BMC Gastroenterology最新文献

{"title":"Diagnostic performance of FIB-6 for identifying FibroScan-defined advanced fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): a cross-sectional diagnostic accuracy study.","authors":"Hossein Bagheri, Niloofar Seighali, Mohammad Sadra Gholami-Chahkand, Mahmood Bakhtiyari, Fateme Seighali, Fatemeh Jodeiri, Mohsen Rajabnia","doi":"10.1186/s12876-026-05245-y","DOIUrl":"https://doi.org/10.1186/s12876-026-05245-y","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver disease worldwide. Accurate non-invasive identification of advanced fibrosis is essential for risk stratification and management. The Fibrosis-6 (FIB-6) score is a recently developed serum-based index, but its performance in MASLD remains unclear.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, 397 adults with MASLD who underwent FibroScan were included. FibroScan-derived liver stiffness categories were used as the surrogate comparator for fibrosis assessment. The diagnostic performance of FIB-6 was evaluated using ROC analysis for significant fibrosis (F2-F4), advanced fibrosis (F3-F4), and cirrhosis (F4), and compared with FIB-4, APRI, NAFLD fibrosis score (NFS), and AST-to-ALT ratio (AAR).</p><p><strong>Results: </strong>Among participants (mean age 47.8 ± 13.0 years; 49.4% male), significant fibrosis was present in 18.4%, advanced fibrosis in 7.6%, and cirrhosis in 4.8%. FIB-6 showed AUROC values of 0.643 for significant fibrosis, 0.749 for advanced fibrosis, and 0.760 for cirrhosis. Among 30 patients with FibroScan-defined advanced fibrosis, FIB-6 identified 29 of 30 cases (96.7%) and had an NPV of 99.4%. Among 19 patients with FibroScan-defined cirrhosis, all cases were identified (19/19), resulting in an NPV of 100% (95% CI: 83.2-100.0); however, these estimates should be interpreted cautiously because of the low prevalence of advanced disease. Outcome-specific optimal cut-offs were identified using the Youden index (1.88 for significant fibrosis and 1.84 for advanced fibrosis/cirrhosis). While FIB-4 and NFS showed slightly higher AUROCs, differences were not statistically significant.</p><p><strong>Conclusions: </strong>FIB-6 demonstrates acceptable diagnostic performance, particularly for excluding advanced fibrosis and cirrhosis in MASLD. Although not superior to established scores, its high negative predictive value and simplicity suggest potential as a rule-out tool pending external validation.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104182","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":"Prognostic value of admission D-dimer in acute pancreatitis: association with disease severity and clinical outcomes in a retrospective cohort study.","authors":"Elahe Nateghi Baygi, Niloofar Seighali, Mohammad-Sadra Gholami-Chahkand, Morteza Doustmohammadi, Fatemeh Jodeiri, Fahime Salehi","doi":"10.1186/s12876-026-05224-3","DOIUrl":"https://doi.org/10.1186/s12876-026-05224-3","url":null,"abstract":"<p><strong>Background: </strong>Early risk stratification in acute pancreatitis (AP) is crucial for improving patient outcomes and guiding timely clinical management. D-dimer has emerged as a potential biomarker reflecting activation of coagulation and fibrinolysis and may assist in early risk stratification of patients with acute pancreatitis. However, its prognostic performance remains incompletely validated across different populations.</p><p><strong>Methods: </strong>This retrospective cohort study included 200 adult patients diagnosed with acute pancreatitis between March 2023 and March 2024 at a tertiary care hospital. Disease severity was classified using the Revised Atlanta Classification. Admission serum D-dimer was measured within the first six hours after hospital presentation. Admission D-dimer levels were analyzed in relation to clinical severity, BISAP and Ranson scores, ICU admission, length of hospital stay, and in-hospital mortality. Statistical analyses included non-parametric tests, correlation analysis, logistic regression, and ROC curve analysis to evaluate predictive performance.</p><p><strong>Results: </strong>Two hundred consecutive patients, with a mean age of 58.1 ± 17.5 years and 54% male patients, were included in this study. Severity distribution showed 68.5% mild, 17% moderately severe, and 14.5% severe AP. Overall mortality was 7% (n = 14), and 56% (n = 112) required ICU admission. Admission D-dimer levels increased significantly with disease severity, with median values of 1534 ng/mL (mild), 1908.5 ng/mL (moderately severe), and 2960 ng/mL (severe). Non-survivors had markedly higher levels than survivors (3776.5 vs. 1663 ng/mL, p < 0.001). D-dimer showed significant positive correlations with BISAP (ρ = 0.6068), Ranson scores (ρ = 0.3425), and hospital length of stay. ROC analysis demonstrated good discriminatory ability for severe AP (AUC = 0.778; cutoff 2035 ng/mL) and good discriminatory performance for mortality prediction (AUC = 0.912; cutoff 2726 ng/mL, sensitivity 85.7%, specificity 80.1%). However, performance for predicting ICU admission was limited (AUC = 0.579). Multivariable analysis demonstrated that each 1-ng/mL increase in admission D-dimer level was independently associated with higher odds of severe AP (OR = 1.001, p < 0.001).</p><p><strong>Conclusion: </strong>Admission D-dimer is a simple and rapid biomarker associated with disease severity and mortality in acute pancreatitis. While it should not replace established scoring systems, it can serve as a valuable adjunct for early risk stratification, particularly for identifying high-risk patients. Prospective multicenter studies are needed to validate its clinical utility and define standardized cutoff values.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104189","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 value of CT-quantified abdominal fat parameters for metabolic dysfunction-associated fatty liver disease.","authors":"Jun Wang, Hongyan Wang, Jianliang Wang, Jie Feng, Zhen Zhang","doi":"10.1186/s12876-026-05101-z","DOIUrl":"https://doi.org/10.1186/s12876-026-05101-z","url":null,"abstract":"<p><strong>Background: </strong>To analyze the diagnostic value of CT-derived abdominal fat indices in predicting MAFLD and establish an integrated diagnostic system.</p><p><strong>Methods: </strong>A retrospective study on 174 patients with a previous history of abdominal CT examination in our institute between January 2022 and June 2024 was conducted, comprising 120 diagnosed with MAFLD, and 54 controls without it. CT-derived measures including SAT, visceral adipose tissue volume(VAT), total liver volume, and average hepatic. The average value and CT attenuation value of the left and right lobe of liver and the VAT/SAT were compared using Mann-Whitney U test. were compared between both groups. Then, we used Spearman's rank correlation analysis to study whether there existed correlations between CT metrics and metabolic indicators. Logistic regression and receiver operating characteristic(ROC)curve analysis were utilized to evaluate the diagnostic accuracy of individual parameters.Calibration of a composite prediction model was evaluated by using calibration plots.</p><p><strong>Results: </strong>In MAFLD groups, SAT, VAT, liver volume, and the VAT / SAT ratio were higher than those of the control group, while the mean hepatic CT attenuation value, as well as the mean attenuation value of the left lobe and right lobe, were all lower than those of the control group (all P < 0.05). The mean hepatic CT attenuation correlated negatively with BMI (r = -0.607) and TG (r = -0.418), while the sign was positive for VAT. In univariate logistic regression, we found that the mean hepatic CT attenuation is the best diagnostic indicator of MAFLD, with an AUC of 0.923, then were left and right hepatic attenuation (AUC = 0.886), liver volume (AUC = 0.814), and VAT's mean CT attenuation (AUC = 0.796). BMI (r = 0.554) and UA (r = 0.362) were also considered. Combining SAT, VAT, and mean hepatic CT attenuation together in one model resulted in an AUC of 0.928 (sensitivity: 91.7%, specificity: 85.2%). The calibration curves demonstrated an acceptable fit of the model. When multiple variables were combined, the sensitivity improved from 85.8% to 91.7% and specificity changed from 87.0% to 85.2%, yielding an AUC of 0.928 (ΔAUC = 0.005 compared with mean hepatic CT attenuation alone, P = 0.62).</p><p><strong>Conclusion: </strong>CT-measured abdominal fat may represent a reliable and noninvasive approach for the diagnosis of MAFLD.The greatest individual diagnostic utility was exhibited by mean liver CT attenuation alone; however, with multiple variables merged into a combined model, the sensitivity and specificity were also further increased, which could be an effective method to image MAFLD in clinical diagnosis.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Procalcitonin for diagnosing infected pancreatic necrosis: a systematic review and meta-analysis.","authors":"Tianrong He, Yangfan Zhang, Xiaoling Wen, Zuopeng Zhang","doi":"10.1186/s12876-026-05216-3","DOIUrl":"10.1186/s12876-026-05216-3","url":null,"abstract":"<p><strong>Background: </strong>Infected pancreatic necrosis (IPN) ranks among the most severe local complications of acute pancreatitis (AP) and plays a central role in driving AP-related death. Procalcitonin (PCT), a serum biomarker that responds preferentially to bacterial infection, has theoretical promise for differentiating infected from sterile necrosis. Earlier systematic reviews, though, are limited by small sample sizes, shallow subgroup analysis, and a lack of formal evidence grading. An updated synthesis that focuses specifically on IPN as the clinical endpoint is missing.</p><p><strong>Aim: </strong>This meta-analysis primarily aimed to evaluate the diagnostic performance of PCT for detecting IPN in patients with AP. Prediction of severe acute pancreatitis (SAP) was assessed as a secondary analysis, and evidence on PCT-guided antibiotic therapy was summarized as an exploratory analysis.</p><p><strong>Methods: </strong>PubMed, Embase, and the Cochrane Library were searched for original studies that assessed PCT for diagnosing IPN (primary objective), predicting severe AP (SAP; secondary analysis), or guiding antibiotic use in AP patients. Pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratios were calculated through a bivariate random-effects model. Hierarchical summary receiver operating characteristic (HSROC) curves were plotted. Pre-specified subgroup analyses covered PCT cutoff value, sampling time, study design, and reference standard. QUADAS-2 was used for bias assessment; evidence certainty was rated with the GRADE-DTA framework.</p><p><strong>Results: </strong>Thirty-nine studies met inclusion criteria: 16 on PCT for IPN diagnosis (2,156 patients; 512 IPN cases), 20 on PCT for SAP prediction (3,386 patients; 934 SAP cases), and 3 randomized controlled trials on PCT-guided antibiotic therapy. For IPN diagnosis, pooled sensitivity was 0.82 (95% CI: 0.75-0.87), pooled specificity 0.84 (95% CI: 0.78-0.89), and area under the curve (AUC) 0.90 (95% CI: 0.87-0.92); GRADE certainty was low. For SAP prediction, pooled sensitivity was 0.83, specificity 0.76, AUC 0.87; evidence certainty was low. A cutoff of 1.0-3.5 ng/mL gave the best trade-off between sensitivity and specificity (AUC 0.92). Serial dynamic monitoring (AUC 0.93) outperformed single admission measurement (AUC 0.85) by a wide margin.</p><p><strong>Conclusions: </strong>PCT shows good overall ability to identify IPN and may be incorporated as an adjunctive biomarker for IPN risk stratification. A cutoff range of 1.0-3.5 ng/mL and serial monitoring may help clinical risk stratification. These cutoff-related findings require external validation in prospective multicenter studies with pre-specified cutoffs and standardized adjudicated reference criteria integrating clinical, radiologic, microbiologic, and procedural evidence, with culture confirmation incorporated when drainage or necrosectomy is clinically performed.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191202","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":"Effect of high dose N-acetyl cysteine supplementation on markers of oxidative stress and insulin resistance in non-diabetic patients with metabolic dysfunction associated steatotic liver disease: a randomized controlled trial.","authors":"Asmaa Mohammad Ramadan, Lamia M El-Wakeel, AbdulMoneim Adel, Mohamed Abdel-Wahab, Sarah Farid Fahmy","doi":"10.1186/s12876-026-05157-x","DOIUrl":"10.1186/s12876-026-05157-x","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a major cause of chronic liver disease. N-acetylcysteine (NAC) has demonstrated antioxidant and hepatoprotective effects in non-alcoholic steatohepatitis. This study evaluated the impact of high-dose NAC on oxidative stress, insulin resistance, and liver-related outcomes in non-diabetic MASLD patients.</p><p><strong>Methods: </strong>This prospective, randomized, open-label controlled trial included 60 non-diabetic adults with MASLD. Participants were randomly assigned to receive either oral NAC (2400 mg/day) combined with lifestyle intervention (n = 30) or lifestyle intervention alone (n = 30) for 12 weeks. The primary outcome was change in serum malondialdehyde (MDA). Secondary outcomes included markers of insulin resistance (leptin, fasting insulin, and HOMA-IR), lipid profile, liver steatosis and fibrosis assessed by FibroScan^® and non-invasive scores, and quality of life (QOL).</p><p><strong>Results: </strong>No significant differences in serum MDA, leptin, fasting insulin, or HOMA-IR (all p > 0.05) between groups. Similarly, FibroScan^® parameters, non-invasive steatosis and fibrosis scores did not differ significantly between groups. A significant reduction in liver steatosis scores in the control group (p = 0.004) while the Hepatic steatosis index improved in both groups (p = 0.008).Triglyceride levels decreased significantly in the control group, whereas HDL-cholesterol increased significantly in the NAC group. QOL scores remained unchanged overall, except for a significant increase in the emotional domain scores in the NAC group.</p><p><strong>Conclusions: </strong>High-dose NAC for three months did not significantly improve oxidative stress, insulin resistance, or hepatic steatosis or fibrosis in non-diabetic MASLD patients. NAC was safe and well tolerated during the study period.</p><p><strong>Trial registration: </strong>This study was registered on clinicaltrials.gov under the identifier number NCT05589584 in October 2022.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722692","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 clues to mismatch repair deficiency in colon adenocarcinoma: the role of mucinous component and intratumoral/Crohn-like immune response.","authors":"Ömer Atmış, Sema Ocak, Fatma Seher Pehli̇van, Hanife Seda Mavi̇li̇, Ayça Tan, Semin Ayhan","doi":"10.1186/s12876-026-05219-0","DOIUrl":"10.1186/s12876-026-05219-0","url":null,"abstract":"<p><strong>Background: </strong>Deficient mismatch repair (dMMR) identifies a biologically distinct subset of colon adenocarcinomas with important diagnostic, hereditary, prognostic, and therapeutic implications. This study investigated whether mucinous component and immune response pattern may serve as practical histopathologic clues to dMMR in routine pathology practice.</p><p><strong>Methods: </strong>This retrospective study included 222 consecutive colon adenocarcinoma resection cases with available mismatch repair (MMR) immunohistochemistry from 2022 to 2025. Clinicopathologic, histomorphologic, and immune response features were evaluated and compared according to MMR status. Multivariable logistic regression was performed to identify factors independently associated with dMMR.</p><p><strong>Results: </strong>Of 222 tumors, 29 (13.1%) were dMMR and 193 (86.9%) were proficient MMR. dMMR was significantly associated with age < 50 years (40.9% vs. 10.0%, p < 0.001), high grade (25.8% vs. 8.5%, p = 0.010), absence of lymph node metastasis (18.8% vs. 6.7%, p = 0.007), absence of perineural invasion (21.6% vs. 6.4%, p = 0.001), larger tumor size (p < 0.001), fewer metastatic lymph nodes (p = 0.038), and higher lymph node yield (p = 0.019). Intratumoral/Crohn-like immune response was strongly associated with dMMR (33.9% vs. 6.1%, p < 0.001). Tumors with a mucinous component showed a higher dMMR rate than those without (26.2% vs. 10.0%, p = 0.005). All associations that were significant in the unadjusted analyses remained significant after false discovery rate correction (q < 0.05). In the combined histopathologic clue analysis, the dMMR rate increased from 2.3% in tumors with no clue to 28.2% with one clue and 40.0% with both clues. In multivariable analysis, age < 50 years (OR 7.212, p = 0.002), intratumoral/Crohn-like immune response (OR 7.089, p < 0.001), and mucinous component (OR 6.067, p = 0.001) remained independently associated with dMMR.</p><p><strong>Conclusions: </strong>Colon adenocarcinomas with a mucinous component and an intratumoral/Crohn-like immune response are enriched for dMMR, whereas tumors lacking both features show a low dMMR rate. These findings provide a detailed histopathologic characterization of a dMMR-enriched phenotype but should not be used to select cases for MMR testing or replace universal testing.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001286","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":"Correction: The effect of BMI on long-term outcome in patients with rectal cancer and establishment of a nomogram prediction model.","authors":"Yang Zhang, Xuyang Yang, Zixuan Zhuang, Mingtian Wei, Wenjian Meng, Xiangbing Deng, Ziqiang Wang","doi":"10.1186/s12876-026-05104-w","DOIUrl":"10.1186/s12876-026-05104-w","url":null,"abstract":"","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705376","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":"Characterisation of liver disease using quantitative MRI: report of the imaging arm of the ELEGANCE study.","authors":"Yi-Chun Wang, Yu Jun Wong, Edward Jackson, Andrea Dennis, Sophie Riddell, Oi Fong Chong, Jeremy Wei Song Choo, Sulaiha Binte Ithnin, Pik Eu Jason Chang, Guan Huei Lee, Marianne Anastasia De Roza, Kalki R Chandrasekaran, Kok Kiong Ong, Patricia Ching Yen Chia, Kee Tung Tan, Ngiap Chuan Tan, Wei Lyn Yang, Xin Yi Yeap, Han Chong Toh, Cheryl Min En Chua, Jacelyn Siou Sze Chua, Jade Shu Qi Goh, Yu Ki Sim, Xin Hui Rachel Teo, Michael Brady, Pierce Kah Hoe Chow","doi":"10.1186/s12876-026-05213-6","DOIUrl":"10.1186/s12876-026-05213-6","url":null,"abstract":"<p><strong>Background: </strong>Evolving disease aetiology and rising prevalence of chronic liver disease are driving an increase in hepatocellular carcinoma (HCC). Non-contrast quantitative MRI (qMRI) has shown promising capability for characterising liver health and risk of liver related outcomes, but has not been evaluated in HCC surveillance or specifically examined in Asian populations. We explored the characteristics of qMRI in participants with chronic liver disease undergoing HCC surveillance as part of the prospective cohort study, ELEGANCE.</p><p><strong>Methods: </strong>Seven hundred sixty-nine participants underwent qMRI using LiverMultiScan to derive information relating to liver disease activity (iron-corrected T1, cT1), liver iron (from T2*) and liver fat content (through proton density fat fraction), as well as structural features of advancing disease such as, liver and spleen volumes, and the caudate to right lobe volume ratio.</p><p><strong>Results: </strong>Three hundred twenty-eight participants had hepatitis B (HBV); 161 metabolic dysfunction-associated steatotic liver disease (MASLD); and 273 had cirrhosis (any aetiology). In HBV, qMRI identified that more than 40% had concurrent SLD. In MASLD, qMRI suggested 31% had MASH. In all aetiologies, cirrhosis was associated with elevated cT1, reduced liver fat, spleen enlargement, and caudate hypertrophy. A model incorporating these features demonstrated strong discriminatory performance for cirrhosis, particularly within the MASLD cohort (AUC = 0.88). In an exploratory analysis the same score demonstrated statistical power to discriminate between those with and without a subsequent HCC diagnosis.</p><p><strong>Conclusion: </strong>This study demonstrates the capability of qMRI for comprehensive characterisation of different liver disease aetiologies and the ability to identify those at highest risk of clinical outcomes.</p>","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987881","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":"EUS-guided and US-guided percutaneous splenic biopsy: a systematic review and meta-analysis of separately pooled diagnostic and safety outcomes.","authors":"Eyad Gadour, Bogdan Miutescu, Bodour Raheem, Calin Burciu, Zahra AlSaeed, Amnah Sharrofna, Syed Anjum Gardezi, Antonio Facciorusso, Sajjad Mahmood","doi":"10.1186/s12876-026-05201-w","DOIUrl":"10.1186/s12876-026-05201-w","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Ultrasound (US)-guided percutaneous splenic biopsy has been widely used to evaluate focal or diffuse splenic lesions and has shown promising efficacy and safety. Endoscopic ultrasound (EUS)-guided biopsy has emerged as an alternative approach for tissue acquisition from splenic lesions because it provides high-resolution imaging and real-time needle guidance. However, because no eligible head-to-head comparative studies were identified, this systematic review and meta-analysis summarizes separately pooled diagnostic and safety outcomes for EUS-guided splenic biopsy and US-guided percutaneous splenic biopsy rather than providing a direct comparative meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;PubMed, Scopus, the Cochrane Library, and Web of Science were searched from inception until January 2026. Studies were included if they assessed diagnostic performance and/or complication rates of EUS-guided splenic biopsy or US-guided percutaneous splenic biopsy. Heterogeneity across pooled studies was evaluated using the I² statistic, and methodological quality was evaluated using the Newcastle-Ottawa Scale (NOS). Diagnostic accuracy was defined as the proportion of correctly diagnosed cases (true positives plus true negatives divided by total assessed cases), and studies applying substantially different definitions were excluded from pooled diagnostic accuracy analyses or flagged during extraction. The protocol was registered in PROSPERO (CRD420261283689).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty studies involving 1,147 patients were included. Separately pooled estimates showed high diagnostic performance for both modalities. EUS-guided splenic biopsy demonstrated diagnostic accuracy of 95% (95% CI, 90% to 100%), sensitivity of 97% (95% CI, 82% to 100%), and specificity of 95% (95% CI, 75% to 100%). US-guided percutaneous splenic biopsy demonstrated diagnostic accuracy of 89% (95% CI, 87% to 92%), sensitivity of 91% (95% CI, 86% to 94%), and specificity of 98% (95% CI, 96% to 99%). Overall complication rates were 7% for EUS-guided splenic biopsy and 3% for US-guided percutaneous splenic biopsy; major complication rates were 4% and 1%, respectively. These numerically different rates should be interpreted cautiously because the comparison is indirect, EUS-guided cohorts were smaller, and selection bias may have favored inclusion of technically challenging cases in the EUS-guided studies. No study reported procedure-related mortality. A formal unadjusted indirect comparison found no evidence of a modality difference in sensitivity, specificity, or diagnostic accuracy. Higher complication odds were observed in the primary study-level comparison, but the overall-complication result was influenced by one study and the major-complication result was fragile; neither should be interpreted as a causal modality effect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;EUS-guided splenic biopsy and US-guided percutaneous splenic biopsy both appear di","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147250","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":"Real-world efficacy and safety of sofosbuvir/velpatasvir/voxilaprevir in treatment-naive and treatment-experienced chronic hepatitis c patients: a single-center study.","authors":"Alper Tahmaz, Ülkü Üser, Merve Safa Keçe","doi":"10.1186/s12876-026-05207-4","DOIUrl":"10.1186/s12876-026-05207-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Although international guidelines primarily position the sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX) combination as a salvage therapy for treatment-experienced patients, specific national reimbursement policies in Türkiye have uniquely positioned this regimen as a first-line treatment for treatment-naive individuals. Because international protocols largely restrict this combination to salvage settings, there remains limited real-world evidence regarding its efficacy and safety as a first-line therapy. This study aims to evaluate the real-world clinical performance of the SOF/VEL/VOX regimen in both treatment-naive and treatment-experienced patients with chronic hepatitis C (CHC), thereby providing additional real-world evidence for this underexplored clinical setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective, single-center observational longitudinal cohort study included 124 non-cirrhotic patients with CHC treated with the SOF/VEL/VOX regimen. The cohort comprised 86 (69.3%) treatment-naive and 38 (30.6%) treatment-experienced patients. Treatment-naive patients received the regimen for 8 weeks, whereas treatment-experienced patients received it for 12 weeks. The primary endpoint was sustained virologic response at 12 weeks post-treatment (SVR12). Liver fibrosis was evaluated using the aspartate aminotransferase-to-platelet ratio index (APRI).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age was 42 years, with a male predominance (81.4%) and a substantial proportion of individuals from the incarcerated population (44.3%). The most prevalent clinical comorbidities within the cohort were hypertension (8.1%) and diabetes mellitus (8.1%). Genotype 1 (58.1%) and genotype 3 (40.3%) were the most common variants. Regarding baseline differences, treatment-experienced patients were younger (mean age: 37.4 vs. 44.1 years) and exhibited a higher prevalence of genotype 1a infection compared to the treatment-naive group. At SVR12, hepatitis C virus ribonucleic acid (HCV RNA) clearance was achieved in 100% of both treatment-naive and treatment-experienced patients, with no significant difference between the groups (p = 1.000). Concomitant with virological clearance, levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) significantly decreased (p &lt; 0.001), reflecting the resolution of hepatic necroinflammation. Furthermore, the median APRI score decreased from 0.28 at baseline to 0.14 at SVR12 (p &lt; 0.001), reflecting the rapid resolution of hepatic necroinflammation following viral clearance rather than definitive structural fibrosis regression in this predominantly non-cirrhotic cohort. The regimen was well tolerated, with no serious adverse events or treatment discontinuations. Minor transient adverse events (3.2%) resolved completely during follow-up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This real-world study demonstrate that the SOF/VEL/VOX combination achiev","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891098","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}