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Oncogenic role of PMEPA1 and its association with immune exhaustion and TGF-β activation in HCC PMEPA1 的致癌作用及其与 HCC 中免疫衰竭和 TGF-β 激活的关系
IF 9.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-07 DOI: 10.1016/j.jhepr.2024.101212
Marta Piqué-Gili , Carmen Andreu-Oller , Agavni Mesropian , Roger Esteban-Fabró , Marina Bárcena-Varela , Marina Ruiz de Galarreta , Carla Montironi , Iris Martinez-Quetglas , Sarah Cappuyns , Judit Peix , Ieva Keraite , Albert Gris-Oliver , Elisa Fernández-Martínez , Ezequiel Mauro , Miguel Torres-Martin , Jordi Abril-Fornaguera , Katherine E. Lindblad , Diether Lambrechts , Jeroen Dekervel , Swan N. Thung , Josep M. Llovet
<div><h3>Background & Aims</h3><div>Transforming growth factor β (TGF-β) plays an oncogenic role in advanced cancer by promoting cell proliferation, metastasis and immunosuppression. <em>PMEPA1</em> (prostate transmembrane protein androgen induced 1) has been shown to promote TGF-β oncogenic effects in other tumour types. Thus, we aimed to explore the role of <em>PMEPA1</em> in hepatocellular carcinoma (HCC).</div></div><div><h3>Methods</h3><div>We analysed 1,097 tumours from patients with HCC, including discovery (n = 228) and validation (n = 361) cohorts with genomic and clinicopathological data. <em>PMEPA1</em> levels were assessed by qPCR (n = 228), gene expression data (n = 869) and at the single-cell level (n = 54). Genetically engineered mouse models overexpressing <em>MYC+PMEPA1</em> compared to <em>MYC</em> were generated and molecular analyses were performed on the HCCs obtained.</div></div><div><h3>Results</h3><div><em>PMEPA1</em> was overexpressed in 18% of HCC samples (fold-change >2; n = 201/1,097), a feature associated with TGF-β signalling activation (<em>p <</em>0.05) and absence of gene body hypomethylation (<em>p <</em>0.01). HCCs showing both TGF-β signalling and high <em>PMEPA1</em> levels (12% of cases) were linked to immune exhaustion, late TGF-β activation, aggressiveness and higher recurrence rates after resection, in contrast to HCCs with only TGF-β signalling (8%) or <em>PMEPA1</em> overexpression (9%). Single-cell RNA sequencing analysis identified <em>PMEPA1</em> expression in HCC and stromal cells. <em>PMEPA1</em>-expressing tumoural cells were predicted to interact with CD4<sup>+</sup> regulatory T cells and CD4<sup>+</sup> CXCL13<sup>+</sup> and CD8<sup>+</sup> exhausted T cells. <em>In vivo</em>, overexpression of <em>MYC</em>+<em>PMEPA1</em> led to HCC development in ∼60% of mice and a decreased survival compared to mice overexpressing <em>MYC</em> alone (<em>p =</em> 0.014). <em>MYC</em>+<em>PMEPA1</em> tumours were enriched in TGF-β signalling, paralleling our human data.</div></div><div><h3>Conclusions</h3><div>In human HCC, <em>PMEPA1</em> upregulation is linked to TGF-β activation, immune exhaustion, and an aggressive phenotype. Overexpression of <em>PMEPA1+MYC</em> led to tumoural development <em>in vivo</em>, demonstrating the oncogenic role of <em>PMEPA1</em> in HCC for the first time.</div></div><div><h3>Impact and implications:</h3><div><em>PMEPA1</em> can enhance the tumour-promoting effects of TGF-β in cancer. In this study, we demonstrate that <em>PMEPA1</em> is highly expressed in ∼18% of patients with hepatocellular carcinoma (HCC), a feature associated with poor prognosis, TGF-β activation and exhaustion of immune cells. Similarly, in mouse models, <em>PMEPA1</em> overexpression promotes HCC development, which demonstrates its oncogenic role. The identification of <em>PMEPA1</em> as oncogenic driver in HCC and its role in immune exhaustion and poor clinical outcomes enhances our under
背景& 目的转化生长因子 β(TGF-β)通过促进细胞增殖、转移和免疫抑制,在晚期癌症中发挥致癌作用。在其他肿瘤类型中,PMEPA1(前列腺跨膜蛋白雄激素诱导 1)已被证明可促进 TGF-β 的致癌作用。因此,我们旨在探索PMEPA1在肝细胞癌(HCC)中的作用。方法我们分析了1,097例HCC患者的肿瘤,包括发现组(n = 228)和验证组(n = 361)的基因组和临床病理数据。通过 qPCR(n = 228)、基因表达数据(n = 869)和单细胞水平(n = 54)评估 PMEPA1 水平。结果PMEPA1在18%的HCC样本中过表达(折叠变化>2; n = 201/1,097),这一特征与TGF-β信号激活(p <0.05)和基因体低甲基化缺失(p <0.01)有关。同时显示 TGF-β 信号和高 PMEPA1 水平的 HCC(12% 的病例)与免疫衰竭、晚期 TGF-β 激活、侵袭性和切除后较高的复发率有关,而仅显示 TGF-β 信号的 HCC(8%)或 PMEPA1 过表达的 HCC(9%)则与之相反。单细胞RNA测序分析确定了PMEPA1在HCC和基质细胞中的表达。据预测,表达PMEPA1的肿瘤细胞会与CD4+调节性T细胞、CD4+ CXCL13+和CD8+衰竭性T细胞相互作用。在体内,与单独过表达 MYC 的小鼠相比,过表达 MYC+PMEPA1 会导致 60% 的小鼠发生 HCC 并降低存活率(p = 0.014)。结论在人类 HCC 中,PMEPA1 的上调与 TGF-β 激活、免疫耗竭和侵袭性表型有关。PMEPA1+MYC的过表达导致体内肿瘤发生,首次证明了PMEPA1在HCC中的致癌作用。本研究表明,PMEPA1在18%的肝细胞癌(HCC)患者中高表达,这一特征与预后不良、TGF-β激活和免疫细胞衰竭有关。同样,在小鼠模型中,PMEPA1 的过表达会促进 HCC 的发展,这表明了它的致癌作用。PMEPA1是HCC的致癌驱动因子,它在免疫耗竭和不良临床预后中的作用加深了我们对HCC发病机制的了解,为靶向治疗干预开辟了新途径。
{"title":"Oncogenic role of PMEPA1 and its association with immune exhaustion and TGF-β activation in HCC","authors":"Marta Piqué-Gili ,&nbsp;Carmen Andreu-Oller ,&nbsp;Agavni Mesropian ,&nbsp;Roger Esteban-Fabró ,&nbsp;Marina Bárcena-Varela ,&nbsp;Marina Ruiz de Galarreta ,&nbsp;Carla Montironi ,&nbsp;Iris Martinez-Quetglas ,&nbsp;Sarah Cappuyns ,&nbsp;Judit Peix ,&nbsp;Ieva Keraite ,&nbsp;Albert Gris-Oliver ,&nbsp;Elisa Fernández-Martínez ,&nbsp;Ezequiel Mauro ,&nbsp;Miguel Torres-Martin ,&nbsp;Jordi Abril-Fornaguera ,&nbsp;Katherine E. Lindblad ,&nbsp;Diether Lambrechts ,&nbsp;Jeroen Dekervel ,&nbsp;Swan N. Thung ,&nbsp;Josep M. Llovet","doi":"10.1016/j.jhepr.2024.101212","DOIUrl":"10.1016/j.jhepr.2024.101212","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; Aims&lt;/h3&gt;&lt;div&gt;Transforming growth factor β (TGF-β) plays an oncogenic role in advanced cancer by promoting cell proliferation, metastasis and immunosuppression. &lt;em&gt;PMEPA1&lt;/em&gt; (prostate transmembrane protein androgen induced 1) has been shown to promote TGF-β oncogenic effects in other tumour types. Thus, we aimed to explore the role of &lt;em&gt;PMEPA1&lt;/em&gt; in hepatocellular carcinoma (HCC).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We analysed 1,097 tumours from patients with HCC, including discovery (n = 228) and validation (n = 361) cohorts with genomic and clinicopathological data. &lt;em&gt;PMEPA1&lt;/em&gt; levels were assessed by qPCR (n = 228), gene expression data (n = 869) and at the single-cell level (n = 54). Genetically engineered mouse models overexpressing &lt;em&gt;MYC+PMEPA1&lt;/em&gt; compared to &lt;em&gt;MYC&lt;/em&gt; were generated and molecular analyses were performed on the HCCs obtained.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;&lt;em&gt;PMEPA1&lt;/em&gt; was overexpressed in 18% of HCC samples (fold-change &gt;2; n = 201/1,097), a feature associated with TGF-β signalling activation (&lt;em&gt;p &lt;&lt;/em&gt;0.05) and absence of gene body hypomethylation (&lt;em&gt;p &lt;&lt;/em&gt;0.01). HCCs showing both TGF-β signalling and high &lt;em&gt;PMEPA1&lt;/em&gt; levels (12% of cases) were linked to immune exhaustion, late TGF-β activation, aggressiveness and higher recurrence rates after resection, in contrast to HCCs with only TGF-β signalling (8%) or &lt;em&gt;PMEPA1&lt;/em&gt; overexpression (9%). Single-cell RNA sequencing analysis identified &lt;em&gt;PMEPA1&lt;/em&gt; expression in HCC and stromal cells. &lt;em&gt;PMEPA1&lt;/em&gt;-expressing tumoural cells were predicted to interact with CD4&lt;sup&gt;+&lt;/sup&gt; regulatory T cells and CD4&lt;sup&gt;+&lt;/sup&gt; CXCL13&lt;sup&gt;+&lt;/sup&gt; and CD8&lt;sup&gt;+&lt;/sup&gt; exhausted T cells. &lt;em&gt;In vivo&lt;/em&gt;, overexpression of &lt;em&gt;MYC&lt;/em&gt;+&lt;em&gt;PMEPA1&lt;/em&gt; led to HCC development in ∼60% of mice and a decreased survival compared to mice overexpressing &lt;em&gt;MYC&lt;/em&gt; alone (&lt;em&gt;p =&lt;/em&gt; 0.014). &lt;em&gt;MYC&lt;/em&gt;+&lt;em&gt;PMEPA1&lt;/em&gt; tumours were enriched in TGF-β signalling, paralleling our human data.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In human HCC, &lt;em&gt;PMEPA1&lt;/em&gt; upregulation is linked to TGF-β activation, immune exhaustion, and an aggressive phenotype. Overexpression of &lt;em&gt;PMEPA1+MYC&lt;/em&gt; led to tumoural development &lt;em&gt;in vivo&lt;/em&gt;, demonstrating the oncogenic role of &lt;em&gt;PMEPA1&lt;/em&gt; in HCC for the first time.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Impact and implications:&lt;/h3&gt;&lt;div&gt;&lt;em&gt;PMEPA1&lt;/em&gt; can enhance the tumour-promoting effects of TGF-β in cancer. In this study, we demonstrate that &lt;em&gt;PMEPA1&lt;/em&gt; is highly expressed in ∼18% of patients with hepatocellular carcinoma (HCC), a feature associated with poor prognosis, TGF-β activation and exhaustion of immune cells. Similarly, in mouse models, &lt;em&gt;PMEPA1&lt;/em&gt; overexpression promotes HCC development, which demonstrates its oncogenic role. The identification of &lt;em&gt;PMEPA1&lt;/em&gt; as oncogenic driver in HCC and its role in immune exhaustion and poor clinical outcomes enhances our under","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"6 11","pages":"Article 101212"},"PeriodicalIF":9.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Liver stiffness measurement predicts clinical outcomes in autoimmune hepatitis 肝脏硬度测量可预测自身免疫性肝炎的临床结果
IF 9.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-06 DOI: 10.1016/j.jhepr.2024.101213
Ignasi Olivas , Pinelopi Arvaniti , Stella Gabeta , Sonia Torres , Maria Del Barrio , Alvaro Díaz-González , Paula Esteban , Mar Riveiro-Barciela , Ezequiel Mauro , Sergio Rodríguez-Tajes , Kalliopi Zachou , George N. Dalekos , María-Carlota Londoño

Background & Aims

Liver stiffness measurement (LSM) has been shown to adequately predict outcomes in patients with liver disease. However, the value of LSM as a predictor of disease progression in autoimmune hepatitis (AIH) remains to be determined. This study aimed to evaluate the role of LSM as a predictor of disease progression and decompensation of cirrhosis in patients with AIH.

Methods

This multicentre cohort study included 439 patients with histologically confirmed AIH and at least one LSM during follow-up. The association between the first LSM performed at least 6 months after treatment initiation (baseline LSM [BLSM]) and cirrhosis development and poor outcomes (decompensation, liver transplantation, and/or liver-related death) was assessed using Cox regression and its discriminating capacity with a receiver-operating characteristic curve.

Results

Most patients were female (n = 301, 70%), with a median age of 52 years. BLSM performed after a median of 2.18 (1.19-4.68) years had a median value of 6 kPa (4.5-8.5). At the time of BLSM, 332 (76%) patients had achieved a biochemical response and 57 (13%) had cirrhosis. During follow-up, eight patients (2%) presented with poor outcomes and 26 (7%) developed cirrhosis. BLSM was higher among patients with poor outcomes (13.5 kPa vs. 6 kPa; p <0.001) and was independently associated with cirrhosis development (hazard ratio 1.300; p <0.001), irrespective of the achievement of biochemical response. A cut-off of 8.5 kPa accurately predicted cirrhosis development and poor outcomes, with AUCs of 0.859 (95% CI 0.789-0.929) and 0.900 (95% CI 0.847-0.954), respectively.

Conclusion

BLSM could play a significant role in predicting AIH outcomes, potentially identifying a subgroup of patients at a high risk of progressing to cirrhosis and experiencing decompensation.

Impact and implications:

The value of liver stiffness measurement as a predictor of outcomes in patients with autoimmune hepatitis (AIH) remains to be determined. In this large multicentre study, liver stiffness measurement was found to be an independent predictive factor of adverse clinical outcomes and cirrhosis development in AIH, irrespective of the achievement of biochemical response. A cut-off of 8.5 kPa accurately predicted cirrhosis development and poor outcomes in AIH.
背景& 目的肝脏僵硬度测量(LSM)已被证明能充分预测肝病患者的预后。然而,肝硬度测量作为自身免疫性肝炎(AIH)疾病进展预测指标的价值仍有待确定。本研究旨在评估 LSM 作为自身免疫性肝炎患者疾病进展和肝硬化失代偿的预测指标的作用。方法这项多中心队列研究纳入了 439 例经组织学确诊的自身免疫性肝炎患者,这些患者在随访期间至少接受过一次 LSM 检查。结果大多数患者为女性(n = 301,70%),中位年龄为 52 岁。在中位 2.18(1.19-4.68)年后进行的 BLSM 的中位值为 6 kPa(4.5-8.5)。在进行 BLSM 时,有 332 名(76%)患者获得了生化应答,57 名(13%)患者出现了肝硬化。在随访期间,8 名患者(2%)出现不良反应,26 名患者(7%)发展为肝硬化。无论是否获得生化应答,预后不良患者的 BLSM 均较高(13.5 kPa vs. 6 kPa; p <0.001),并且与肝硬化的发展独立相关(危险比 1.300; p <0.001)。8.5 kPa 临界值可准确预测肝硬化的发展和不良预后,其 AUC 分别为 0.859 (95% CI 0.789-0.929) 和 0.900 (95% CI 0.847-0.954)。影响和意义:肝脏硬度测量作为自身免疫性肝炎(AIH)患者预后预测指标的价值仍有待确定。在这项大型多中心研究中发现,肝脏僵硬度测量是自身免疫性肝炎患者不良临床结局和肝硬化发展的独立预测因素,与生化反应的实现无关。8.5 kPa的临界值可准确预测AIH患者肝硬化的发生和不良预后。
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引用次数: 0
A home-based exercise programme attenuates fatigue in primary biliary cholangitis: Results from the EXCITED clinical trial 家庭锻炼计划可减轻原发性胆汁性胆管炎患者的疲劳感:EXCITED 临床试验的结果
IF 9.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-06 DOI: 10.1016/j.jhepr.2024.101210
Alice Freer , Felicity R. Williams , Simon Durman , Jennifer Hayden , Matthew J. Armstrong , Palak J. Trivedi

Background & Aims

Fatigue is a commonly reported symptom of primary biliary cholangitis (PBC). We conducted a single-arm, open-label clinical trial to assess the efficacy of a physiotherapist-led home-based exercise programme (HBEP) in patients with PBC and moderate-to-severe fatigue (NCT04265235).

Methods

A 12-week individualised HBEP (aerobic + resistance based) was delivered to patients with a PBC-40 fatigue domain score ≥33. The primary efficacy outcome measure was a reduction in fatigue severity by ≥5 points. Secondary outcome measures included other domains of PBC-40, the FIS (fatigue impact scale), ESS (Epworth sleepiness score), HADS (hospital anxiety and depression scale), aerobic capacity (ISWT [incremental shuttle walk test], Duke activity status index (predicted VO₂ peak) and physical function (short physical performance battery [SPPB]).

Results

A total of 31 patients were recruited, of whom 30 completed the 12-week HBEP (29 women; median age 53 years, median alkaline phosphatase value: 1.5x the upper limit of normal, median bilirubin: 12 μmol/L, and median baseline PBC-40 fatigue score 42). The primary outcome was met by 26 patients, with a median reduction in PBC-40 fatigue score of -10.5 points (IQR -9 to -13; p <0.001). Reductions were also observed in the symptom, cognition, and emotion domains of PBC-40, and in the FIS, ESS and HADS (p <0.01 for all measures). This was alongside increases in the median ISWT (+90 m; IQR 57.5-110), predicted VO₂ peak (+2.41 ml/kg/min; IQR 0.01-4.05), and SPPB (+1 point; IQR 0-1.4) (all p <0.001). 28 participants achieved the maximum SPPB score of 12/12 (vs. 13 patients at baseline; p <0.001). No significant adverse events were reported.

Conclusion

This proof-of-concept study shows that a HBEP is safe, feasible, and has the potential to attenuate fatigue. Controlled trials are needed to validate the efficacy of exercise interventions in PBC.

Impact and implications:

Fatigue is a common symptom in primary biliary cholangitis (PBC), and is linked to cognitive dysfunction, somnolence, and reduced activity. The pathogenesis is multifactorial, and muscle bioenergetic abnormalities have been proposed to contribute. In this study, we show that a home-based exercise programme, consisting of aerobic and resistance-based sets, can be safely delivered to people living with PBC. In addition, the programme led to a reduction in fatigue severity, less daytime sleepiness and improved cognitive function.
背景& 目的疲劳是原发性胆汁性胆管炎(PBC)的常见症状。我们开展了一项单臂、开放标签临床试验,以评估物理治疗师指导的家庭锻炼计划(HBEP)对中度至重度疲劳的 PBC 患者的疗效(NCT04265235)。主要疗效指标是疲劳严重程度降低≥5分。次要疗效指标包括 PBC-40 的其他领域、FIS(疲劳影响量表)、ESS(埃普沃斯嗜睡评分)、HADS(医院焦虑抑郁量表)、有氧能力(ISWT[增量穿梭步行测试]、杜克活动状态指数(预测 VO₂峰值))和身体功能(短期体能测试 [SPPB])。结果 共招募了 31 名患者,其中 30 人完成了为期 12 周的 HBEP(29 名女性;中位年龄 53 岁,中位碱性磷酸酶值:正常值上限的 1.5 倍,中位胆红素:12 μmol/L,中位 PBC-40 疲劳基线评分 42 分)。26名患者达到了主要疗效,PBC-40疲劳评分的中位数降低了-10.5分(IQR-9至-13;p<0.001)。在 PBC-40 的症状、认知和情绪领域,以及 FIS、ESS 和 HADS 中也观察到了减少(所有测量的 p 均为 0.01)。同时,ISWT 中位数(+90 米;IQR 57.5-110)、预测 VO₂峰值(+2.41 毫升/千克/分钟;IQR 0.01-4.05)和 SPPB(+1 分;IQR 0-1.4)也有所提高(均为 p <0.001)。28 名参与者的 SPPB 最高分达到了 12/12(与基线时的 13 名患者相比;p <0.001)。结论这项概念验证研究表明,HBEP 是安全、可行的,并有可能减轻疲劳。影响和意义:疲劳是原发性胆汁性胆管炎(PBC)的常见症状,与认知功能障碍、嗜睡和活动减少有关。其发病机制是多因素的,肌肉生物能异常被认为是其中的一个因素。在这项研究中,我们发现可以安全地为胆汁淤积症患者提供由有氧运动和阻力运动组成的家庭锻炼计划。此外,该计划还能减轻疲劳的严重程度,减少白天嗜睡,改善认知功能。
{"title":"A home-based exercise programme attenuates fatigue in primary biliary cholangitis: Results from the EXCITED clinical trial","authors":"Alice Freer ,&nbsp;Felicity R. Williams ,&nbsp;Simon Durman ,&nbsp;Jennifer Hayden ,&nbsp;Matthew J. Armstrong ,&nbsp;Palak J. Trivedi","doi":"10.1016/j.jhepr.2024.101210","DOIUrl":"10.1016/j.jhepr.2024.101210","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Fatigue is a commonly reported symptom of primary biliary cholangitis (PBC). We conducted a single-arm, open-label clinical trial to assess the efficacy of a physiotherapist-led home-based exercise programme (HBEP) in patients with PBC and moderate-to-severe fatigue (NCT04265235).</div></div><div><h3>Methods</h3><div>A 12-week individualised HBEP (aerobic + resistance based) was delivered to patients with a PBC-40 fatigue domain score ≥33. The primary efficacy outcome measure was a reduction in fatigue severity by ≥5 points. Secondary outcome measures included other domains of PBC-40, the FIS (fatigue impact scale), ESS (Epworth sleepiness score), HADS (hospital anxiety and depression scale), aerobic capacity (ISWT [incremental shuttle walk test], Duke activity status index (predicted VO₂ peak) and physical function (short physical performance battery [SPPB]).</div></div><div><h3>Results</h3><div>A total of 31 patients were recruited, of whom 30 completed the 12-week HBEP (29 women; median age 53 years, median alkaline phosphatase value: 1.5x the upper limit of normal, median bilirubin: 12 μmol/L, and median baseline PBC-40 fatigue score 42). The primary outcome was met by 26 patients, with a median reduction in PBC-40 fatigue score of -10.5 points (IQR -9 to -13; <em>p &lt;</em>0.001). Reductions were also observed in the symptom, cognition, and emotion domains of PBC-40, and in the FIS, ESS and HADS (<em>p &lt;</em>0.01 for all measures). This was alongside increases in the median ISWT (+90 m; IQR 57.5-110), predicted VO₂ peak (+2.41 ml/kg/min; IQR 0.01-4.05), and SPPB (+1 point; IQR 0-1.4) (all <em>p &lt;</em>0.001). 28 participants achieved the maximum SPPB score of 12/12 (<em>vs.</em> 13 patients at baseline; <em>p &lt;</em>0.001). No significant adverse events were reported.</div></div><div><h3>Conclusion</h3><div>This proof-of-concept study shows that a HBEP is safe, feasible, and has the potential to attenuate fatigue. Controlled trials are needed to validate the efficacy of exercise interventions in PBC.</div></div><div><h3>Impact and implications:</h3><div>Fatigue is a common symptom in primary biliary cholangitis (PBC), and is linked to cognitive dysfunction, somnolence, and reduced activity. The pathogenesis is multifactorial, and muscle bioenergetic abnormalities have been proposed to contribute. In this study, we show that a home-based exercise programme, consisting of aerobic and resistance-based sets, can be safely delivered to people living with PBC. In addition, the programme led to a reduction in fatigue severity, less daytime sleepiness and improved cognitive function.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"6 12","pages":"Article 101210"},"PeriodicalIF":9.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of artificial intelligence for liver diseases: A survey from the EASL congress 2024 人工智能在肝脏疾病中的应用:2024 年 EASL 大会调查报告
IF 9.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-06 DOI: 10.1016/j.jhepr.2024.101209
Laura Žigutytė , Thomas Sorz-Nechay , Jan Clusmann , Jakob Nikolas Kather
Artificial intelligence (AI) methods enable humans to analyse large amounts of data, which would otherwise not be feasibly quantifiable. This is especially true for unstructured visual and textual data, which can contain invaluable insights into disease. The hepatology research landscape is complex and has generated large amounts of data to be mined. Many open questions can potentially be addressed with existing data through AI methods. However, the field of AI is sometimes obscured by hype cycles and imprecise terminologies. This can conceal the fact that numerous hepatology research groups already use AI methods in their scientific studies. In this review article, we aim to assess the contemporaneous use of AI methods in hepatology in Europe. To achieve this, we systematically surveyed all scientific contributions presented at the EASL Congress 2024. Out of 1,857 accepted abstracts (1,712 posters and 145 oral presentations), 6 presentations (∼4%) and 69 posters (∼4%) utilised AI methods. Of these, 55 posters were included in this review, while the others were excluded due to missing posters or incomplete methodologies. Finally, we summarise current academic trends in the use of AI methods and outline future directions, providing guidance for scientific stakeholders in the field of hepatology.
人工智能(AI)方法使人类能够分析大量数据,否则这些数据是无法量化的。这对于非结构化的视觉和文本数据来说尤其如此,因为这些数据可能包含对疾病的宝贵见解。肝病学研究领域十分复杂,产生了大量有待挖掘的数据。通过人工智能方法,可以利用现有数据解决许多开放性问题。然而,人工智能领域有时会被炒作周期和不精确的术语所掩盖。这可能掩盖了一个事实,即许多肝病研究小组已经在其科学研究中使用了人工智能方法。在这篇综述文章中,我们旨在评估人工智能方法在欧洲肝病学领域的使用情况。为此,我们系统地调查了在 2024 年 EASL 大会上发表的所有科学论文。在1,857份被接受的摘要(1,712份海报和145份口头报告)中,6份报告(∼4%)和69份海报(∼4%)使用了人工智能方法。其中,55 篇海报被纳入本综述,其他海报因缺失或方法不完整而被排除在外。最后,我们总结了当前使用人工智能方法的学术趋势,并概述了未来的发展方向,为肝病学领域的科研相关人员提供指导。
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引用次数: 0
Metabolomic profiles differentiate between porto-sinusoidal vascular disorder, cirrhosis, and healthy individuals 代谢组图谱区分门静脉血管疾病、肝硬化和健康人
IF 9.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-04 DOI: 10.1016/j.jhepr.2024.101208
Georg Semmler , Oleksandr Petrenko , Juanjo Jose Lozano , Sarah Shalaby , Juan I. Sánchez-Avila , Nara Marella , Thomas Hannich , Katharina Wöran , Lorenz Balcar , Benedikt Simbrunner , Katharina Lampichler , Behrang Mozayani , Michael Trauner , Mattias Mandorfer , Thomas Reiberger , Juan-Carlos García-Pagán , Bernhard Scheiner

Background & Aims

Porto-sinusoidal vascular disorder (PSVD) is a rare and diagnostically challenging vascular liver disease. This study aimed to identify distinct metabolomic signatures in patients with PSVD or cirrhosis to facilitate non-invasive diagnosis and elucidate perturbed metabolic pathways.

Methods

Serum samples from 20 healthy volunteers (HVs), 20 patients with histologically confirmed PSVD or 20 patients with cirrhosis were analyzed. Metabolites were measured using liquid chromatography-mass spectrometry. Differential abundance was evaluated with Limma’s moderated t-statistics. Artificial neural network and support vector machine models were developed to classify PSVD against cirrhosis or HV metabolomic profiles. An independent cohort was used for validation.

Results

A total of 283 metabolites were included for downstream analysis. Clustering effectively separated PSVD from HV metabolomes, although a subset of patients with PSVD (n = 5, 25%) overlapped with those with cirrhosis. Differential testing revealed significant PSVD-linked metabolic perturbations, including pertubations in taurocholic and adipic acids, distinguishing patients with PSVD from both HVs and those with cirrhosis. Alterations in pyrimidine, glycine, serine, and threonine pathways were exclusively associated with PSVD. Machine learning models utilizing selected metabolic signatures reliably differentiated the PSVD group from HVs or patients with cirrhosis using only 4 to 6 metabolites. Validation in an independent cohort demonstrated the high discriminative ability of taurocholic acid (AUROC 0.899) for patients with PSVD vs. HVs and the taurocholic acid/aspartic acid ratio (AUROC 0.720) for PSVD vs. cirrhosis.

Conclusions

High-throughput metabolomics enabled the identification of distinct metabolic profiles that differentiate between PSVD, cirrhosis, and healthy individuals. Unique alterations in the glycine, serine, and threonine pathways suggest their potential involvement in PSVD pathogenesis.

Impact and implications:

Porto-sinusoidal vascular disorder (PSVD) is a vascular liver disease that can lead to pre-sinusoidal portal hypertension in the absence of cirrhosis, with poorly understood pathophysiology and no established treatment. Our study demonstrates that analyzing the serum metabolome could reveal distinct metabolic signatures in patients with PSVD, including alterations in the pyrimidine, glycine, serine and threonine pathways, potentially shedding light on the disease's underlying pathways. These findings could enable earlier and non-invasive diagnosis of PSVD, potentially reducing reliance on invasive procedures like liver biopsy and guiding diagnostic pathways.
背景& 目的门静脉血管病变(PSVD)是一种罕见的血管性肝病,在诊断上具有挑战性。本研究旨在确定PSVD或肝硬化患者独特的代谢组学特征,以促进无创诊断并阐明受干扰的代谢途径。方法分析了20名健康志愿者(HVs)、20名经组织学证实的PSVD患者或20名肝硬化患者的血清样本。代谢物采用液相色谱-质谱法进行测定。差异丰度用 Limma 修正的 t 统计量进行评估。研究人员开发了人工神经网络和支持向量机模型,将 PSVD 与肝硬化或 HV 代谢组学特征进行分类。结果 共有283个代谢物被纳入下游分析。聚类分析有效地将 PSVD 与 HV 代谢组分开,尽管 PSVD 患者(5 人,25%)与肝硬化患者重叠。差异检验发现了与 PSVD 相关的重大代谢紊乱,包括牛磺胆酸和脂肪酸的中枢变化,从而将 PSVD 患者与 HV 和肝硬化患者区分开来。嘧啶、甘氨酸、丝氨酸和苏氨酸通路的改变与 PSVD 完全相关。利用精选代谢特征的机器学习模型只需使用 4 到 6 个代谢物就能可靠地将 PSVD 组与 HV 或肝硬化患者区分开来。在一个独立队列中进行的验证表明,牛磺胆酸(AUROC 0.899)对 PSVD 患者与 HVs 具有很高的区分能力,牛磺胆酸/天冬氨酸比值(AUROC 0.720)对 PSVD 与肝硬化具有很高的区分能力。影响和意义:门静脉血管病变(PSVD)是一种血管性肝病,可在无肝硬化的情况下导致门静脉前高压,其病理生理学尚不清楚,也没有成熟的治疗方法。我们的研究表明,分析血清代谢组可以发现 PSVD 患者的不同代谢特征,包括嘧啶、甘氨酸、丝氨酸和苏氨酸通路的改变,从而揭示该疾病的潜在通路。这些发现可以让人们更早地对 PSVD 进行非侵入性诊断,从而减少对肝活检等侵入性程序的依赖,并为诊断路径提供指导。
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引用次数: 0
Quantification of alcohol intake in patients with steatotic liver disease and excessive alcohol intake 脂肪变性肝病和过量酒精摄入患者酒精摄入量的定量分析
IF 9.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-02 DOI: 10.1016/j.jhepr.2024.101200
Emil Deleuran Hansen , Nikolaj Torp , Stine Johansen , Johanne Kragh Hansen , Marianne Lerbæk Bergmann , Camilla Dalby Hansen , Sönke Detlefsen , Peter Andersen , Ida Villesen , Katrine Bech , Katrine Thorhauge , Gitte Hedegaard Jensen , Katrine Prier Lindvig , Torben Hansen , Emmanuel A. Tsochatzis , Jonel Trebicka , Maja Thiele , Aleksander Krag , Mads Israelsen , the GALAXY and MicrobLiver consortia

Background & Aims

Quantifying alcohol intake is crucial for subclassifying participants with steatotic liver disease (SLD) and interpreting clinical trials of alcohol-related liver disease (ALD) and metabolic and alcohol-related liver disease (MetALD). However, the accuracy of self-reported alcohol intake is considered imprecise. We compared the diagnostic and prognostic utility of self-reported alcohol intake with blood-based biomarkers of alcohol intake: phosphatidylethanol (PEth) and carbohydrate-deficient transferrin (CDT).

Methods

We studied 192 participants from two randomized controlled trials on MetALD and ALD, all with current or former excessive alcohol intake (≥24/36 [♀/♂] grams daily for at least 1 year) and biopsy-proven liver disease. We assessed self-reported alcohol intake, PEth, and CDT at four time points. We collected follow-up data on hepatic decompensation and death manually through electronic medical records.

Results

Most participants were male (n = 161, 84%) with a mean age of 59 (SD 9) years and 73 participants reported 1-week abstinence before inclusion; the remaining reported a median alcohol intake of 43 g/day. Median PEth was 0.5 μmol/L (IQR: 0.0–1.3) and %CDT = 1.9 (IQR: 1.6–2.3). Of 32 patients reporting at least 6 months of abstinence; 27 (84%) was confirmed by PEth <0.05 μmol/L. Self-reported alcohol intake correlated well with PEth (r = 0.617) and moderately with CDT (r = 0.316). Self-reported alcohol intake, PEth, and CDT all predicted hepatic decompensation and death. However, PEth showed the highest prediction, surpassing self-reported alcohol intake (Harrel’s C, PEth = 0.80 vs. self-reported = 0.68, p = 0.026).

Conclusions

Self-reported abstinence can be considered reliable in clinical trials. However, PEth is superior in predicting hepatic decompensation and death in patients with MetALD and ALD.

Impact and implications

An accurate quantification of alcohol intake is crucial in the clinical phenotyping of patients with steatotic liver disease and when designing clinical trials. This study found self-reported abstinence to be reliable but phosphatidylethanol was a more accurate prognostic biomarker of hepatic decompensation and death in a clinical trial setting. Findings may inform the design of future trials in patients with steatotic liver disease.
背景,目的量化酒精摄入量对于脂肪变性肝病(SLD)患者的亚分类以及解释酒精相关肝病(ALD)、代谢性和酒精相关肝病(MetALD)的临床试验至关重要。然而,自我报告的酒精摄入量的准确性被认为是不精确的。我们比较了自我报告的酒精摄入量与基于血液的酒精摄入量生物标志物:磷脂酰乙醇(PEth)和碳水化合物缺乏转铁蛋白(CDT)的诊断和预后效用。方法:我们研究了192名来自MetALD和ALD两项随机对照试验的参与者,所有参与者目前或曾经过量饮酒(≥24/36[♀/♂]克每天至少1年),并活检证实有肝脏疾病。我们在四个时间点评估了自我报告的酒精摄入量、PEth和CDT。我们通过电子病历手工收集肝失代偿和死亡的随访数据。结果大多数参与者为男性(n = 161, 84%),平均年龄59岁(SD 9), 73名参与者在纳入前报告了1周的禁欲;其余的人平均每天摄入43克酒精。中位PEth为0.5 μmol/L (IQR: 0.0 ~ 1.3), %CDT = 1.9 (IQR: 1.6 ~ 2.3)。32例患者报告至少禁欲6个月;27个(84%)经PEth 0.05 μmol/L确证。自我报告的酒精摄入量与PEth有良好的相关性(r = 0.617),与CDT有中度相关性(r = 0.316)。自我报告的酒精摄入量、PEth和CDT均可预测肝功能失代偿和死亡。然而,PEth的预测最高,超过了自我报告的酒精摄入量(Harrel 's C, PEth = 0.80 vs.自我报告= 0.68,p = 0.026)。结论自我报告戒断在临床试验中是可靠的。然而,PEth在预测MetALD和ALD患者肝功能失代偿和死亡方面具有优势。影响和意义准确量化酒精摄入量对脂肪肝患者的临床表型和临床试验设计至关重要。该研究发现自我报告的戒断是可靠的,但在临床试验中,磷脂酰乙醇是肝失代偿和死亡的更准确的预后生物标志物。研究结果可能为未来脂肪变性肝病患者试验的设计提供信息。
{"title":"Quantification of alcohol intake in patients with steatotic liver disease and excessive alcohol intake","authors":"Emil Deleuran Hansen ,&nbsp;Nikolaj Torp ,&nbsp;Stine Johansen ,&nbsp;Johanne Kragh Hansen ,&nbsp;Marianne Lerbæk Bergmann ,&nbsp;Camilla Dalby Hansen ,&nbsp;Sönke Detlefsen ,&nbsp;Peter Andersen ,&nbsp;Ida Villesen ,&nbsp;Katrine Bech ,&nbsp;Katrine Thorhauge ,&nbsp;Gitte Hedegaard Jensen ,&nbsp;Katrine Prier Lindvig ,&nbsp;Torben Hansen ,&nbsp;Emmanuel A. Tsochatzis ,&nbsp;Jonel Trebicka ,&nbsp;Maja Thiele ,&nbsp;Aleksander Krag ,&nbsp;Mads Israelsen ,&nbsp;the GALAXY and MicrobLiver consortia","doi":"10.1016/j.jhepr.2024.101200","DOIUrl":"10.1016/j.jhepr.2024.101200","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Quantifying alcohol intake is crucial for subclassifying participants with steatotic liver disease (SLD) and interpreting clinical trials of alcohol-related liver disease (ALD) and metabolic and alcohol-related liver disease (MetALD). However, the accuracy of self-reported alcohol intake is considered imprecise. We compared the diagnostic and prognostic utility of self-reported alcohol intake with blood-based biomarkers of alcohol intake: phosphatidylethanol (PEth) and carbohydrate-deficient transferrin (CDT).</div></div><div><h3>Methods</h3><div>We studied 192 participants from two randomized controlled trials on MetALD and ALD, all with current or former excessive alcohol intake (≥24/36 [♀/♂] grams daily for at least 1 year) and biopsy-proven liver disease. We assessed self-reported alcohol intake, PEth, and CDT at four time points. We collected follow-up data on hepatic decompensation and death manually through electronic medical records.</div></div><div><h3>Results</h3><div>Most participants were male (n = 161, 84%) with a mean age of 59 (SD 9) years and 73 participants reported 1-week abstinence before inclusion; the remaining reported a median alcohol intake of 43 g/day. Median PEth was 0.5 μmol/L (IQR: 0.0–1.3) and %CDT = 1.9 (IQR: 1.6–2.3). Of 32 patients reporting at least 6 months of abstinence; 27 (84%) was confirmed by PEth &lt;0.05 μmol/L. Self-reported alcohol intake correlated well with PEth (r = 0.617) and moderately with CDT (r = 0.316). Self-reported alcohol intake, PEth, and CDT all predicted hepatic decompensation and death. However, PEth showed the highest prediction, surpassing self-reported alcohol intake (Harrel’s C, PEth = 0.80 <em>vs.</em> self-reported = 0.68, <em>p</em> = 0.026).</div></div><div><h3>Conclusions</h3><div>Self-reported abstinence can be considered reliable in clinical trials. However, PEth is superior in predicting hepatic decompensation and death in patients with MetALD and ALD.</div></div><div><h3>Impact and implications</h3><div>An accurate quantification of alcohol intake is crucial in the clinical phenotyping of patients with steatotic liver disease and when designing clinical trials. This study found self-reported abstinence to be reliable but phosphatidylethanol was a more accurate prognostic biomarker of hepatic decompensation and death in a clinical trial setting. Findings may inform the design of future trials in patients with steatotic liver disease.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 1","pages":"Article 101200"},"PeriodicalIF":9.5,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Editorial Board page 编辑委员会页面
IF 9.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-01 DOI: 10.1016/S2589-5559(24)00207-6
{"title":"Editorial Board page","authors":"","doi":"10.1016/S2589-5559(24)00207-6","DOIUrl":"10.1016/S2589-5559(24)00207-6","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"6 9","pages":"Article 101203"},"PeriodicalIF":9.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589555924002076/pdfft?md5=e4a27c989694a622d4c22d6a3640d55d&pid=1-s2.0-S2589555924002076-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142148334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Copyright and information 版权和信息
IF 9.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-01 DOI: 10.1016/S2589-5559(24)00210-6
{"title":"Copyright and information","authors":"","doi":"10.1016/S2589-5559(24)00210-6","DOIUrl":"10.1016/S2589-5559(24)00210-6","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"6 9","pages":"Article 101206"},"PeriodicalIF":9.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589555924002106/pdfft?md5=36611aac042aa5927b580993b9e51763&pid=1-s2.0-S2589555924002106-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142148336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting liver ablation volumes with real-time MRI thermometry 利用实时磁共振成像测温技术预测肝脏消融体积
IF 9.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-08-31 DOI: 10.1016/j.jhepr.2024.101199
Osman Öcal , Olaf Dietrich , Sergio Lentini , Pierre Bour , Thibaut Faller , Valery Ozenne , Florian Maier , Matthias Philipp Fabritius , Daniel Puhr-Westerheide , Vanessa F. Schmidt , Elif Öcal , Ricarda Seidensticker , Moritz Wildgruber , Jens Ricke , Max Seidensticker

Background & Aims

MRI guidance offers better lesion targeting for microwave ablation of liver lesions with higher soft-tissue contrast, as well as the possibility of real-time thermometry. This study aims to evaluate the correlation of real-time MR thermometry-predicted lesion volume with the ablation zone in postprocedural first-day images.

Methods

This single-center retrospective analysis evaluated prospectively included patients who underwent MRI-guided microwave ablation with real-time thermometry between December 2020 and July 2023. All procedures were performed under general anesthesia on a 1.5 T MRI scanner. Real-time thermometry data were acquired using multi-slice gradient-echo echoplanar imaging sequences, and thermal dose maps (CEM43 of 240 min as a threshold) were created. The volume of tissue exposed to a lethal thermal dose in MR thermometry (thermal dose) was compared with the ablation zone volume in portal phase T1w MRI on the postprocedural first day using the Pearson correlation test, and visual quantitative assessment by radiologists was performed to evaluate the similarity of shapes and volumes.

Results

Out of 30 patients with 33 lesions with thermometry images, six (18.1%) lesions were excluded because of artifacts limiting interpretation of thermal dose volume. Twenty-four patients with 27 lesions (20 male, age 63.1 ± 9.1 years) were evaluated for the volume correlation. The volume of thermal dose-predicted lesions and the postprocedural first-day ablation zones showed a strong correlation (R = 0.89, p <0.001). Similarly, visual similarity of molecular resonance thermometry-predicted shape and the ablation zone shape was graded as perfect in 23 (85.1%) lesions.

Conclusions

Real-time thermal dose-predicted volumes show very good correlation with the ablation zone volumes in images obtained 1 day after the procedure, which could reduce the local recurrence rates with the possibility of re-ablating lesions within the same procedure.

Impact and implications:

Heat-based ablation is an established treatment for liver tumors; however, there is a considerable rate of incomplete treatment because of the lack of real-time visualization of the treated area during treatment. Our results show that MRI-guided ablation enables the visualization of the treatment area in real-time with high accuracy using a special technique of MR thermometry in patients with liver tumors.
背景& 目的MRI引导为肝脏病变的微波消融提供了更好的病灶定位,软组织对比度更高,而且可以进行实时测温。本研究旨在评估实时磁共振温度计预测的病灶体积与术后第一天图像中消融区的相关性。方法这项单中心回顾性分析评估了 2020 年 12 月至 2023 年 7 月期间在磁共振引导下接受实时温度计微波消融术的前瞻性纳入患者。所有手术均在 1.5 T 核磁共振扫描仪上全身麻醉下进行。使用多切片梯度回波回旋成像序列获取实时测温数据,并绘制热剂量图(以240分钟的CEM43为阈值)。使用皮尔逊相关性检验将 MR 测温中暴露于致死热剂量的组织体积(热剂量)与术后第一天门相 T1w MRI 中的消融区体积进行比较,并由放射科医生进行视觉定量评估,以评价形状和体积的相似性。对 24 名患者的 27 个病灶(20 名男性,年龄为 63.1 ± 9.1 岁)进行了体积相关性评估。热剂量预测的病灶体积与手术后第一天的消融区显示出很强的相关性(R = 0.89,p <0.001)。同样,在 23 个(85.1%)病灶中,分子共振测温预测形状与消融区形状的视觉相似度被评为完美。结论实时热剂量预测体积与术后 1 天获得的图像中的消融区体积显示出很好的相关性,这可以降低局部复发率,并有可能在同一次手术中再次消融病灶。影响和意义:热消融是一种治疗肝脏肿瘤的成熟方法,但由于治疗过程中缺乏对治疗区域的实时观察,因此存在相当高的治疗不完全率。我们的研究结果表明,磁共振成像引导下的消融术能利用磁共振测温这一特殊技术实时、高精度地观察肝肿瘤患者的治疗区域。
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引用次数: 0
Reply to: “Unlocking hope: HCV re-treatment strategy for patients with active hepatocellular carcinoma” 答复"开启希望:活动性肝细胞癌患者的 HCV 再治疗策略"
IF 9.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-08-28 DOI: 10.1016/j.jhepr.2024.101197
Christiana Graf , Christoph Sarrazin , Julia Dietz
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引用次数: 0
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JHEP Reports
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