Clinics and research in hepatology and gastroenterology最新文献

{"title":"Evaluating the accuracy of the histological diagnosis in unexplained liver injury: A retrospective study","authors":"Zhikun Wang ,&nbsp;Linqian Wu ,&nbsp;Ke Bai ,&nbsp;Mengru Qiu ,&nbsp;Qing Li ,&nbsp;Liangtao Zeng ,&nbsp;Yipeng Wan ,&nbsp;Hui Zhu ,&nbsp;Lifang Chen ,&nbsp;Zhili Wen ,&nbsp;Lingling Yang","doi":"10.1016/j.clinre.2025.102747","DOIUrl":"10.1016/j.clinre.2025.102747","url":null,"abstract":"<div><h3>Backgrounds and Aims</h3><div>Liver biopsy is a valuable tool for diagnosing liver diseases with unknown etiology, but it sometimes fails to provide a clear diagnosis. This study aimed to identify the cause of unexplained liver injury and evaluate the accuracy of histological diagnosis.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on the clinical and histological data of patients with chronic liver disease of unknown etiology at the Second Affiliated Hospital of Nanchang University, China, who underwent liver biopsy between September 2019 and June 2024. Diagnoses were divided into admission diagnosis, histological diagnosis, and final clinical diagnosis groups.</div></div><div><h3>Results</h3><div>A total of 104 patients were included, with 64 women (61.5 %) and 40 men (38.5 %), 96 (92.3 %) of whom received a definitive diagnosis through liver biopsy. The main diseases were autoimmune liver disease (AILD, 49 cases, 47.1 %), non-alcoholic fatty liver disease (NAFLD, 26 cases, 25.0 %), drug-induced liver injury (DILI, 22 cases, 21.2 %), others (11 cases, 10.6 %) and unknown etiology (8 cases, 6.9 %). AILD was most common in women (40 cases, 55.6 %), while NAFLD was most common in men (19 cases, 40.4 %). Histological diagnosis showed higher sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) compared to admission diagnosis. Venn diagram analysis revealed that 57.7 % of cases matched between admission and histological diagnosis, 60.6 % matched between admission and final clinical diagnosis, and 92.3 % matched between the histological and final clinical diagnosis.</div></div><div><h3>Conclusions</h3><div>Histological diagnosis is effective in determining the cause of unexplained liver injury, and liver biopsy remains a crucial tool.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 1","pages":"Article 102747"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780587","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":"Physiology-guided albumin therapy in decompensated cirrhosis: the expanding role of point-of-care ultrasound","authors":"Froylan D Martínez-Sánchez ,&nbsp;David Aguirre-Villarreal ,&nbsp;Eduardo R Argaiz ,&nbsp;Luis A Rosales-Rentería ,&nbsp;Mario AJ Leal-Villarreal ,&nbsp;Ignacio García-Juárez","doi":"10.1016/j.clinre.2025.102744","DOIUrl":"10.1016/j.clinre.2025.102744","url":null,"abstract":"<div><div>Point-of-care ultrasound (POCUS) enables physiology-guided hemodynamic assessment in decompensated cirrhosis, moving beyond protocolized albumin use toward individualized therapy. By integrating IVC/IJV indices, lung ultrasound, and intrarenal venous Doppler, clinicians can tailor albumin and vasopressor strategies to fluid tolerance, potentially improving AKI reversal while limiting overload. We outline a pragmatic bedside framework to operationalize POCUS-guided albumin management in routine hepatology practice.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 1","pages":"Article 102744"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741379","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":"Switch from cetuximab to panitumumab during encorafenib-based therapy in BRAF V600E mutated metastatic colorectal cancer: An international multicenter analysis from the AGEO group","authors":"Annalice Gandini ,&nbsp;Victoria Probst ,&nbsp;Matteo Landi ,&nbsp;Maria Caterina De Grandis ,&nbsp;Chiara Cremolini ,&nbsp;Sara Lonardi ,&nbsp;Paul Girot ,&nbsp;Marie Decraecker ,&nbsp;Alessandro Passardi ,&nbsp;Lisa Salvatore ,&nbsp;Alessandro Pastorino ,&nbsp;Jeremy C Jones ,&nbsp;Lucien Grados ,&nbsp;Lina Sayah ,&nbsp;Isabelle Trouilloud ,&nbsp;David Tougeron ,&nbsp;Julien Taieb","doi":"10.1016/j.clinre.2025.102746","DOIUrl":"10.1016/j.clinre.2025.102746","url":null,"abstract":"<div><div><em>BRAF</em> V600E mutation (<em>BRAF</em>m) is present in around 8 % of metastatic colorectal cancers (mCRC) and is associated with a poor prognosis. The encorafenib-cetuximab combination (ENCO<img>CET) is currently the standard second-line treatment of <em>BRAF</em>m mCRC. However, 2–5 % of patients treated with cetuximab experience grade 3–4 infusion-related reactions (IRRs), leading to treatment discontinuation. In addition, BRAF inhibitors must be combined with an anti-EGFR to have any efficacy in <em>BRAFm</em> mCRC. As panitumumab (PANI) is associated with a lower risk of IRRs, this study aimed to assess the safety and efficacy of ENCO-PANI as an alternative strategy in patients experiencing an IRR to CET.</div><div>We retrospectively collected <em>BRAFm</em> mCRC patients that switched ENCO<img>CET for ENCO-PANI following an IRR to CET. Twenty pts were identified across 12 centers from 4 countries. Most were male (12/20), 11/20 had right-sided primary tumor and 5/20 pts were dMMR/MSI. Median age was 66, treatment line was 2nd line in 85 % and 3rd line in 15 % of patients; 19 patients started ENCO<img>CET and switched to ENCO-PANI (cycle 2 or 3) and 1 received ENCO-PANI upfront due to patient’s choice. Response rate was 25 % and disease control rate 85 %. Median progression-free survival was 6.2 and median overall survival 11 months. Adverse events (AEs) during ENCO-PANI occurred in 15/20, mostly G1-G2. No new IRRs nor toxic deaths were reported.</div><div>ENCO-PANI appears to be as safe and effective in pts treated for a <em>BRAFm</em> mCRC unable to continue CET and may represent a valid alternative therapeutic option in this setting.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 1","pages":"Article 102746"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780565","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":"Low muscle density and five times sit-to-stand test predict poor outcome in liver transplant candidates","authors":"Maxence Lepour ,&nbsp;Alicia Delorme ,&nbsp;Alexis Goffaux ,&nbsp;Pierre Trefois ,&nbsp;Elodie Dubois ,&nbsp;Caroline Catoul ,&nbsp;Frédéric Braem ,&nbsp;David de Azevedo ,&nbsp;Alix Collard ,&nbsp;Nicolas Lanthier ,&nbsp;Geraldine Dahlqvist","doi":"10.1016/j.clinre.2025.102743","DOIUrl":"10.1016/j.clinre.2025.102743","url":null,"abstract":"<div><h3>Background</h3><div>Muscle-related parameters (myopenia, sarcopenia, myosteatosis, frailty) are linked to increased mortality in liver transplant candidates but have not been prospectively compared in the same cohort.</div></div><div><h3>Aim</h3><div>This study aimed to identify the most accurate muscle predictor of morbidity and mortality in patients with cirrhosis on the liver transplant waiting list.</div></div><div><h3>Methods</h3><div>A prospective, single-center study included all consenting adult liver transplant candidates from June 2021 to October 2023. Skeletal muscle mass index, muscle density, and myosteatosis were assessed via computed tomography at third lumbar vertebrae. Frailty was evaluated using the liver frailty index and the 6-minute walk test.</div></div><div><h3>Results</h3><div>Among 194 screened patients, 135 were listed for transplant, including 108 with cirrhosis. Alcohol-related liver disease was the leading etiology, 47 % were listed for hepatocellular carcinoma. Myopenia was present in 31 %, myosteatosis in 34 %, and 20 % were frail. One-year survival was 82 %. Myosteatosis was the strongest univariate predictor of mortality, but in multivariate analysis, the five times sit to stand test was the best predictor of morbi-mortality.</div></div><div><h3>Conclusion</h3><div>The five times sit to stand test emerged as the most robust predictor in multivariate analysis. Its simplicity and reliability make it a valuable tool for identifying high-risk patients on the liver transplant waiting list.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 1","pages":"Article 102743"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145741353","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":"Creating and validating an anastomotic leakage risk prediction model after laparoscopic low anterior resection for rectal cancer","authors":"Wenqiang Li ,&nbsp;Susu Zhou ,&nbsp;Qikai Zhong ,&nbsp;Luqiao Huang ,&nbsp;Ning Li ,&nbsp;Chengyu Sun ,&nbsp;Liang Zhang ,&nbsp;Zhengguo Zhang","doi":"10.1016/j.clinre.2025.102745","DOIUrl":"10.1016/j.clinre.2025.102745","url":null,"abstract":"<div><h3>Purpose</h3><div>Anastomotic leakage (AL) is a serious complication after rectal cancer surgery, and there is still a lack of effective prediction tools. This study aims to provide a basis for the development of individualized AL prevention plans.</div></div><div><h3>Methods</h3><div>585 patients who underwent laparoscopic low anterior resection for rectal cancer in Xuzhou Central Hospital from 2019 to 2023 were retrospectively enrolled and randomly divided into a training set (410 cases) and a validation set (175 cases). Predictors were screened by LASSO regression, and a nomogram prediction model based on logistic regression was constructed. The area under the curve (AUC), calibration curve, decision curve and clinical impact curve were used to evaluate the model performance.</div></div><div><h3>Results</h3><div>The incidence of AL was approximately 13 % (76/585). According to LASSO regression, 8 predictors were identified: male gender, larger tumor diameter, a shorter distance between the tumor's lower margin and the anal verge, non-preservation of the left colic artery during surgery, preoperative neoadjuvant therapy, higher levels of carbohydrate antigen 19–9, no preventive stoma, and prolonged operative time. The AUC of the model in the training set and validation set was 0.745 (95 % CI: 0.675–0.814) and 0.733 (95 % CI: 0.606–0.859), respectively, and the calibration and clinical practicality were also favorable.</div></div><div><h3>Conclusions</h3><div>The prediction model is relatively accurate and can provide a basis for the formulation of individualized AL prevention strategies.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 1","pages":"Article 102745"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755379","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":"The critical next question: Is the association between proton pump inhibitors and hepatic encephalopathy dose-dependent?","authors":"Muhammad Mohid Haroon","doi":"10.1016/j.clinre.2025.102734","DOIUrl":"10.1016/j.clinre.2025.102734","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"50 1","pages":"Article 102734"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582178","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":"Diagnosis and management of patients with Crohn’s disease. Position paper from the GETAID","authors":"Aurélien Amiot ,&nbsp;Anthony Buisson ,&nbsp;Jean Marc Gornet ,&nbsp;Mathurin Fumery ,&nbsp;Lucine Vuitton ,&nbsp;Pascal Juillerat ,&nbsp;Arnaud Bourreille ,&nbsp;David Laharie ,&nbsp;Guillaume Bouguen ,&nbsp;GETAID educational committee","doi":"10.1016/j.clinre.2025.102728","DOIUrl":"10.1016/j.clinre.2025.102728","url":null,"abstract":"<div><div>The therapeutic arsenal for treating Crohn’s disease has grown rapidly, expanding to include advanced therapies with various modes of action. Over the last two decades, physicians and patients have significantly improved the treatment of Crohn’s disease, setting ambitious goals. In 2024, French clinical guidelines were established through a validated process involving the adaptation of international gastroenterology societies' clinical guidelines and French consensus meetings. The French guidelines aimed to ensure the applicability of new approaches in France, taking into account specific restrictions on drug authorization and reimbursement. This position statement outlines the specificity of the French guidelines compared to other international recommendations.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102728"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437275","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 advanced therapies in inflammatory bowel diseases","authors":"M. Uzzan ,&nbsp;M. Barrau ,&nbsp;X. Roblin","doi":"10.1016/j.clinre.2025.102726","DOIUrl":"10.1016/j.clinre.2025.102726","url":null,"abstract":"","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102726"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426424","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":"Do serum biomarkers correlate to the risk of gastric lesions in patients with autoimmune gastritis༟—A systematic review and meta-analysis","authors":"Zijin Liu ,&nbsp;Yingqi Wang ,&nbsp;Jiayi Hong ,&nbsp;Fang He ,&nbsp;Lijie Hao ,&nbsp;Linmin Liu ,&nbsp;Huihong Zhai","doi":"10.1016/j.clinre.2025.102722","DOIUrl":"10.1016/j.clinre.2025.102722","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Current surveillance strategies for autoimmune gastritis (AIG) lack consensus, and the prognostic role of serum biomarkers remains unclear. This meta-analysis aimed to evaluate the correlation between serum biomarkers and the risks of gastric lesions in AIG patients.</div></div><div><h3>Methods</h3><div>Studies comparing serum biomarkers in AIG patients with versus without neuroendocrine tumor (NET), gastric polyp (GP), or gastric cancer (GC) were identified by searching PubMed, EMBASE, and Cochrane databases (up to March 2025). Basic studies, meta-analyses, reviews, case reports, or studies not published in English were excluded. Two investigators independently extracted data and quality-assessed using the Newcastle–Ottawa and AHRQ scales. Statistical analysis used Review Manager 5.4 and Stata MP18. Heterogeneity and publication bias were evaluated. Sensitivity analysis was used to manage heterogeneity and assess the stability of the result.</div></div><div><h3>Results</h3><div>Thirteen studies (10 for NET, 4 for GP, and 1 for GC) were included. Elevated serum gastrin correlated significantly with NET (MD: 519.05, 95% CI: 227.96∼810.13, <em>P</em> = 0.0005, I²=85%) and GP (MD: 70.54, 95% CI: 43.59∼97.49, <em>P</em> &lt; 0.00001, I²=0%; weighted mean: 240.02 pg/ml). With a high heterogeneity in the NET group, we arranged sensitivity analysis and removed two studies that caused heterogeneity, the result consistently showed a statistical difference (MD: 196.62, 95% CI: 76.61∼316.64, <em>P</em> = 0.001, I²=22%; weighted mean: 811.53 pg/ml). Publication bias was found neither in NET (Begg’s test: <em>P</em> = 0.1078, Egger’s test: <em>P</em> = 0.3553) nor in GP (Begg’s test: <em>P</em> = 1.0000, Egger’s test: <em>P</em> = 0.4771) groups. Chromogranin A (CgA), vitamin B12, and parietal cell antibody (PCA) showed no consistent associations. For GC, limited data suggested milder gastrin elevation and higher <em>Helicobacter pylori</em> co-infection rates.</div></div><div><h3>Discussion</h3><div>Serum gastrin is correlated with NET and GP in AIG patients. The weighted mean serum gastrin level was 811.53 pg/ml in AIG patients with NET, and 240.02 pg/ml in those with GP. Non-enrollment of randomized controlled trials (RCTs), inconsistency in laboratory methods for biomarker detection and diagnostic criteria, and different units of biomarkers may cause limitations of the present study.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102722"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407775","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":"Metabolomic biomarkers enhance prediction of feeding intolerance in ICU septic patients","authors":"Kunlin Hu ,&nbsp;Shulin Xiang ,&nbsp;Jing Pang ,&nbsp;Baoyue Huang ,&nbsp;Bin Xiong","doi":"10.1016/j.clinre.2025.102731","DOIUrl":"10.1016/j.clinre.2025.102731","url":null,"abstract":"<div><h3>Background</h3><div>Accurate assessment of enteral feeding intolerance (ENFI) in septic patients remains challenging, as existing clinical tools show limited predictive value.</div></div><div><h3>Methods</h3><div>A prospectively cohort of 60 patients with sepsis (30 ENFI, 30 with feeding tolerance) and 20 healthy controls was enrolled. Serum samples were drawn for metabolomic profiling on the 1st day following sepsis. LC/MS was used to profile serum metabolites. The feeding intolerance outcome was collected at 14 days after ICU admission. Using a deep learning algorithm, we developed three ENFI prediction models: a metabolite-based model, a clinical risk model, and a new combined model integrating both feature types.</div></div><div><h3>Results</h3><div>The metabolite-based model included four key biomarkers—palmitic acid, histidine-threonine, glutamate-histidine, and dehydrobilirubin—and achieved an area under the receiver operating characteristic curve (AUC) of 0.85. The clinical model, based on variables such as APACHE II score, intra-abdominal pressure, and albumin, achieved an AUC of 0.88. The combined model demonstrated the best performance, with an AUC of 0.94. It also showed higher accuracy, precision, F1-score, and net benefit in decision curve analysis, particularly when the risk threshold exceeded 4%. Statistical comparisons confirmed its superiority (Net Reclassification Index = 0.33, Integrated Discrimination Improvement = 0.31, <em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Integrating metabolomics with clinical data significantly improves ENFI risk prediction in septic patients. External validation is warranted before clinical application.</div></div>","PeriodicalId":10424,"journal":{"name":"Clinics and research in hepatology and gastroenterology","volume":"49 10","pages":"Article 102731"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480916","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}