Translational gastroenterology and hepatology最新文献

{"title":"Early diagnosis of liver graft steatosis and fibrosis: are non-invasive tests the answer?","authors":"Colin Dumont, Samuele Iesari, Pamela Baldin, Selda Aydin, Guillaume Henin, Marie Philippart, Eliano Bonaccorsi-Riani, Olga Ciccarelli, Laurent Coubeau, Hubert Piessevaux, Nicolas Lanthier, Géraldine Dahlqvist","doi":"10.21037/tgh-24-131","DOIUrl":"10.21037/tgh-24-131","url":null,"abstract":"<p><strong>Background: </strong>Graft steatosis and fibrosis detection is a challenge to avoid graft loss. The role of liver biopsy (LB) after liver transplantation (LT) is changing with the emergence of non-invasive tests. Our aim is to evaluate the accuracy of transient elastography (TE) in predicting steatosis and fibrosis post-LT.</p><p><strong>Methods: </strong>This prospective study was performed on 158 LT patients. Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were carried out prior to LB. We built receiver operating characteristic (ROC) curves to evaluate the predictive performance of TE.</p><p><strong>Results: </strong>Using CAP, the area under the curve (AUC) were 0.872 [95% confidence interval (CI): 0.791-0.953, P=0.01] and 0.708 (95% CI: 0.614-0.801, P<0.001) for the diagnosis of steatosis ≥ S2 and ≥ S1, respectively. Using LSM, the AUC were 0.588 (95% CI: 0.486-0.691, P=0.10) and 0.651 (95% CI: 0.480-0.822, P=0.10) for the diagnosis of fibrosis ≥ F2 and F3-F4, respectively. Cut-offs for CAP were 246.5 dB/m for S1 and 275.5 dB/m for S2. Cut-offs for LSM were 7.65 kPa for ≥ F2 and 9.25 kPa for ≥ F3.</p><p><strong>Conclusions: </strong>TE may be useful for screening advanced fibrosis and, interestingly, steatosis after LT. TE might gain relevance to track graft metabolic dysfunction and to propose lifestyle interventions.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"51"},"PeriodicalIF":2.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic and monitoring potential of circulating tumor DNA in resectable pancreatic cancer.","authors":"Knut Jørgen Labori","doi":"10.21037/tgh-24-167","DOIUrl":"10.21037/tgh-24-167","url":null,"abstract":"","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"37"},"PeriodicalIF":2.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A step towards multimodality relief for painful hepatic cancer: the CCTG HE1 trial.","authors":"Jeffrey Sum Lung Wong, Roland Leung, Bryan Cho Wing Li, Thomas Yau","doi":"10.21037/tgh-25-3","DOIUrl":"10.21037/tgh-25-3","url":null,"abstract":"","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"38"},"PeriodicalIF":2.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is BEER the answer?-non-immunotherapeutic targeted maintenance treatment of chemotherapy-responsive advanced biliary tract cancers.","authors":"Umair Mahmood, Alex B Munster, Khurum Khan","doi":"10.21037/tgh-24-158","DOIUrl":"10.21037/tgh-24-158","url":null,"abstract":"","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"40"},"PeriodicalIF":2.5,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Earlier initiation of tenofovir in pregnancy with infant hepatitis B vaccination obviates the need for hepatitis B immune globulin.","authors":"Kevin Pak, Sammy Saab","doi":"10.21037/tgh-25-14","DOIUrl":"10.21037/tgh-25-14","url":null,"abstract":"","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"39"},"PeriodicalIF":2.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of early-stage hepatocellular carcinoma: a retrospective evaluation of ultrasonography surveillance and surveillance adherence.","authors":"Adina Olaru, Anmol Gangi-Burton, Meetal Shah, Christopher Clarke, Suresh V Venkatachalapathy, James Franklin, Aloysious D Aravinthan","doi":"10.21037/tgh-24-119","DOIUrl":"10.21037/tgh-24-119","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) surveillance using 6-monthly ultrasonography (US) intervals is recommended. This study investigated the factors associated with early-stage HCC detection.</p><p><strong>Methods: </strong>All patients with a new HCC diagnosis for the first time between 2019 and 2022 were included. All pre-treatment imaging was independently reviewed according to Liver Imaging Reporting and Data System (LI-RADS) criteria. Early-stage HCC was defined as a single tumour <50 mm or up to 3 tumours all <30 mm. Rate of adherence was expressed as the proportion of the number of 6-monthly surveillance US performed relative to the total number of surveillance US the patient should have undergone over the preceding 5 years or since the diagnosis of cirrhosis, if it was within the preceding 5 years.</p><p><strong>Results: </strong>The study cohort included 175 patients with new HCC. The median age at diagnosis was 71 years; 78% were males; median body mass index (BMI) was 29.3 kg/m²; 94% were of European ancestry and the most common aetiology was metabolic dysfunction-associated steatotic liver disease (MASLD) (58%). One third (37%) presented through primary surveillance (surveillance group) and the remainder were found to have HCC when investigated for other indications (incidental group). Only the age at presentation [P=0.003; odds ratio (OR) 0.937, 95% confidence interval (CI): 0.899-0.978] and being on HCC surveillance (P<0.001; OR 5.867, 95% CI: 2.533-13.586), but not surveillance adherence were independently associated with early-stage HCC detection.</p><p><strong>Conclusions: </strong>Being part of primary surveillance, irrespective of adherence rate, is associated with early stage HCC detection. As many patients as possible should be enrolled into primary surveillance programme, even if adherence to recommended frequency is not followed rigorously.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"46"},"PeriodicalIF":2.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The current landscape of fecal microbiota transplantation in treating inflammatory bowel disease.","authors":"Yajun Bi, Bomin Cheng, Biao Zou, Shengxuan Liu, Zhenze Cui","doi":"10.21037/tgh-24-138","DOIUrl":"10.21037/tgh-24-138","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), is a chronic, immune-mediated disorder that impacts the intestinal tract. The gut microbiota, a diverse community of microorganisms, plays a pivotal role in the initiation, development, and progression of IBD by modulating inflammation, and immune responses, and maintaining gut homeostasis. Dysbiosis, or an imbalance in the gut microbiota, is frequently observed in IBD patients and is believed to contribute to the pathogenesis of the disease by disrupting the mucosal immune system. Fecal microbiota transplantation (FMT) involves transferring feces from a healthy donor (HD) into a recipient and has emerged as a promising therapeutic approach for IBD. The primary goal of FMT is to restore microbial balance in the recipient's gut, improving both microbiota composition and immune function. Numerous preclinical and clinical studies have demonstrated varying degrees of success in alleviating IBD symptoms through FMT. The benefits of FMT include modulation of gut bacteria abundance, restoration of microbial diversity, and enhancement of immune system regulation, all of which contribute to reducing IBD-related inflammation. This review presents a comprehensive analysis of animal studies and clinical trials exploring using FMT as a treatment for IBD. Understanding the underlying mechanisms of FMT in IBD is crucial for designing effective therapeutic strategies and optimizing its clinical impact.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"55"},"PeriodicalIF":2.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a machine learning-based nomogram for preoperative prediction of laparoscopic surgical difficulty in gallstone patients.","authors":"Kun Huang, Shunhu Jia, Xinzhu Yuan, Pingwu Zhao, Dou Bai","doi":"10.21037/tgh-24-124","DOIUrl":"10.21037/tgh-24-124","url":null,"abstract":"<p><strong>Background: </strong>Preoperative prediction of laparoscopic surgical difficulty in gallstone patients is crucial for improving surgical outcomes. This study aimed to develop and validate a nomogram based on advanced machine learning algorithms, incorporating key clinical and systemic inflammatory response indicators, such as the C-reactive protein to albumin ratio (CAR).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 362 eligible patients who underwent laparoscopic cholecystectomy (LC) for gallstones between 2013 and 2019. A total of 420 patients were initially identified, with 58 excluded based on predefined criteria such as age and incomplete records. The remaining patients were divided into a training set (n=253) and a validation set (n=109). The development of the nomogram involved multiple analytical techniques, including machine learning methods such as least absolute shrinkage and selection operator (LASSO) regression, decision tree analysis, and support vector machine (SVM) models, along with traditional statistical methods like univariate and multivariate logistic regression. Significant predictors, including CAR, white blood cell count (WBC), and gallbladder wall thickness, were integrated into the final predictive model. Model performance was evaluated using receiver operating characteristic (ROC) curve analysis and calibration plots.</p><p><strong>Results: </strong>The machine learning-based model demonstrated strong predictive capability, with an area under the curve (AUC) of 0.774 in the training set and 0.863 in the validation set. Calibration plots showed good agreement between predicted and actual outcomes, with mean absolute errors of 0.035 and 0.05 for the training and validation sets, respectively.</p><p><strong>Conclusions: </strong>This study demonstrates the utility of applying machine learning algorithms to develop a robust nomogram for preoperative prediction of laparoscopic surgical difficulty. By integrating key clinical variables and systemic inflammatory markers, the model provides an effective tool for improving surgical planning and enhancing patient outcomes.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"49"},"PeriodicalIF":2.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic resection improves the prognosis of gastric cancer liver metastasis patients with resected primary lesions.","authors":"Yun Feng, Mingzhu Huang, Bingran Yu, Chenchen Wang, Changming Zhou, Yilin Wang, Xiaodong Zhu, Lu Wang","doi":"10.21037/tgh-24-126","DOIUrl":"10.21037/tgh-24-126","url":null,"abstract":"<p><strong>Background: </strong>Although patients with gastric cancer liver metastases (GCLM) may achieve survival benefits after radical surgery, there is controversy regarding the surgical indications and choice of surgical methods. This study aims to investigate the impact of hepatic resection (HR) on the prognosis of patients with GCLM who have undergone radical resection of the primary tumor.</p><p><strong>Methods: </strong>This study conducted a retrospective analysis of 120 patients with GCLM who have undergone resection of the primary tumor. The patients were divided into an HR group and a non-hepatic resection (NHR) group. Propensity score matching (PSM) was analyzed and patients' prognoses were followed up and compared.</p><p><strong>Results: </strong>The PSM analysis included a total of 88 patients. The HR group had a median overall survival (OS) time of 35.0 months [95% confidence interval (CI): 30.7-39.3], with 1-, 2-, and 3-year survival rates of 88.0%, 81.5%, and 46.8% respectively. The NHR group had a median OS time of 16.0 months (95% CI: 10.5-21.5), with 1-, 2-, and 3-year survival rates of 56.8%, 30.8%, and 22.4% respectively. The median OS time was statistically different between the two groups. Extrahepatic metastasis (hazard ratio =2.777; 95% CI: 1.598-5.223; P=0.002) and HR (hazard ratio =0.154; 95% CI: 0.040-0.594; P=0.007) were significant factors for OS. In the HR group, laparoscopic surgery (P=0.004) and extrahepatic recurrence (P=0.008) were significant factors for intrahepatic recurrence-free survival (IHRFS).</p><p><strong>Conclusions: </strong>HR can significantly improve the prognosis of GCLM with resected primary tumors. Laparoscopic surgery is preferred as the surgical approach. Patients with extrahepatic recurrence have a shorter IHRFS.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"48"},"PeriodicalIF":2.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking chromogranin A: unveiling gastrointestinal factors beyond neuroendocrine neoplasms-a narrative review.","authors":"Elena Romano, Maria Rinzivillo, Giuseppe Lamberti, Matteo Marasco, Gianluca Esposito, Davide Campana, Francesco Panzuto","doi":"10.21037/tgh-24-113","DOIUrl":"10.21037/tgh-24-113","url":null,"abstract":"<p><strong>Background and objective: </strong>Chromogranin A (CgA) is extensively recognized as a biomarker in neuroendocrine neoplasms (NENs) due to its secretion alongside peptide hormones and biogenic amines in neuroendocrine cells. Despite its widespread clinical use, the reliability of CgA as a diagnostic and prognostic tool remains controversial because of its variable expression in various diseases and the influence of factors such as medication and disease characteristics. This review critically examines the role of CgA beyond neuroendocrine contexts, particularly in gastrointestinal conditions where increased levels may mislead clinical diagnostics.</p><p><strong>Methods: </strong>This review was conducted by performing a search on the PubMed database regarding CgA and both pathological and non-pathological conditions, excluding NENs.</p><p><strong>Key content and findings: </strong>Conditions such as chronic atrophic gastritis (CAG), proton pump inhibitor usage, and inflammatory bowel diseases (IBDs), among others, can lead to elevated CgA levels, often without any malignant association. Studies reviewed underscore the necessity for cautious interpretation of elevated CgA levels to avoid misdiagnosis and unnecessary anxiety in patients. The review further discusses the implications of non-neuroendocrine diseases contributing to elevated CgA levels, emphasizing the need for improved specificity in testing and a greater awareness among clinicians about the factors influencing CgA levels.</p><p><strong>Conclusions: </strong>This comprehensive understanding assists in better managing patient outcomes through more accurate diagnosis and appropriate therapeutic interventions.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"57"},"PeriodicalIF":2.5,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}