Clinics and research in hepatology and gastroenterology最新文献

{"title":"Fecal calprotectin in patients with concomitant primary sclerosing cholangitis and inflammatory bowel disease: a systematic review and meta-analysis","authors":"Giorgia Burrelli Scotti ,&nbsp;Fabrizio Zullo ,&nbsp;Marco Mattana ,&nbsp;Francesco Covotta ,&nbsp;Emanuela Ribichini ,&nbsp;Domenico Alvaro ,&nbsp;Vincenzo Cardinale","doi":"10.1016/j.clinre.2026.102764","DOIUrl":"10.1016/j.clinre.2026.102764","url":null,"abstract":"<div><h3>Background</h3><div>Primary sclerosing cholangitis (PSC) is strongly associated with inflammatory bowel disease (IBD), with up to 70% of PSC patients having concomitant IBD (PSC-IBD). Fecal Calprotectin (FC) is a validated surrogate biomarker of intestinal inflammation in IBD. Emerging evidence suggests that FC may also reflect biliary inflammation in PSC.</div></div><div><h3>Aim</h3><div>This study aimed to compare FC concentrations in patients with PSC-IBD versus IBD only.</div></div><div><h3>Methods</h3><div>A systematic literature search was performed (PROSPERO registration no. CRD42024600985). Studies reporting FC levels in both PSC-IBD and IBD-only patients were included. The outcome of interest was the difference in mean FC concentration between the two groups.</div></div><div><h3>Results</h3><div>Seven studies met the inclusion criteria. There was no significant difference in the mean FC levels between PSC-IBD and IBD patients (-5.10, 95% confidence interval [CI] -45.40 to -35.2; p= 0.8). The findings remained non-significant when endoscopic remission was considered (12.82, 95% CI -19.33 to 44.97; p= 0.43).</div></div><div><h3>Conclusions</h3><div>FC levels did not significantly differ between PSC-IBD and IBD groups. The available evidence is limited and heterogeneous. Larger, well-designed studies are needed to determine whether FC can serve as a surrogate biomarker of PSC progression, particularly in patients with endoscopic remission of colitis or without concomitant IBD.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102764"},"PeriodicalIF":2.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Comparison of repeat hepatectomy with radiofrequency ablation for the survival of hepatocellular carcinoma with solitary intrahepatic recurrence after hepatectomy”","authors":"Kanishka Harariya ,&nbsp;Thakur Rohit Singh ,&nbsp;Ankita Kalra ,&nbsp;Swarupanjali Padhi ,&nbsp;Fayaz Ahamed","doi":"10.1016/j.clinre.2026.102762","DOIUrl":"10.1016/j.clinre.2026.102762","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102762"},"PeriodicalIF":2.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and risk factors of drug-induced hepatotoxicity in cancer patients following repeated chemotherapy cycles.","authors":"Qunxiang Cao, Siyang Chen, Yutian Zhang, Juping Yang, Zhaohui Wang","doi":"10.1016/j.clinre.2026.102763","DOIUrl":"10.1016/j.clinre.2026.102763","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study investigates the incidence, clinical characteristics, and risk factors of drug-induced liver injury (DILI) in cancer patients undergoing multiple courses of common chemotherapy drugs, providing evidence for developing DILI prevention and control strategies in clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective cohort study included 165 cancer patients who received multiple courses of common chemotherapy drugs between January 2023 and January 2025. Participants were divided into a study group (n = 45, DILI occurrence) and a control group (n = 120, no DILI occurrence) based on DILI development. Baseline patient data, chemotherapy regimens, and liver function indicators were collected. Univariate analysis screened potential risk factors, while multivariate logistic regression validated independent risk factors. Spearman's rank correlation analyzed associations between risk factors and DILI severity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The overall DILI incidence among 165 patients was 27.27% (45/165), predominantly moderate in severity. Distribution by grade was: Grade 1 (mild) 14 cases (31.11%), Grade 2 (moderate) 24 cases (53.33%), Grade 3 (severe) 7 cases (15.56%), with no Grade 4 injury. Comparison of baseline characteristics between groups revealed higher DILI incidence among patients aged ≥60 years, with alcohol consumption history, viral hepatitis history, underlying liver disease, ≥3 chemotherapy drugs, and without prophylactic hepatoprotective/cholagogue use (all p &lt; 0.05). Post-chemotherapy, the study group exhibited significantly higher levels of ALT, AST, ALP, GGT, and TBIL compared to the control group (all p &lt; 0.001). Multivariate analysis confirmed that age ≥60 years (OR=2.964, 95% CI: 1.247-7.043, p = 0.014), history of alcohol consumption (OR=3.684, 95% CI: 1.523-8.912, p = 0.004), history of viral hepatitis (OR=3.116, 95% CI: 1.116-8.696, p = 0.030), underlying liver disease (OR=3.293, 95% CI: 1.312-8.266, p = 0.011), use of ≥3 chemotherapy drugs (OR=1.666, 95% CI: 1.031-2.690, p = 0.037), and lack of prophylactic hepatoprotective and cholagogue medication use (OR=0.326, 95% CI: 0.137-0.772, p = 0.011) were identified as independent risk factors for DILI occurrence. Spearman analysis revealed positive correlations between age, alcohol consumption history, viral hepatitis history, underlying liver disease, and number of chemotherapy drugs with DILI severity, while a negative correlation was observed between hepatoprotective and cholagogue drug use and DILI severity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Tumor patients undergoing multiple courses of common chemotherapy drugs exhibit a high incidence of DILI, predominantly moderate in severity. Age ≥60 years, history of alcohol consumption, history of viral hepatitis, underlying liver disease, use of ≥3 chemotherapy drugs, and lack of prophylactic hepatoprotective and cholagogue drugs are independent risk factors for DILI. The first fiv","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":" ","pages":"102763"},"PeriodicalIF":2.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling the importance of coenzyme Q9, glutathione and mitochondrial complex activity in a high fat diet model by a multivariate approach.","authors":"Francisco Baez, Damian Soria, Mario Contin, Carolina Caniffi, Valeria Tripodi","doi":"10.1016/j.clinre.2026.102766","DOIUrl":"10.1016/j.clinre.2026.102766","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":" ","pages":"102766"},"PeriodicalIF":2.4,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of episodic and tonic appetite-related signals with malnutrition and appetite dysregulation in end-stage liver disease","authors":"François Le Calvez ,&nbsp;James King ,&nbsp;Alexis Couret ,&nbsp;Armand Abergel ,&nbsp;David Thivel ,&nbsp;Gaël Ennequin","doi":"10.1016/j.clinre.2026.102765","DOIUrl":"10.1016/j.clinre.2026.102765","url":null,"abstract":"<div><div>Malnutrition is highly prevalent in end-stage liver disease (ESLD), while being strongly associated with sarcopenia and poor prognosis in this population. The physiological regulation of energy intake is influenced by tonic signals, reflecting body composition and metabolic demands, and episodic signals, arising from gastrointestinal peptides, that remain to be better explored in the context of ESLD. The present narrative review analyzed 94 studies that characterises circulating concentrations of ghrelin, CCK, PYY, GLP-1 and leptin in cirrhosis and hepatocellular carcinoma. Overall, in patients with ESLD, orexigenic signaling, particularly from ghrelin and Fat-Free Mass (FFM) appears blunted, while anorexigenic peptides (CCK, PYY, GLP-1) are frequently elevated, prolonging satiety. Leptin regulation is inconsistent, reflecting both inflammation-driven increases and fat mass-related decreases. These disturbances converge toward a mismatch between elevated metabolic requirements and insufficient energy intake. Understanding how ESLD disrupts appetite-regulating pathways may help design new strategies to restore nutritional balance and improve clinical outcomes.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102765"},"PeriodicalIF":2.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145974722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BEND3 is associated with poor prognosis and treatment response in Hepatocellular Carcinoma","authors":"Valbert Oliveira Costa Filho ,&nbsp;Pedro Robson Costa Passos ,&nbsp;Márcia Valéria Pitombeira Ferreira ,&nbsp;Silvia Helena Barem Rabenhorst","doi":"10.1016/j.clinre.2026.102759","DOIUrl":"10.1016/j.clinre.2026.102759","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102759"},"PeriodicalIF":2.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liver gains beyond glycemic control: GLP-1 vs. SGLT2 in metabolic dysfunction–associated steatohepatitis (MASH): A real-world data analysis","authors":"Elizabeth Beyene ,&nbsp;Lakshmi Chirumamilla ,&nbsp;Mekdem Bisrat ,&nbsp;Allan Bowen ,&nbsp;Yonas Fetle ,&nbsp;Brandon Wilkerson ,&nbsp;Addishiwot Wudeneh ,&nbsp;Syed Fahad Gillani ,&nbsp;Daniel Larbi ,&nbsp;Miriam Michael","doi":"10.1016/j.clinre.2026.102760","DOIUrl":"10.1016/j.clinre.2026.102760","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction associated steatohepatitis (MASH) is a progressive liver disease associated with metabolic syndrome. While both GLP-1 receptor agonists and SGLT2 inhibitors offer cardiometabolic benefits, their comparative impact on liver-related outcomes in MASH remains unclear.</div></div><div><h3>Objective</h3><div>To compare the incidence of cirrhosis, hepatocellular carcinoma (HCC), and changes in liver enzyme profiles in patients with MASH treated with GLP-1 receptor agonists versus SGLT2 inhibitors.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used de-identified electronic health records from the TriNetX network. Adults with MASH were grouped into GLP-1 receptor agonist users (n=19,421) or SGLT2 inhibitor users (n=12,772). After 1:1 propensity score matching on demographics, BMI, diabetes, liver enzymes, and substance use, 10,803 patients remained in each cohort. Patients with overlapping use of both drug classes or with preexisting cirrhosis, fibrosis, HCC, viral hepatitis, or alcoholic liver disease were excluded. Outcomes included incidence of cirrhosis, HCC, and liver enzyme normalization (ALT &lt;60 U/L, AST &lt;60 U/L, GGT ≤140 U/L). Risk estimates and hazard ratios were calculated using TriNetX analytics; p&lt;0.05 was considered significant.</div></div><div><h3>Results</h3><div>After matching, 10,803 patients were included in each cohort. Compared to SGLT2 inhibitors, the GLP-1 cohort showed significantly lower risks of cirrhosis (5.8 %¦vs. 17.3 %; HR: 0.31, 95 % CI: 0.29–0.34), HCC (0.4 %¦vs. 1.8 %; HR: 0.25, 95 % CI: 0.18–0.34), and elevated GGT (5.4 %¦vs. 6.8 %; HR: 0.80, 95 % CI: 0.72–0.89). Liver enzyme control (ALT and AST &lt; 60 U/L) was also more favorable in the GLP-1 group (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>In this large real-world cohort of patients with MASH, GLP-1 receptor agonists were associated with significantly better liver-related outcomes compared to SGLT2 inhibitors. These findings support the potential hepatoprotective role of GLP-1 agents and highlight their promise in managing MASH beyond glycemic control.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102760"},"PeriodicalIF":2.4,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory ascites following pancreatoduodenectomy after preoperative oxaliplatin based chemotherapy: be aware of nodular regenerative hyperplasia!","authors":"Jennifer Candi ,&nbsp;Emma Zuppi ,&nbsp;Camille Besch ,&nbsp;Thibault Wolf ,&nbsp;Pietro Addeo","doi":"10.1016/j.clinre.2025.102753","DOIUrl":"10.1016/j.clinre.2025.102753","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102753"},"PeriodicalIF":2.4,"publicationDate":"2025-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145862548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-assisted endoscopic submucosal dissection in gastrointestinal lesions: A systematic review and meta-analysis","authors":"Amany Mahmoud Genidy ,&nbsp;Abdelaziz Awad ,&nbsp;Omar Khaled Abdelsalam ,&nbsp;Belal Mohamed Hamed ,&nbsp;Nesma Mahmoud Ibrahim ,&nbsp;Ahmed K.M. Khaled ,&nbsp;Omar Saeed ,&nbsp;May Mahmoud Elgamal ,&nbsp;Manar A Balouz ,&nbsp;Ahmed Abdelgayed M Hussein ,&nbsp;Fatma S Mohamed ,&nbsp;Ahmed L. Youseif ,&nbsp;Jawad Mahmood","doi":"10.1016/j.clinre.2025.102752","DOIUrl":"10.1016/j.clinre.2025.102752","url":null,"abstract":"<div><h3>Introduction</h3><div>Endoscopic submucosal dissection (ESD) is an increasingly effective endoscopic technique worldwide. Robot-assisted ESD is a novel technique that enables complex movements by providing an extended range of motions to improve the visualization of the surgical field and provide better cosmetic surgical outcomes. We aim to systematically review and meta-analyze the efficacy and safety of robot-assisted ESD.</div></div><div><h3>Methods</h3><div>We followed the PRISMA guidelines for meta-analysis. We included studies reporting on patients with GI tumors or masses who underwent robot-assisted ESD. Our primary outcomes were en bloc resection rates, recurrence rates, and complications like bleeding and perforation. Secondary outcomes encompassed the length of the procedure, lesion size, complete resection rates, and duration of hospital stay. We used Joanna Briggs Institute's (JBI) Critical Appraisal Tool and the ROBINS-I tool for quality assessment. Continuous data were pooled as means, while dichotomous data were pooled as proportions with a 95 % confidence interval (95 % CI).</div></div><div><h3>Results</h3><div>Eight studies consisting of two clinical trials, three cohort studies, and three case reports with 115 participants were included. The en bloc resection rate was 97.400 %, 95 % CI (0.901, 0.993). According to the complete resection outcome, the rate was 82.900 %, 95 % CI (0.722, 0.900). Procedure time and Hospital Stay were 82.030 min 95 % CI: 48.130, 115.940), 1.640 days 95 % CI (-0.180, 3.740), respectively. The intraoperative bleeding rate was 1.800 %, 95 % CI (0.004, 0.068).</div></div><div><h3>Conclusion</h3><div>Our systematic review and meta-analysis demonstrated robot-assisted endoscopic submucosal dissection's potential efficacy and safety. However, future high-quality studies with larger sample sizes and extended follow-up periods are needed to support our initial findings further. Robot-assisted ESD may be promising in dealing with larger lesions, which are often challenging with conventional ESD.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102752"},"PeriodicalIF":2.4,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145848919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rifaximin for Primary prophylaxis of overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt: A cohort analysis","authors":"Chuanfu Ding ,&nbsp;Youwei Xing ,&nbsp;Siwei Liang ,&nbsp;Chunxiang Wang ,&nbsp;Wei Zhang ,&nbsp;Huan Chen ,&nbsp;Xueqian Li ,&nbsp;Yuyun Jia ,&nbsp;Zihao Cai ,&nbsp;Wei Li ,&nbsp;Yang Cheng ,&nbsp;Song Zhang ,&nbsp;Jiangqiang Xiao ,&nbsp;Lei Wang ,&nbsp;Qin Yin ,&nbsp;Yuzheng Zhuge ,&nbsp;Feng Zhang","doi":"10.1016/j.clinre.2025.102751","DOIUrl":"10.1016/j.clinre.2025.102751","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Transjugular intrahepatic portosystemic shunt (TIPS) is linked to an elevated risk of overt hepatic encephalopathy (OHE), yet evidence supporting primary prophylaxis for post-TIPS OHE remains limited. This study aimed to evaluate whether rifaximin reduces the incidence of post-TIPS OHE in cirrhotic patients.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 72 patients who received rifaximin (400 mg twice daily) for 6 months after TIPS (rifaximin group). A matched control group (<em>n</em> = 72) was recruited from a randomized clinical trial (ChiCTR-INR-17,012,479). The primary endpoint was the occurrence of OHE within 6 months. Secondary endpoints included 1-year mortality, rebleeding episodes, stent dysfunction, and improvements in liver function.</div></div><div><h3>Results</h3><div>The 6-month incidence of OHE was significantly lower in the rifaximin group (21%, 15/72) than in the control group (40%, 29/72; <em>P</em> = 0.011). The risk difference was -19.5% (95% confidence interval [CI]: -34.2% to -4.7%), with an odds ratio (OR) of 0.39 (95% CI: 0.19–0.82). Kaplan-Meier analysis demonstrated a significantly reduced cumulative risk of OHE in the rifaximin group (log-rank <em>P</em> = 0.009). No significant differences were observed between groups in terms of mortality, rebleeding, or stent dysfunction (all <em>P</em> &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>Six-month rifaximin prophylaxis following TIPS significantly reduced the incidence of early OHE in patients with cirrhosis.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 2","pages":"Article 102751"},"PeriodicalIF":2.4,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}