JHEP Reports最新文献

英文中文

From queues to questions: Reflections on EASL’s Love Your Liver campaign in Amsterdam 从排队到提问：对阿姆斯特丹“爱你的肝脏”活动的思考

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

JHEP Reports

Pub Date : 2025-12-01 DOI: 10.1016/j.jhepr.2025.101600

Sarwa Darwish Murad , Maraika Black , Shira Zelber-Sagi , Ben C. Hainsworth , Debbie L. Shawcross

引用次数: 0

Disease-modifying effect of efruxifermin in compensated cirrhosis due to MASH: To miss the forest for the tree(s) fruxifermin对MASH代偿性肝硬化的改善作用：只见树木不见森林

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

JHEP Reports

Pub Date : 2025-12-01 DOI: 10.1016/j.jhepr.2025.101568

Mattias Mandorfer , Georg Semmler

引用次数: 0

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

JHEP Reports

Pub Date : 2025-12-01 DOI: 10.1016/S2589-5559(25)00380-5

引用次数: 0

Corrigendum to “Peginterferon-alpha-2a add-on to treatment with siRNA JNJ-73763989 in virologically suppressed chronic hepatitis B: The phase II PENGUIN study” [JHEP Reports 2025 7(10) 101516] “peg -干扰素- α -2a添加到siRNA JNJ-73763989治疗病毒学抑制的慢性乙型肝炎：II期企鹅研究”的更正[JHEP报告2025 7(10)101516]

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

JHEP Reports

Pub Date : 2025-12-01 DOI: 10.1016/j.jhepr.2025.101662

Edward Gane , Ewa Janczewska , Tetsuo Takehara , Wan-Long Chuang , Cheng-Yuan Peng , Maria Hlebowicz , Yasuhiro Asahina , Ting-Tsung Chang , Ronald Kalmeijer , John Jezorwski , Gloria Kim , Zacharias Anastasiou , Thomas N. Kakuda , Thierry Verbinnen , Nonko Pehlivanov , Adam Bakala , Oliver Lenz , Michael Biermer

引用次数: 0

Editorial Board page 编委会页面

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

JHEP Reports

Pub Date : 2025-12-01 DOI: 10.1016/S2589-5559(25)00377-5

引用次数: 0

Corrigendum to ‘Primary percutaneous stenting for palliative biliary drainage of patients with malignant hilar biliary obstruction: TESLA trial’ [JHEP Reports 7 (2025) 101541] “原发性经皮支架置入术治疗恶性肝门胆道梗阻患者姑息性胆道引流：TESLA试验”的更正[JHEP报告7 (2025)101541]

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

JHEP Reports

Pub Date : 2025-12-01 DOI: 10.1016/j.jhepr.2025.101633

Stijn Franssen , Merve Rousian , Victorien van Verschuer , Marco Bruno , Michail Doukas , Lydi van Driel , Marjolein Homs , Behnam Mohseny , Roeland de Wilde , Jeroen de Jonge , Wojciech Polak , Robert Porte , Diederik Bijdevaate , Adriaan Moelker , Bas Groot Koerkamp

引用次数: 0

Old blood, new results: Will CORE fulfil the need for liver prognostication 老血，新结果：CORE能满足肝脏预后的需要吗

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

JHEP Reports

Pub Date : 2025-11-25 DOI: 10.1016/j.jhepr.2025.101648

Maja Thiele

引用次数: 0

Shunt magnitude is a key determinant of overt hepatic encephalopathy in patients undergoing TIPS 分流大小是TIPS患者肝性脑病的关键决定因素

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

JHEP Reports

Pub Date : 2025-11-11 DOI: 10.1016/j.jhepr.2025.101676

Davide Roccarina , Dario Saltini , Marco Senzolo , Silvia Nardelli , Martina Rosi , Valentina Adotti , Marcello Bianchini , Lara Biribin , Stefania Gioia , Cristian Caporali , Lucia Ragozzino , Tomas Guasconi , Margherita Falcini , Federico Casari , Antonio Piscopo , Francesco Pindozzi , Stefano Gitto , Silvia Aspite , Gianmarco Falcone , Angelica Ingravallo , Francesco Vizzutti

Background & Aims

Under-dilated transjugular intrahepatic portosystemic shunts (U-TIPS) has been proposed to reduce the risk of overt hepatic encephalopathy (OHE) while effectively treating portal hypertension (PH) complications. In this study we assessed how end-procedural porto-caval pressure gradient (PCPG), obtained in sedated patients, and endoprosthesis dilation affect the risk of OHE after TIPS.

Methods

Consecutive patients with cirrhosis receiving TIPS for refractory ascites or recurrent PH-related bleeding were enrolled. OHE within 1-year was analyzed using a competing risk model, accounting for death and liver transplantation. Adequate hemodynamic response (AHR) was defined as post-TIPS PCPG <12 mmHg or reduction ≥60% in refractory ascites, and <12 mmHg or reduction ≥50% in PH-related bleeding. PCPG values outside of the above criteria were considered as inadequate response. U-TIPS was defined as endoprosthesis dilation ≤7 mm, as opposed to standard TIPS (S-TIPS).

Results

Among 408 patients enrolled, 50% received U-TIPS, 63% achieved AHR, and 46% had a PCPG <10 mmHg. One-year cumulative incidence of OHE was 33% and 50% in U-TIPS and S-TIPS, respectively (p <0.001). In the univariable analysis, both AHR and PCPG <10 mmHg, and S-TIPS were associated with higher cumulative incidence of OHE. In a model comprising age, previous history of OHE, TIPS indication, liver disease severity and endoprosthesis dilation, only S-TIPS along with older age, previous history of OHE and Child-Pugh class B and C, were statistically significantly associated with OHE.

Subgroup analysis stratified by U-TIPS vs. S-TIPS confirmed that AHR and PCPG <10 mmHg were not associated with OHE within either TIPS group.

Conclusions

The magnitude of the shunt emerges as an independent key determinant of post-TIPS OHE.

Impact and implications

TIPS carries a significant risk of overt hepatic encephalopathy. Low portosystemic pressure gradient and larger shunt diameter have been reported to increase the risk of overt hepatic encephalopathy. The TIPS dilation diameter represents an independent key determinant of post-TIPS overt hepatic encephalopathy. Thus, TIPS under-dilation reduces overt hepatic encephalopathy occurrence while effectively controlling portal hypertension complications even without meeting established hemodynamic targets.

背景和目的经颈静脉肝内门静脉系统分流术（U-TIPS）已被提出用于降低显性肝性脑病（OHE）的风险，同时有效治疗门静脉高压（PH）并发症。在本研究中，我们评估了镇静患者术末门静脉压力梯度（PCPG）和假体扩张对TIPS术后OHE风险的影响。方法纳入连续接受TIPS治疗难治性腹水或复发性ph相关性出血的肝硬化患者。使用竞争风险模型分析1年内的OHE，考虑死亡和肝移植。充分的血流动力学反应（AHR）被定义为tips后难治性腹水PCPG≤12 mmHg或降低≥60%，ph相关性出血≤12 mmHg或降低≥50%。PCPG值超出上述标准被认为是不充分的反应。U-TIPS定义为假体内扩张≤7 mm，与标准TIPS （S-TIPS）相反。结果在408例入组患者中，50%接受了U-TIPS治疗，63%达到AHR， 46%的患者PCPG为10mmhg。U-TIPS组和S-TIPS组一年累积OHE发生率分别为33%和50% （p <0.001）。在单变量分析中，AHR和PCPG （10mmhg）以及S-TIPS与较高的OHE累积发病率相关。在一个包含年龄、既往OHE史、TIPS适应症、肝脏疾病严重程度和假体扩张的模型中，只有S-TIPS与年龄、既往OHE史和Child-Pugh B级和C级OHE有统计学意义相关。通过U-TIPS和S-TIPS分层的亚组分析证实，在两个TIPS组中，AHR和PCPG <；10 mmHg与OHE无关。结论分流的大小是tips后OHE的独立关键决定因素。影响和意义stips具有明显的肝性脑病风险。据报道，低门静脉系统压力梯度和较大的分流直径可增加显性肝性脑病的风险。TIPS扩张直径是TIPS后肝性脑病的独立关键决定因素。因此，TIPS欠扩张可减少明显肝性脑病的发生，同时有效控制门脉高压并发症，即使没有达到既定的血流动力学指标。

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引用次数: 0

Liver biopsy quality criteria to exclude cirrhosis in case of suspicion of porto-sinusoidal vascular disorder 肝活检质量标准，排除肝硬化时，怀疑门窦血管病变

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

JHEP Reports

Pub Date : 2025-11-10 DOI: 10.1016/j.jhepr.2025.101670

Chloé de Broucker , Valérie Paradis , Maria Luisa Botero , Miguel Albuquerque , Audrey Payancé , Aurélie Plessier , Laure Elkrief , François Durand , Sophie Hillaire , Paul-Emile Zafar , Juan Carlos Garcia Pagan , Pierre-Emmanuel Rautou

Background & Aims

Baveno VII guidelines based porto-sinusoidal vascular disorder (PSVD) diagnosis on a liver biopsy excluding cirrhosis. However, evidence-based quality criteria for liver biopsy are lacking. This study aimed to determine biopsy length and staining appropriate to rule out cirrhosis.

Methods

Liver explants from 12 patients with cirrhosis and 12 with PSVD were selected. Slides were stained with Picrosirius red or Masson’s trichrome. A total of 36,000 virtual liver biopsies were randomly generated, including different biopsy widths (572 and 1,000 μm corresponding to transjugular and percutaneous biopsies, respectively) and lengths (5 mm, 10 mm, 15 mm, 20 mm, 25 mm; fragmented 5 + 10 mm and 5 + 5 + 5 mm). Biopsies were assessed by an expert pathologist for the presence or absence of cirrhosis.

Results

Overall sensitivity of percutaneous biopsies for the diagnosis of cirrhosis was 85%, higher with Picrosirius red (86%) than with Masson’s trichrome (83%) (p <0.001). Sensitivity increased with the length of percutaneous biopsies, reaching a plateau from 15 mm (88%). Sensitivity was significantly higher for percutaneous (89%) than for transjugular biopsies (84%) (p <0.001). A plateau was also observed from 15 mm for transjugular biopsies. Fragmented biopsies with at least one 10-mm-long fragment (5 + 10 mm) had similar sensitivity as 15-mm-long biopsies. Diagnostic accuracy was lower in case of Laennec A cirrhosis, HBV-associated disease, or incomplete septal fibrosis. Validation by a second pathologist gave similar results.

Conclusions

For the diagnosis of PSVD, the minimum length of liver biopsy to exclude cirrhosis was 15 mm with at least one fragment of 10 mm. Picrosirius red had a better performance than Masson's trichrome staining. The transjugular route showed lower sensitivity, but provides additional information.

Impact and implications

This study shows that, for the diagnosis of porto-sinusoidal vascular disorder, the minimum length of liver biopsy to exclude cirrhosis is 15 mm, with a minimum fragment of 10 mm. Picrosirius red had a slightly better performance than Masson's trichrome staining. Future guidelines might consider that a ≥15-mm-long biopsy, with a fragment ≥10 mm, is sufficient to rule out cirrhosis in case of suspicion of porto-sinusoidal vascular disorder with signs of portal hypertension.

背景和目的baveno VII指南基于肝活检排除肝硬化的门窦血管病变（PSVD）诊断。然而，缺乏以证据为基础的肝活检质量标准。本研究旨在确定活检长度和染色是否适合排除肝硬化。方法选取12例肝硬化患者和12例PSVD患者的银外植体。载玻片用小天狼星红或马森三色染色。随机生成36,000个虚拟肝脏活检，包括不同的活检宽度（分别为572 μm和1000 μm，分别为经颈静脉和经皮活检）和长度（5mm, 10mm, 15mm, 20mm, 25mm；碎片化的5 + 10mm和5 + 5 + 5mm）。活检由专家病理学家评估是否存在肝硬化。结果经皮活检诊断肝硬化的总体敏感性为85%，小天狼星红（86%）高于马松三色（83%）（p <0.001）。敏感性随着经皮活检长度的增加而增加，从15 mm达到平稳期（88%）。经皮活检（89%）的敏感性明显高于经颈静脉活检（84%）（p <0.001）。经颈静脉活检也观察到从15mm处出现平台。至少有一个10mm长的碎片（5 + 10mm）的碎片活检与15mm长的活检具有相似的敏感性。在Laennec A肝硬化、hbv相关疾病或不完全间隔纤维化的情况下，诊断准确性较低。另一位病理学家也给出了类似的结果。结论对于PSVD的诊断，排除肝硬化的肝活检最小长度为15mm，至少有一个10mm的碎片。小天狼星红染色效果优于马森三色染色。经颈静脉路径显示出较低的敏感性，但提供了额外的信息。影响和意义本研究表明，对于门窦血管病变的诊断，排除肝硬化的肝活检最小长度为15mm，最小切片为10mm。小天狼星红的染色效果略好于马森三色染色。未来的指南可能会考虑≥15mm长活检，碎片≥10mm，足以排除肝硬化的怀疑门窦血管紊乱和门静脉高压的迹象。

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引用次数: 0

Impact of LEAP-012 and EMERALD-1 in the management of HCC LEAP-012和EMERALD-1在HCC治疗中的影响

IF 7.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

JHEP Reports

Pub Date : 2025-11-06 DOI: 10.1016/j.jhepr.2025.101664

Amit G. Singal , Kirema Garcia-Reyes , Robin K. Kelley , Edward Kim

The introduction of immune checkpoint inhibitors (ICIs) for hepatocellular carcinoma (HCC) has spurred interest in evaluating their use in earlier lines of therapy, including in combination with locoregional therapy for patients with intermediate-stage disease. Transarterial chemoembolisation (TACE) is believed to increase neoantigen release and local tumour PD-L1 expression, suggesting the potential for enhanced antitumour responses if combined with ICIs. The EMERALD-1 trial randomised 616 patients with Child-Pugh A-B7 and localised HCC (including 6-8% with Vp1-Vp2 vascular invasion) to durvalumab plus bevacizumab plus TACE, durvalumab plus placebo plus TACE, and placebo plus TACE. The primary endpoint, progression-free survival, was significantly longer with durvalumab plus bevacizumab plus TACE vs. TACE alone (hazard ratio [HR] 0.77, 95% CI 0.61–0.98) but not durvalumab plus TACE vs. TACE alone (HR 0.94, 95% CI 0.75–1.19). The LEAP-012 trial randomised 480 patients with Child-Pugh A and liver-localised HCC to lenvatinib plus pembrolizumab plus TACE vs. placebos plus TACE. Progression-free survival was significantly longer with lenvatinib plus pembrolizumab plus TACE vs. TACE alone (HR 0.66, 95% CI 0.51–0.84). Both trials demonstrated increased grade 3-4 treatment-related adverse events in the combination vs. TACE alone arms, including those resulting in treatment discontinuation. Early data from LEAP-012 suggested a trend toward overall survival benefit (HR 0.80, 95% CI 0.57–1.11), although this failed to achieve statistical significance on follow-up analyses. Neither trial has yet reported on other outcomes, including quality of life. Clinicians should emphasise individualised patient selection when deciding between TACE plus ICI vs. TACE alone in patients with HCC eligible for locoregional therapy.

免疫检查点抑制剂（ICIs）用于肝细胞癌（HCC）的引入激发了人们对评估其在早期治疗中的应用的兴趣，包括与中期疾病患者的局部区域治疗联合使用。经动脉化疗栓塞（TACE）被认为可以增加新抗原释放和局部肿瘤PD-L1表达，这表明如果与ICIs联合使用，可能会增强抗肿瘤反应。EMERALD-1试验将616例Child-Pugh A-B7和局部HCC患者（包括6-8%的Vp1-Vp2血管侵犯）随机分配到durvalumab +贝伐单抗+ TACE， durvalumab +安慰剂+ TACE，以及安慰剂+ TACE。主要终点，无进展生存期，durvalumab +贝伐单抗+ TACE与单独TACE相比明显更长（风险比[HR] 0.77, 95% CI 0.61-0.98），但durvalumab + TACE与单独TACE相比没有（风险比[HR] 0.94, 95% CI 0.75-1.19）。LEAP-012试验将480名Child-Pugh A和肝脏局限性HCC患者随机分为lenvatinib + pembrolizumab + TACE组和安慰剂+ TACE组。lenvatinib + pembrolizumab + TACE组的无进展生存期明显长于单独使用TACE组（HR 0.66, 95% CI 0.51-0.84）。两项试验均表明，与单独使用TACE组相比，联合使用TACE组的3-4级治疗相关不良事件增加，包括导致治疗中断的不良事件。LEAP-012的早期数据显示总体生存获益趋势（HR 0.80, 95% CI 0.57-1.11），尽管在随访分析中未能达到统计学意义。这两项试验尚未报告其他结果，包括生活质量。临床医生在决定适合局部治疗的HCC患者是TACE + ICI还是TACE单独治疗时，应强调个体化患者选择。

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