BMC Gastroenterology最新文献

{"title":"Portal vein thrombosis and associated factors among patients admitted to Tibebe Ghion hospital, Bahir Dar, Ethiopia: a cross-sectional study, 2021-2024.","authors":"Getie Baylie Alem, Dessalegne Nigatu Achenef, Tsion Adebabay Kassie, Gebeyaw Addis Bezie","doi":"10.1186/s12876-025-04260-9","DOIUrl":"10.1186/s12876-025-04260-9","url":null,"abstract":"<p><strong>Background: </strong>Portal vein thrombosis (PVT) is a Liver vascular disease characterized by the development of a blood clot inside the portal vein's main branches or trunk. There are limited studies on PVT and associated factors in Africa, with no studies from Ethiopia. Therefore, this study was conducted to assess the prevalence of portal vein thrombosis and associated factors among patients at the TGSH medical ward in Bahir Dar, Ethiopia, from January 1, 2021, to December 31, 2024.</p><p><strong>Method: </strong>A retrospective cross-sectional study was conducted involving 422 patient charts selected through simple random sampling. Data were collected using structured tools, entered into EpiData v4.6, and analyzed using SPSS v25. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with PVT, with statistical significance set at p < 0.05. Ethical clearance was obtained from the Institutional Review Board of Bahir Dar University.</p><p><strong>Result: </strong>A total of 407 study subjects were included, and 64 (15.7%) had portal vein thrombosis. Having a diagnosis of chronic liver disease(CLD), the AOR is 2.139 (95% CI: 1.017-4.499) with a p-value of 0.045, patients with hepatocellular carcinoma (HCC) with an AOR of 3.912 (95% CI: 1.609-9.512) and a significant p-value of 0 003, Platelet count > 450 K, with an AOR of 4.574 (95% CI: 1.989-10.519) and a p-value of 0.001, were significantly associated with portal vein thrombosis.</p><p><strong>Conclusion and recommendations: </strong>This study found a notably high prevalence of portal vein thrombosis (15.7%) among hospitalized patients, while chronic liver disease, hepatocellular carcinoma, and elevated platelets significantly increasing risk. These findings underscore the need for heightened clinical vigilance and targeted screening in high-risk populations. Future research should focus on elucidating underlying causal mechanisms, including potential thrombophilic conditions, and should incorporate more diverse and representative patient cohorts to inform comprehensive preventive and therapeutic strategies.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"646"},"PeriodicalIF":2.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145173864","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 relationship between insomnia and multiple gastrointestinal disorders: a Mendelian randomization study.","authors":"Jin Yu, Yongyao Shen, Zeping Wang, Wanying Shen, Bo Chen, Yongjin Guo, Liying Jiang","doi":"10.1186/s12876-025-04228-9","DOIUrl":"10.1186/s12876-025-04228-9","url":null,"abstract":"<p><strong>Background: </strong>Some observational studies have suggested an association between insomnia and the risk of certain gastrointestinal disorders, such as gastroesophageal reflux, irritable bowel syndrome and peptic ulcers. However, the direction and magnitude of the causal relationship are difficult to determine due to confounding and reverse causation. The aim of this study is to explore the causal association between insomnia and a variety of gastrointestinal disorders from genetic level using Mendelian randomization.</p><p><strong>Methods: </strong>We used a two-sample, two-way MR to analyze the link between insomnia and several gastrointestinal disorders (nine in total). Genetic variants used as instrumental variables were obtained from genome-wide association study (GWAS) data in the Open GWAS database. Causal effects were primarily estimated using inverse variance weighted (IVW), weighted median (WM) and MR-Egger. Horizontal pleiotropy was tested using MR-PRESSO and MR-Egger regression. Heterogeneity and sensitivity were assessed using Cochran's Q and leave-one-out.</p><p><strong>Results: </strong>The forward MR analysis demonstrated significant causal effects of insomnia on gastroesophageal reflux disease (GERD) (IVW: OR = 1.864, 95%CI: 1.16-2.98, P = 0.009) and irritable bowel syndrome(IBS) (IVW: OR = 2.401, 95%CI:1.06-5.44, P = 0.036; WM: OR = 3.381, 95%CI:1.12-10.22, P = 0.031). Conversely, reverse MR analyses indicated protective associations against insomnia development for chronic gastritis (IVW: OR = 0.98, 95%CI: 0.97-0.99, P = 0.027), while revealing risk-enhancing effects for acute gastritis (IVW: OR = 1.013, 95% CI: 1.006-1.019, P < 0.001). No causal associations were observed between insomnia and the remaining five gastrointestinal conditions.</p><p><strong>Conclusions: </strong>Through bidirectional MR analysis of nine gastrointestinal disorders, we provide genetic evidence for causal effects of insomnia on four conditions: gastroesophageal reflux disease (GERD), irritable bowel syndrome (IBS), chronic gastritis, and acute gastritis.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"643"},"PeriodicalIF":2.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147835","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 cirrhosis and other chronic liver diseases caused by specific etiologies from 1990 to 2021.","authors":"Ying Zhang, Ming Luo, Yingzi Ming","doi":"10.1186/s12876-025-04264-5","DOIUrl":"10.1186/s12876-025-04264-5","url":null,"abstract":"<p><strong>Background: </strong>The global burden of cirrhosis and chronic liver diseases has remained substantial and continues to evolve in response to shifting etiological patterns. While viral hepatitis and alcohol use have historically dominated, non-alcoholic fatty liver disease (NAFLD) is emerging as a major contributor worldwide. A comprehensive understanding of these trends across regions and sociodemographic levels is essential for targeted public health interventions.</p><p><strong>Methods: </strong>We analyzed data on cirrhosis and chronic liver diseases from 1990 to 2021 using estimates from the Global Burden of Disease (GBD) study. Age-standardized incidence rate (ASIR), prevalence rate (ASPR), mortality rate (ASMR), and disability-adjusted life years rate (ASDR) were assessed globally and across sociodemographic index (SDI) levels. Estimated annual percentage change (EAPC) was calculated to quantify temporal trends.</p><p><strong>Results: </strong>From 1990 to 2021, NAFLD-related cirrhosis was the only etiology with a significantly increasing ASIR (EAPC = 0.73; 95% CI: 0.69-0.77), while viral and alcohol-related cirrhosis showed stable or declining trends. In 2021, NAFLD became the leading global cause of incident cirrhosis. Although high-SDI countries demonstrated effective control of HBV and HCV-related mortality, NAFLD remains a major and growing challenge. The ASMR of NAFLD-related cirrhosis showed a fluctuating pattern overall but increased notably in several low- to middle-SDI countries, particularly in Eastern Europe (e.g., EAPC in ASMR = 3.8). HCV-related ASIRs were concentrated in Central Asia, especially in Mongolia, Turkmenistan, and Uzbekistan. HBV-related ASMR declined rapidly in countries with SDI below 0.65, then plateaued.</p><p><strong>Conclusions: </strong>Cirrhosis and chronic liver diseases remain a major global health challenge. NAFLD has emerged as the predominant cause of incident cirrhosis, affecting both high-income and lower-SDI countries, signaling a critical shift toward metabolic etiologies. These findings call for urgent, region-specific strategies that integrate prevention, early detection, and management of both infectious and metabolic liver disease risk factors.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"641"},"PeriodicalIF":2.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091129","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":"Predictors of health-seeking behavior in patients with chronic liver disease and a comparison of health-seeking based on patient-type.","authors":"Sara Rizvi Jafree, Ammara Naveed, Humna Ahsan, Syeda Khadija Burhan, Amna Khawar, Masha Asad Khan, Florian Fischer","doi":"10.1186/s12876-025-04235-w","DOIUrl":"10.1186/s12876-025-04235-w","url":null,"abstract":"<p><strong>Background: </strong>Pakistan has one of the highest rates of chronic liver disease (CLD) burden in the world. Poor and underserved patients of CLD in the country may suffer from limited health-seeking behaviors, but there is not much research in this area. The aim of this study is to better plan support for CLD patients by identifying: (i) Health-seeking behaviors (HSB) according to patient-type; and (ii) the relationship of HSB with patient socio-demographic variables and independent study domains.</p><p><strong>Methods: </strong>We conducted a cross-sectional study. Data was collected over a four-month period from May 2022 to August 2022. A total of 850 patients visiting the Pakistan Kidney and Liver Institute and Research Centre were part of the study. We used correlation tests and multivariate logistic regression to investigate the relationship between the health-seeking behavior and the independent study domains (economic stability, health literacy, social support, experiencing grief, mental health, healthcare service quality, and coping strategies).</p><p><strong>Results: </strong>Main results suggest that patients with hepatocellular carcinoma, non-viral liver disease, and cirrhosis have less HSB, compared to patient with chronic viral hepatitis. Multivariate logistic regression results reveal that the following groups have lower odds for health-seeking behavior: (i) illiterate people; (ii) those living in rented homes; (iii) those belonging to nuclear families; and (iv) those with low monthly household income. The following study domains also show lower odds for HSB: (i) health illiteracy; (ii) low health service quality; (iii) low ability to use coping strategies; (iv) grief; (v) lack of social support; (vi) mental health challenges; and (vii) economic instability.</p><p><strong>Conclusions: </strong>Our study highlights that the majority of CLD patients are poor, illiterate, or semi-literate and in urgent need of holistic care with respect to health literacy, mental health counseling, financial help, and improved support from provider and families. This is only possible through the integration of social policy officers and social workers in the tertiary health sector of the country.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"642"},"PeriodicalIF":2.5,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091175","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 insights into diabetic gastroparesis: gastric scintigraphy-based diagnosis and treatment outcomes.","authors":"Mohamed-Naguib Wifi, Mohamed El-Sherbiny, Rasha Sobh Mohamed, Ahmed Kandeel, Sobhi Eid Rizk","doi":"10.1186/s12876-025-03977-x","DOIUrl":"10.1186/s12876-025-03977-x","url":null,"abstract":"<p><strong>Background: </strong>Long-standing diabetes mellitus (DM) can lead to macrovascular and microvascular complications, including autonomic neuropathy, which disrupts gut motility. Gastroparesis (GP) is defined as delayed gastric emptying of solids (with or without liquids) in the absence of any mechanical obstruction. The gold standard test for diagnosing gastroparesis is gastric scintigraphy (GS) using a solid meal. Gastroparesis poses diagnostic and therapeutic challenges, and can significantly impact patients with DM. The purpose of this study is to evaluate the prevalence of gastroparesis among symptomatic patients and assess treatment outcomes, with particular focus on identifying clinical predictors of delayed gastric emptying and factors associated with response to medical therapy in confirmed cases.</p><p><strong>Patients and methods: </strong>From June 2022 to June 2024, all patients visiting the diabetes clinic in Cairo University Hospital for any reason were screened for symptoms of gastroparesis using the gastroparesis cardinal symptom index (GCSI). Symptomatic patients underwent solid gastric scintigraphy. Those diagnosed with GP were treated for three months and refractory cases were offered G-POEM.</p><p><strong>Results: </strong>Thirty-two patients with moderate-to-severe symptoms of gastroparesis were the population of this study. Of these, 62.5% had delayed gastric emptying on solid gastric scintigraphy. A GCSI > 23 independently predicted delayed gastric emptying on solid gastric scintigraphy (OR 1.153, 95% CI (1.009-1.317), p = 0.036). 55% of GP patients achieved improvement in symptoms after three months of optimized medical therapy, and two out of four cases had sustained improvement for one year after G-POEM. The responders to medical treatment were significantly older, had lower GCSI and greater reduction in hemoglobin A1c (HbA1c) compared to those in the refractory group (p = 0.046, 0.012, 0.012, respectively).</p><p><strong>Conclusion: </strong>This study highlighted the role of the GCSI in assessing and monitoring gastroparesis, particularly in resource-limited settings. Diabetic GP differs in clinical presentation and management from other types of GP. Optimizing glycemic control may contribute to symptoms improvement. Older age and lower symptoms burden at presentation may help identify patients more likely to benefit from medical therapy.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"640"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069134","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":"Screening for metabolic-associated fatty liver disease in type 2 diabetes patients using non-invasive scores and ultrasound: a cross-sectional study in Egypt.","authors":"Atteyat A Semeya, Raafat S A Abdel Hafez, Suzan H M Ewais, Sahar M Mostafa, Ahmed Eldeeb, Rasha Elgamal, Amira A A Othman","doi":"10.1186/s12876-025-03844-9","DOIUrl":"10.1186/s12876-025-03844-9","url":null,"abstract":"<p><strong>Background: </strong>MAFLD is very common among T2DM patients and contributes significantly to both liver and systemic complications. This study aimed to evaluate the reliability of non-invasive scores and abdominal ultrasound for diagnosing and screening MAFLD in Egyptian T2DM patients.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 300 patients with T2DM who attended the Diabetes Outpatient Clinic at Benha Teaching Hospital. Liver enzymes, non-invasive fibrosis (FIB-4 and NFS), and steatosis (HSI and FLI) indices were evaluated alongside abdominal ultrasonography. Patients were stratified into two groups based on MAFLD diagnosis and assessed for disease presence and severity predictors using logistic regression models.</p><p><strong>Results: </strong>MAFLD prevalence was 46.33%. FIB-4 with an AUC of 0.826 (95% CI:0.778-0.875)and NFS with an AUC of 0.964 (95% CI:0.942-0.986) demonstrated high diagnostic accuracy for fibrosis, while HSI with an AUC of 0.847 (95% CI:0.803-0.890) and FLI with an AUC of 0.835 (95% CI:0.789-0.881) effectively identified hepatic steatosis. The HSI (38.31 ± 6.93) and FLI (68.78 ± 29.98) placed patients in the high probability category for liver steatosis, while the FIB-4 (1.94 ± 0.81) and NFS (0.56 ± 1.24) scores indicated moderate fibrosis risk. Ultrasound findings corroborated these results, with 80.58% of patients presenting with mild to moderate steatosis. Higher BMI, increased waist circumference, elevated liver function markers (elevated ALT, AST, GGT, and albumin), higher lipid profile, and poor glycemic control (HbA1c) were key predictors of MAFLD.</p><p><strong>Conclusions: </strong>Non-invasive indices alongside ultrasound support screening efforts to detect MAFLD in T2DM patients early, offering opportunities for timely management and prevention of disease progression.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"639"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069131","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 clinical characteristics of 117 cases of ischemic colitis.","authors":"Shan-Shan Hong","doi":"10.1186/s12876-025-04224-z","DOIUrl":"10.1186/s12876-025-04224-z","url":null,"abstract":"<p><strong>Objective: </strong>Ischemic colitis (IC) represents a significant gastrointestinal condition requiring precise clinical characterization. This study aimed to analyze the clinical features and risk factors associated with IC through a comprehensive retrospective analysis of 117 cases.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients diagnosed with IC at the Department of Gastroenterology, Second People's Hospital of Anhui Province, from December 2019 to December 2024. Clinical data were systematically collected and analyzed for patient characteristics and associated risk factors.</p><p><strong>Results: </strong>From 136 initially identified cases, 117 met the inclusion criteria (91 females, 26 males; female-to-male ratio 3.5:1). The mean age was 65.2 ± 13.6 years, with 65.8% of patients aged ≥ 60 years. Underlying disease were present in 86 patients, predominantly hypertension, cerebrovascular disease, type 2 diabetes mellitus, and coronary artery disease. Medication history was significant in 69 patients, with antihypertensive, antiplatelet, statin, and hypoglycemic agents being most common. The primary presenting symptom in 81 patients (69.2%) was abdominal pain accompanied by hematochezia. Clinical staging analysis revealed significant associations with elevated neutrophil counts, increased C-reactive protein(CRP) levels, positive computed tomography findings, and CAR (C-reactive protein to albumin ratio) values. Age-stratified analysis demonstrated significant correlations with underlying disease.</p><p><strong>Conclusion: </strong>Our findings demonstrate that IC predominantly affects elderly females and preferentially involves the left hemicolon. The condition shows strong associations with cardiovascular and metabolic comorbidities and their corresponding medications. The CAR ratio (≥ 0.335) may serve as a potential marker for mild to moderate IC, warranting further investigation as a prognostic indicator.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"638"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991517","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":"Acute versus acute-on-chronic liver failure: comparative analysis of clinical outcomes in Beijing, China.","authors":"Hebing Guo, Ningning Yin, Jingyuan Liu, Ang Li","doi":"10.1186/s12876-025-04234-x","DOIUrl":"10.1186/s12876-025-04234-x","url":null,"abstract":"<p><strong>Background: </strong>Acute liver failure (ALF) and acute-on-chronic liver failure (ACLF) pose significant threats to patient outcomes, frequently resulting in multiple organ dysfunction syndrome (MODS) and elevated mortality rates. This study investigates MODS outcomes among ALF and ACLF patients in China, identifying key factors that influence mortality and prognosis.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted at a specialized tertiary hospital in Beijing, covering the period from June 2009 to May 2022, which included 585 patients:195 with ALF and 390 with ACLF.</p><p><strong>Results: </strong>Among these, 61% of ALF patients and 45.1% of ACLF patients developed MODS. ALF patients exhibited a higher incidence of organ failures and significantly higher median admission critical illness scores. Multivariate logistic regression analysis identified age, number of organ failures, and platelet count as independent predictors of 90-day mortality. Kaplan-Meier survival hazards analysis revealed significantly higher 90-day cumulative mortality rates for ALF patients compared to ACLF patients (33.8% vs. 25.9%, p = 0.009).</p><p><strong>Conclusion: </strong>Approximately 50% of liver failure patients progress to MODS, with ALF patients demonstrating a higher incidence of MODS and poorer 90-day prognoses.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"637"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942585","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":"Coagulation markers as independent predictors of colorectal cancer aggressiveness.","authors":"Hanaa Ali El-Sayed, Doaa H Sakr, Mostafa Abdelhakiem, Mohamed Awad Ebrahim, Maha Othman, Hanan Azzam","doi":"10.1186/s12876-025-04249-4","DOIUrl":"10.1186/s12876-025-04249-4","url":null,"abstract":"","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"634"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942599","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":"Histopathologic discrepancies between endoscopic forceps biopsy and resection specimens in duodenal papillary lesions: a retrospective study.","authors":"Zhuoqun Zheng, Jin Ding, Yanping Chen, Hongjun Hua","doi":"10.1186/s12876-025-04255-6","DOIUrl":"10.1186/s12876-025-04255-6","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic papillectomy (EP) has been used for the treatment of duodenal papillectomy, and the results of preoperative endoscopic biopsy are important for the selection of treatment plans for the patients. However, some lesions cannot be precisely diagnosed based solely on biopsy results. In the study, we attempted to assess the accuracy of histopathological diagnosis of endoscopic forceps biopsy and to avoid over - or under-treatment.</p><p><strong>Methods: </strong>This retrospective observational analysis involved clinical data and endoscopic images of lesions diagnosed as non-cancerous on preoperative biopsy at the Gastroenterology Department of Jinhua Central Hospital from January 2021 to December 2024 and received follow-up treatment. We assessed the histological discrepancies between endoscopic forceps biopsy and specimens, and analyzed their correlation with clinical characteristics.</p><p><strong>Results: </strong>The study included 58 patients. The discrepancy rate between forceps biopsy and resected specimens was 50% (29/58 ). 28 of the 29 inconsistent biopsies were diagnosed with a higher grade, and the other one was diagnosed as a neuroendocrine tumor. 8 of the 40 biopsies that were diagnosed as indefinite for neoplasia or low-grade intraepithelial neoplasia were upgraded to HGIN or ampullary cancer after resection, which was related to duct (pancreatic duct or bile duct) dilatation (p = 0.003). Moreover, 13 of the 18 biopsies that were diagnosed with HGIN were upgraded to ampullary cancer after resection, which was related to lesion size (p = 0.035), and gender (p = 0.008). According to the postoperative pathological results, the lesions were divided into benign lesions and the malignant(HGIN and ampullary cancer), and histological discrepancy was associated with lesion size (p = 0.008), color (p = 0.000), and duct dilatation ( p = 0.001). Logistic regression analysis revealed that lesion size(OR = 3.566, 95%CI:1.085 ~ 11.723, P = 0.036) was a significant predictor of malignancy in ampullary adenomas.</p><p><strong>Conclusions: </strong>Histological discrepancies between endoscopic forceps biopsy and resected specimens of ampullary lesions were commonly observed in clinical practice. The presence of symptoms, including red color, lesion size > 1.25 cm and duct dilatation on radiologic imaging suggests the possibility of malignancy in ampullary adenoma.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"25 1","pages":"632"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942763","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}