/s12876-025-04071-y","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic performances of washout (WO) criteria confined to portal venous phase (PVP), extended to transition phase (TP) or hepatobiliary phase (HBP) for subcentimeter hepatocellular carcinoma (HCC) using gadoxetic acid-enhanced MRI.</p><p><strong>Materials and methods: </strong>Two hundred patients (mean age, 53.4 ± 10.4 years) who were scanned with 1.5-T gadoxetic acid-enhanced MRI were included. Arterial phase hyperenhancement and signal intensity on PVP, TP and HBP images were evaluated. Three WO criteria were established: WO confined to the PVP, WO extended to the TP and WO extended to the HBP.</p><p><strong>Assessment: </strong>Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy with 95% confidence interval were calculated for WO confined to the PVP and WO extended to the TP or HBP, and generalized estimating equation was used to compare sensitivity, specificity, PPV, NPV and accuracy.</p><p><strong>Results: </strong>A total of 200 surgically confirmed subcentimeter hepatic nodules (171 HCCs and 29 non-HCCs) were included. For solitary subcentimeter HCCs, WO extended to the TP showed significantly higher sensitivity and accuracy than WO confined to the PVP (70.80% vs. 49.64%, P < 0.05; 71.52% vs. 55.70%, P < 0.001) and AFP (70.80% vs. 51.09%, P < 0.05; 71.52% vs. 55.70%, P < 0.05), but no significant difference in specificity (76.19% vs. 95.24%, P > 0.05; 76.19% vs. 85.71%, P > 0.05). Extending WO to the HBP achieved significantly higher sensitivity (78.10% vs. 49.64%, P < 0.001; 78.10% vs. 70.80%, P < 0.05) and accuracy (75.32% vs. 55.70%, P < 0.001; 75.32% vs. 71.52%, P < 0.05) compared to WO confined to the PVP and WO extended to the TP, but lower specificity (57.14%% vs. 95.24%, P < 0.05) compared to WO confined to the PVP. The combination of AFP with WO confined to the PVP, WO extended to the TP, or WO extended to the HBP yielded significantly higher sensitivities and accuracies compared to each MRI washout criterion alone (all P < 0.001).</p><p><strong>Conclusion: </strong>WO extending to TP rather than HBP may be a preferred alternative for diagnosing subcentimeter HCC, and the supplement of AFP may improve sensitivity and accuracy.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"483"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538616","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":"Global burden of early-onset gallbladder and biliary tract cancer from 1990 to 2021.","authors":"Jin Liu, Wei Fang, XiangYi He, XianTu Zhang, Hong Liu","doi":"10.1186/s12876-025-04080-x","DOIUrl":"10.1186/s12876-025-04080-x","url":null,"abstract":"<p><strong>Background: </strong>Gallbladder and biliary tract cancer (GBTC) denotes a range of invasive tumors. Emerging evidence has revealed a rising trend in the incidence of early-onset GBTC (EOGBTC) patients, referring to individuals under the age of 50 years old. We conducted an epidemiological study to assess the disease burden of EOGBTC.</p><p><strong>Methods: </strong>Data on EOGBTC from 1990 to 2021 were sourced from the Global Burden of Disease Study 2021. Average annual percentage changes (AAPCs) and age-standardized rates (ASRs) were calculated to assess overall trends in the burden of EOGBTC. Statistical models including decomposition analysis, health inequality analysis, and Nordpred were utilized in the research.</p><p><strong>Results: </strong>The study indicated over 24,555 prevalent cases, 13,611 new cases, and roughly 8777 deaths of EOGBTC in 2021. The global ASR of incidence and prevalence displayed increased trends, while the ASR of mortality and disability-adjusted life years (DALYs) were downward trends. East Asia and South Asia represented the heaviest disease burdens. The disease burden is mainly concentrated in the middle, low-middle, and low SDI regions. Decomposition analysis revealed that the primary influence of disease burden was population growth. Health inequalities showed improvement. Nordpred model forecasted that by 2040, global EOGBTC incidence and prevalence may steadily increase, while the deaths and DALYs display a general downward trend.</p><p><strong>Conclusions: </strong>The overall burden of EOGBTC continues to be considerable, especially in regions with middle, low-middle, and low SDI levels. These findings underscore the necessity for innovative healthcare strategies to alleviate the burden faced by EOGBTC globally.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"461"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538623","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":"Lipid metabolism disturbance and immune dysfunction in HBV-related acute-on-chronic liver failure: a retrospective cohort study.","authors":"Neng Wang, Yu Zheng, Shuai Tao, Liang Chen","doi":"10.1186/s12876-025-04004-9","DOIUrl":"10.1186/s12876-025-04004-9","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to elucidate the correlations among dyslipidemia, immune function, and clinical outcomes in patients with acute-on-chronic liver failure (ACLF), with particular emphasis on the clinical significance of lipid metabolism and cellular immune parameters in hepatitis B virus-associated ACLF (HBV-ACLF).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 803 patients with HBV-ACLF admitted to the Shanghai Public Health Clinical Center from January 2014 to January 2024. Patients were stratified into deceased (n = 414) and survival (n = 389) groups based on clinical outcomes. Clinical baseline data, lipid metabolic indices, and cellular immune parameters were collected. The Spearman correlation coefficient was utilized to assess the correlation between lipid metabolic indices and cellular immune parameters, and a multivariate Cox proportional hazards model was applied to analyze risk factors for mortality.</p><p><strong>Results: </strong>Compared to the survival group, lipid metabolism indices in the deceased group were significantly reduced (P < 0.05). Lipid metabolism indices, including high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (APOA1), apolipoprotein B (APOB), total cholesterol (TC), and triglycerides (TG), demonstrated significant negative correlations with the severity of liver failure (P < 0.05). Correlation analysis with lymphocyte subset counts revealed positive correlations between low-density lipoprotein, TG, TC, APOB, and CD3 + T cells, CD4 + T cells, CD8 + T cells, and CD45 + T cells (P < 0.05). APOA1 and HDL-C were positively correlated with B cells and NK cells (P < 0.05). TG and APOB showed significant negative correlations with the CD4/CD8 ratio (P < 0.05). Multivariate Cox analysis identified age, creatinine, total bilirubin, international normalized ratio (INR), hepatic encephalopathy, and hepatorenal syndrome as independent risk factors affecting the short-term prognosis of HBV-ACLF, while sodium, APOA1, and APOB were identified as independent protective factors for ACLF (HR = 0.984, 95% CI: 0.974-0.995, P < 0.001, HR = 0.267,95% CI: 0.120-0.596, P = 0.001, HR = 0.486, 95% CI: 0.282-0.838, P = 0.010).</p><p><strong>Conclusion: </strong>Patients with HBV-ACLF exhibit decreased levels of TC, TG, LDL-C, HDL-C, APOA1, and APOB. These alterations in serum lipid profiles are associated with immune dysfunction and disease progression in HBV-ACLF. Notably, APOA1 and APOB serve as protective factors against 90-day mortality in hospitalized ACLF patients. Further investigation is warranted to elucidate the relationship between lipid metabolism disturbances and peripheral immunity in ACLF.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"444"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538636","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}