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2023 Reviewer Acknowledgement. 2023 审稿人致谢。
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-28 DOI: 10.14218/JCTH.2023.000RA
Editorial Office Of Journal Of Clinical And Translational Hepatology
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引用次数: 0
Antiviral Therapy Favors a Lower Risk of Liver Cirrhosis in HBeAg-negative Chronic Hepatitis B with Normal Alanine Transaminase and HBV DNA Positivity. 抗病毒治疗有利于降低丙氨酸转氨酶和 HBV DNA 阳性的 HBeAg 阴性慢性乙型肝炎患者罹患肝硬化的风险。
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-28 Epub Date: 2023-08-25 DOI: 10.14218/JCTH.2023.00272
Jing Zhou, Fa-Da Wang, Lan-Qing Li, Yu-Jin Li, Shi-Yan Wang, En-Qiang Chen

Background and aims: Direct evidence on the outcomes of hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients with normal alanine transaminase after long-term antiviral treatment is lacking.

Methods: HBeAg-negative patients with normal ALT and positive HBV DNA (≥20 IU/mL) were retrospectively enrolled. The endpoints included virological response (HBV DNA<100 IU/mL), changes in aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4), and the incidence of liver nodules, cirrhosis, and hepatocellular carcinoma (HCC).

Results: This cohort (n=194) was divided into three subgroups, untreated (n=67), treatment-continued (n=87), and treatment-discontinued patients (n=40), with a median follow-up of 54 months. The treatment-continued group achieved 100% (95% CI: 94.7-100) virological response, and significantly reduced APRI and FIB-4 scores (both p<0.001). The risk of liver nodules and cirrhosis in that group was reduced by 76% (HR: 0.24, 95% CI: 0.11-0.54, p<0.001) and 89% (HR: 0.11, 95% CI: 0.14-0.91, p=0.041) vs. the untreated group and by 77% (HR: 0.23, 95% CI: 0.10-0.49, p<0.001) and 95% (HR: 0.05, 95% CI: 0.01-0.44, p=0.006) vs. the treatment-discontinued group. For patients with HBV DNA≥2,000 IU/mL, adherence to treatment lowered the risks of liver cirrhosis by 92% (95% CI: 0.01-0.67) and 93% (95% CI: 0.01-0.53) vs. the untreated and treatment-discontinued patients, respectively. No patient adhering to treatment developed HCC, but one in each of the remaining groups did.

Conclusions: Continuous nucleos(t)ide analog (NA) treatment has a satisfactory effectiveness and helps to lower the risk of liver cirrhosis in HBeAg-negative CHB patients with normal alanine transaminase, especially in those with HBV DNA≥2,000 IU/mL.

背景和目的:方法:回顾性入组丙氨酸转氨酶正常且 HBV DNA 阳性(≥20 IU/mL)的乙肝 e 抗原(HBeAg)阴性慢性乙型肝炎(CHB)患者。终点包括病毒学应答(HBV DNAResults):该队列(194 人)分为三个亚组:未治疗组(67 人)、继续治疗组(87 人)和停止治疗组(40 人),中位随访时间为 54 个月。与未治疗组相比,继续治疗组获得了100%(95% CI:94.7-100)的病毒学应答,并显著降低了APRI和FIB-4评分(均ppp=0.041),与停止治疗组相比降低了77%(HR:0.23,95% CI:0.10-0.49,ppp=0.006)。对于HBV DNA≥2,000 IU/mL的患者,与未治疗和停止治疗的患者相比,坚持治疗可将肝硬化风险分别降低92%(95% CI:0.01-0.67)和93%(95% CI:0.01-0.53)。坚持治疗的患者中没有人发展为HCC,但其余各组中均有一人发展为HCC:持续核苷酸类似物(NA)治疗效果令人满意,有助于降低丙氨酸转氨酶正常的HBeAg阴性CHB患者,尤其是HBV DNA≥2,000 IU/mL的患者发生肝硬化的风险。
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引用次数: 0
Expert Consensus on Pathological Diagnosis of Intrahepatic Cholangiocarcinoma (2022 version). 肝内胆管癌病理诊断专家共识(2022 年版)。
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-28 Epub Date: 2023-07-24 DOI: 10.14218/JCTH.2023.00118
Han Wang, Jun Chen, Xin Zhang, Xia Sheng, Xiao-Yan Chang, Jie Chen, Min-Shan Chen, Hui Dong, Guang-Jie Duan, He-Ping Hu, Zhi-Yong Huang, Wei-Dong Jia, Xiao-Qing Jiang, Dong Kuang, Shan-Shan Li, Zeng-Shan Li, Chang-Li Lu, Shu-Kui Qin, Xue-Shan Qiu, Li-Juan Qu, Chun-Kui Shao, Feng Shen, Guo-Ming Shi, Su-Sheng Shi, Yu-Jun Shi, Hui-Chuan Sun, Xiao-Dong Teng, Bin Wang, Zhan-Bo Wang, Tian-Fu Wen, Jia-Mei Yang, Qiao-Qiao Yang, Sheng-Long Ye, Hong-Fang Yin, Zhen-Gang Yuan, Jing-Ping Yun, Feng-Lin Zang, Hong-Qi Zhang, Li-Hong Zhang, Jing-Min Zhao, Jian Zhou, Wei-Xun Zhou, Jia Fan, Xiao-Ping Chen, Wan Yee Lau, Yuan Ji, Wen-Ming Cong

Intrahepatic cholangiocarcinoma (iCCA) can originate from the large bile duct group (segment bile ducts and area bile ducts), small bile duct group (septal bile ducts and interlobular bile ducts), and terminal bile duct group (bile ductules and canals of Hering) of the intrahepatic biliary tree, which can be histopathological corresponding to large duct type iCCA, small duct type iCCA and iCCA with ductal plate malformation pattern, and cholangiolocarcinoma, respectively. The challenge in pathological diagnosis of above subtypes of iCCA falls in the distinction of cellular morphologies, tissue structures, growth patterns, invasive behaviors, immunophenotypes, molecular mutations, and surgical prognoses. For these reasons, this expert consensus provides nine recommendations as a reference for standardizing and refining the diagnosis of pathological subtypes of iCCA, mainly based on the 5th edition of the World Health Organization Classification of Tumours of the Digestive System.

肝内胆管癌(iCCA)可起源于肝内胆管树的大胆管组(节段胆管和区域胆管)、小胆管组(隔段胆管和叶间胆管)和终末胆管组(胆管小泡和赫林管)、肝内胆管树的终末胆管组(胆总管和赫林管),组织病理学上可分别与大导管型 iCCA、小导管型 iCCA 和导管板畸形型 iCCA 以及胆管癌相对应。上述亚型 iCCA 病理诊断的难点在于细胞形态、组织结构、生长模式、侵袭行为、免疫表型、分子突变和手术预后的区分。因此,本专家共识提供了九项建议,作为规范和完善 iCCA 病理亚型诊断的参考,主要依据是世界卫生组织消化系统肿瘤分类的第五版。
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引用次数: 0
Differential Mortality Outcomes in Real-world Patients with Lean, Nonobese, and Obese Nonalcoholic Fatty Liver Disease. 现实世界中瘦型、非肥胖型和肥胖型非酒精性脂肪肝患者的不同死亡率结果。
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-28 Epub Date: 2023-11-27 DOI: 10.14218/JCTH.2023.00016
Vy H Nguyen, Audrey Ha, Nicholas Ajit Rouillard, Richard Hieu Le, Ashley Fong, Surya Gudapati, Jung Eun Park, Mayumi Maeda, Scott Barnett, Ramsey Cheung, Mindie H Nguyen

Background and aims: Nonalcoholic fatty liver disease (NAFLD) is commonly associated with obesity but can develop in normal-weight people (lean NAFLD). We compared outcomes in lean, overweight, and obese NAFLD.

Methods: This retrospective chart review included patients at Stanford University Medical Center with NAFLD confirmed by imaging between March 1995 and December 2021. Lean, overweight, and obese patients had body mass index of <25.0, >25.0 and <29.9, and ≥30.0 kg/m2 for non-Asian and >23.0 and ≥27.5 for overweight and obese Asian patients.

Results: A total of 9061 lean (10.2%), overweight (31.7%), and obese (58.1%) patients were included. Lean patients were 5 years older than obese patients (53±17.4 vs. 48.7±15.1 years), more were female (59.6% vs. 55.2%), white (49.1% vs. 46.5%), had NASH (29.2% vs. 22.5%), cirrhosis (25.3% vs.19.2%), or nonliver cancer (25.3% vs. 18.3%). Fewer had diabetes (21.7% vs. 35.8%) or metabolic comorbidities (all p<0.0001). Lean NAFLD patients had liver-related mortality similar to other groups but higher overall (p=0.01) and nonliver-related (p=0.02) mortality. After multivariable model adjustment for covariates, differences between lean and obese NAFLD in liver-related, nonliver-related, and overall mortality (adjusted hazard ratios of 1.34, 1.00, and 1.32; p=0.66, 0.99, and 0.20, respectively) were not significant.

Conclusions: Lean NAFLD had fewer metabolic comorbidities but similar adverse or worse outcomes, suggesting that it is not benign. Healthcare providers should provide the same level of care and intervention as for overweight and obese NAFLD.

背景和目的:非酒精性脂肪肝(NAFLD)通常与肥胖有关,但体重正常的人也可能患上非酒精性脂肪肝(瘦人非酒精性脂肪肝)。我们比较了瘦型、超重型和肥胖型非酒精性脂肪肝的治疗效果:这项回顾性病历审查包括 1995 年 3 月至 2021 年 12 月期间斯坦福大学医学中心经影像学证实患有非酒精性脂肪肝的患者。非亚洲人瘦弱、超重和肥胖患者的体重指数分别为25.0和2,亚洲人超重和肥胖患者的体重指数>23.0和≥27.5:共纳入 9061 名瘦弱(10.2%)、超重(31.7%)和肥胖(58.1%)患者。瘦患者比肥胖患者大 5 岁(53±17.4 岁对 48.7±15.1 岁),女性(59.6% 对 55.2%)、白人(49.1% 对 46.5%)、患有 NASH(29.2% 对 22.5%)、肝硬化(25.3% 对 19.2%)或非肝癌(25.3% 对 18.3%)的患者较多。糖尿病(21.7% 对 35.8%)或代谢合并症(所有 pp=0.01)和非肝脏相关(p=0.02)死亡率较低。在对协变量进行多变量模型调整后,瘦型和肥胖型非酒精性脂肪肝在肝脏相关、非肝脏相关和总死亡率方面的差异(调整后危险比分别为1.34、1.00和1.32;P=0.66、0.99和0.20)并不显著:瘦型非酒精性脂肪肝的代谢合并症较少,但不良结局或更差的结局相似,这表明非酒精性脂肪肝并非良性。医疗服务提供者应提供与超重和肥胖非酒精性脂肪肝相同水平的护理和干预。
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引用次数: 0
Focal Nodular Hyperplasia: A Comprehensive Review with a Particular Focus on Pathogenesis and Complications 局灶性结节性增生:全面综述,特别关注发病机制和并发症
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-21 DOI: 10.14218/jcth.2023.00265
Jaimy Villavicencio Kim, George Y. Wu
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引用次数: 0
Journal of Clinical and Translational Hepatology 10th Anniversary Editorial 临床与转化肝脏病学杂志》十周年社论
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-19 DOI: 10.14218/jcth.2023.00001
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引用次数: 0
Predictive Model of Oxaliplatin-induced Liver Injury Based on Artificial Neural Network and Logistic Regression 基于人工神经网络和逻辑回归的奥沙利铂诱发肝损伤预测模型
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-12-04 DOI: 10.14218/jcth.2023.00399
Rui Huang, Yuanxuan Cai, Yisheng He, Zao-qin Yu, Li Zhao, Tao Wang, Xiaofang Shangguan, Yuhang Zhao, Zherui Chen, Yunzhou Chen, Chengliang Zhang
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引用次数: 0
Causal Relationship Between Gut Microbiota and Liver Cirrhosis: 16S rRNA Sequencing and Mendelian Randomization Analyses 肠道微生物群与肝硬化的因果关系:16S rRNA 测序和孟德尔随机分析
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-11-30 DOI: 10.14218/jcth.2023.00259
Mengqin Yuan, Xue Hu, Lichao Yao, Ping Chen, Zheng Wang, Pingji Liu, Zhiyu Xiong, Yingan Jiang, Lanjuan Li
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引用次数: 0
Liver Lesions at Risk of Transformation into Hepatocellular Carcinoma in Cirrhotic Patients: Hepatobiliary Phase Hypointense Nodules without Arterial Phase Hyperenhancement 肝硬化患者有转化为肝细胞癌风险的肝脏病变:无动脉期强化的肝胆期高密度结节
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-11-29 DOI: 10.14218/jcth.2023.00130
N. Brandi, Matteo Renzulli
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引用次数: 0
Molecular Detection of FGFR2 Rearrangements in Resected Intrahepatic Cholangiocarcinomas: FISH Could Be An Ideal Method in Patients with Histological Small Duct Subtype. 肝内胆管癌中FGFR2重排的分子检测:FISH可能是组织学小导管亚型患者的理想方法。
IF 3.1 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2023-11-28 Epub Date: 2023-07-27 DOI: 10.14218/JCTH.2022.00060S
Yining Zou, Kun Zhu, Yanrui Pang, Jing Han, Xin Zhang, Zhengzeng Jiang, Yufeng Huang, Wenyi Gu, Yuan Ji

Background and aims: Intrahepatic cholangiocarcinoma (ICC) is a subtype of primary liver cancer for which effective therapeutic agents are lacking. Fibroblast growth factor receptor 2 (FGFR2) has become a promising therapeutic target in ICC; however, its incidence and optimum testing method have not been fully assessed. This study investigated the rearrangement of FGFR2 in intrahepatic cholangiocarcinoma using multiple molecular detection methods.

Methods: The samples and clinical data of 167 patients who underwent surgical resection of intrahepatic cholangiocarcinoma in Zhongshan hospital, Fudan university were collected. The presence of FGFR2 gene rearrangement was confirmed using fluorescence in situ hybridization (FISH) and targeted next-generation sequencing (NGS). FGFR2 protein expression was determined using immunohistochemistry (IHC). The concordance between the methods was statistically compared. PD-L1 expression was also assessed in this cohort. The clinicopathological characteristics and genomic profile related to FGFR2 rearrangements were also analyzed to assist candidate-screening for targeted therapies.

Results: FGFR2 rearrangement was detected in 21 of the 167 ICC cases (12.5%) using FISH. NGS analysis revealed that FGFR2 rearrangement was present in 16 of the 20 FISH-positive cases, which was consistent with the FISH results (kappa value=0.696, p<0.01). IHC showed that 80 of the 167 cases (48%) were positive for FGFR2 expression, which was discordant with both FISH and NGS results. By comparison, FGFR2-positivity tended to correlate with unique clinicopathological subgroups, featuring early clinical stage, histologically small duct subtype, and reduced mucus production (P<0.05), with improved overall survival (p<0.05). FGFR2-positivity was not associated with PD-L1 expression in ICCs. In genome research, we identified eight partner genes fused with FGFR2, among which FGFR2-BICC1 was the most common fusion type. BAP1, CDKN2A, and CDKN2B were the most common concomitant genetic alterations of FGFR2, whereas KRAS and IDH1 mutations were mutually exclusive to FGFR2 rearrangements.

Conclusions: FISH achieved satisfactory concordance with NGS, has potential value for FGFR2 screening for targeted therapies. FGFR2 detection should be prioritized for unique clinical subgroups in ICC, which features a histological small duct subtype, early clinical stage, and reduced mucus production.

背景与目的:肝内胆管癌(ICC)是原发性肝癌癌症的一种亚型,缺乏有效的治疗药物。成纤维细胞生长因子受体2(FGFR2)已成为ICC的一个有前景的治疗靶点;然而,其发生率和最佳检测方法尚未得到充分评估。本研究采用多种分子检测方法研究了肝内胆管癌中FGFR2的重排。方法:收集复旦大学中山医院167例肝内胆管癌手术切除患者的临床资料。使用荧光原位杂交(FISH)和靶向下一代测序(NGS)证实了FGFR2基因重排的存在。用免疫组织化学(IHC)测定FGFR2蛋白的表达。对两种方法之间的一致性进行了统计比较。PD-L1的表达也在该队列中进行了评估。还分析了与FGFR2重排相关的临床病理特征和基因组图谱,以帮助筛选靶向治疗的候选药物。结果:在167例ICC病例中,FISH检测到21例(12.5%)FGFR2重排。NGS分析显示,在20例FISH阳性病例中有16例存在FGFR2重排,与FISH结果一致(kappa值=0.696,pFGFR2表达,与FISH和NGS结果不一致。相比之下,FGFR2阳性倾向于与独特的临床病理亚组相关,其特征是早期临床阶段、组织学上小导管亚型和粘液产生减少(在ICCs中,PpFGFR2阳性与PD-L1表达无关。在基因组研究中,我们鉴定了8个与FGFR2融合的伴侣基因,其中FGFR2-BICC1是最常见的融合型。BAP1、CDKN2A和CDKN2B是FGFR2最常见的伴随遗传改变,而KRAS和IDH1突变对FGFR2重排是互斥的与NGS的工厂一致性对靶向治疗的FGFR2筛选具有潜在价值。FGFR2检测应优先用于ICC中独特的临床亚组,其特征是组织学小管亚型、早期临床阶段和粘液产生减少。
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引用次数: 0
期刊
Journal of Clinical and Translational Hepatology
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