Journal of Digestive Diseases最新文献_第3页

The Diagnostic and Prognostic Utility of Transabdominal Ultrasound in Crohn's Disease: A Clinical Study 经腹超声在克罗恩病诊断和预后中的应用：一项临床研究

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2025-09-17 DOI: 10.1111/1751-2980.70009

Chen Xie, Xin Wang, Jie Gu, Xue Qin Pang, Qin Hua Xi, Lan Xiang Zhu, Jun Sun, Wei Chang Chen

Objectives

In this retrospective study we aimed to assess the diagnostic, monitoring, and prognostic utility of transabdominal ultrasound (TBUS) in patients with Crohn's disease in China and evaluate the utility of 16-week bowel wall thickness (BWT) reduction as a predictor of long-term outcomes.

Methods

Patients with CD, either newly or previously diagnosed, who received biologic therapy for the first time and underwent baseline TBUS and endoscopy between June 2022 and September 2023 were included, with follow-up TBUS performed at Weeks 16 and 52 after the initiation of biologic therapy; clinical, ultrasound, laboratory, and disease activity data were collected.

Results

Among the 60 patients, TBUS identified bowel wall thickening in 55 patients, with an average thickness of 7.36 ± 2.56 mm. The Limberg score of vascularization in the affected segments was ≥ 3 in 58.3% of the patients. Ascites, lymphadenopathy, and mesenteric fat hypertrophy were observed in 23.3%, 41.7%, and 41.7% of the patients, respectively. Significant correlations were found between baseline SES-CD or CDAI and BWT (r = 0.650 for SES-CD and 0.331 for CDAI) and the Limberg score (r = 0.538 for SES-CD and 0.387 for CDAI). The receiver operating characteristic (ROC) curve analysis revealed high diagnostic accuracy for BWT (area under the ROC curve [AUROC] 0.973) and the Limberg score (AUROC 0.927). Follow-up TBUS at Weeks 16 and 52 showed significant reductions in BWT and Limberg score. BWT reduction at Week 16 was significantly associated with CD clinical remission at Week 52 (p < 0.05).

Conclusion

TBUS, particularly BWT and Limberg score, may serve as a useful noninvasive tool for diagnosis, monitoring, and prognosis in CD.

目的：在这项回顾性研究中，我们旨在评估经腹超声（TBUS）在中国克罗恩病患者中的诊断、监测和预后价值，并评估16周肠壁厚度（BWT）减少作为长期预后预测指标的价值。方法：纳入在2022年6月至2023年9月期间首次接受生物治疗并接受基线TBUS和内窥镜检查的新诊断或先前诊断的CD患者，并在生物治疗开始后的第16周和第52周进行TBUS随访；收集临床、超声、实验室和疾病活动资料。结果：60例患者中TBUS检出肠壁增厚55例，平均厚度为7.36±2.56 mm。58.3%的患者患节段血管化的Limberg评分≥3分。腹水、淋巴结病变和肠系膜脂肪增生分别占23.3%、41.7%和41.7%。基线SES-CD或CDAI与BWT （SES-CD为0.650，CDAI为0.331）和Limberg评分（SES-CD为0.538，CDAI为0.387）之间存在显著相关性。受试者工作特征（ROC）曲线分析显示，BWT （ROC曲线下面积[AUROC] 0.973）和Limberg评分（AUROC] 0.927）具有较高的诊断准确率。第16周和第52周随访TBUS显示BWT和Limberg评分显著降低。结论：TBUS，特别是BWT和Limberg评分，可以作为一种有用的非侵入性工具，用于CD的诊断、监测和预后。

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引用次数: 0

Efficacy and Safety of Linaclotide as an Adjunct to Polyethylene Glycol in Bowel Preparation: A Meta-Analysis 利那克洛肽辅助聚乙二醇用于肠道准备的有效性和安全性：一项荟萃分析。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2025-09-16 DOI: 10.1111/1751-2980.70008

Muhammad Shahzil, Fariha Hasan, Ali Akram Qureshi, Zainab Jamil, Talha Kashif, Muhammad Saad Faisal, Taha Bin Arif, Ammad Javaid Chaudhary, Umer Farooq, Hassam Ali, John M. Levenick

Objectives

Linaclotide, a guanylyl cyclase-C agonist, may enhance efficacy and tolerability when combined with polyethylene glycol (PEG) for bowel preparation. This meta-analysis evaluated linaclotide plus PEG versus PEG alone for bowel preparation prior to colonoscopy.

Methods

Randomized controlled trials (RCTs) including adults undergoing colonoscopy that compared linaclotide plus PEG with PEG alone for bowel preparation were identified via database search up to March 2024. Statistical analysis was performed in RevMan Web using random-effects models.

Results

Eleven RCTs were analyzed. Adequate bowel preparation rate was comparable (risk ratio [RR] 1.01, 95% confidence interval [CI] 0.98–1.04; I² = 23%), as was cecal intubation rate (RR 1.01, 95% CI 1.00–1.01). Subgroup analyses showed that compared with 3-L PEG alone, 2-L PEG plus linaclotide was non-inferior, while 3-L PEG plus linaclotide was superior regarding bowel preparation adequacy (RR 1.11, 95% CI 1.01–1.23) and total Boston Bowel Preparation Scale (BBPS) score (mean difference 0.44, 95% CI 0.04–0.85). Right and left colon BBPS scores were also higher with linaclotide. Polyp detection rate improved significantly in the 3-L PEG plus linaclotide subgroup (RR 1.78, 95% CI 1.32–2.40), whereas adenoma detection rate and withdrawal time were comparable. Linaclotide reduced abdominal pain, bloating, nausea, and sleep disturbance, and increased willingness to repeat colonoscopy.

Conclusions

Linaclotide with PEG provides comparable overall bowel cleansing to PEG alone while reducing adverse events and improving patient acceptance. Importantly, 2-L PEG plus linaclotide was non-inferior compared with 3-L PEG, whereas 3-L PEG plus linaclotide showed superiority over 3-L PEG alone, supporting its use in low-volume bowel preparation strategies.

目的：利那氯肽是一种胍基环化酶- c激动剂，与聚乙二醇（PEG）联合用于肠道准备可提高疗效和耐受性。本荟萃分析评估了利那洛肽加聚乙二醇与单独聚乙二醇在结肠镜检查前肠道准备中的作用。方法：随机对照试验（rct）包括接受结肠镜检查的成年人，通过数据库检索确定利那洛肽加PEG与单独PEG用于肠道准备的比较，截至2024年3月。采用随机效应模型在RevMan Web中进行统计分析。结果：共分析了11项随机对照试验。充分的肠道准备率（风险比[RR] 1.01, 95%可信区间[CI] 0.98-1.04; I2 = 23%）和盲肠插管率（RR 1.01, 95% CI 1.00-1.01）具有可比性。亚组分析显示，与单独使用3-L PEG相比，2-L PEG加利那洛肽并不差，而3-L PEG加利那洛肽在肠准备充分性（RR 1.11, 95% CI 1.01-1.23）和波士顿肠准备量表（BBPS）总评分（平均差异0.44,95% CI 0.04-0.85）方面优于3-L PEG加利那洛肽。利那洛肽组的左、右结肠BBPS评分也较高。3-L聚乙二醇加利那洛肽组息肉检出率显著提高（RR 1.78, 95% CI 1.32-2.40），而腺瘤检出率和停药时间相当。利那氯肽减轻了腹痛、腹胀、恶心和睡眠障碍，并增加了重复结肠镜检查的意愿。结论：与单独使用聚乙二醇相比，利那洛肽联合使用聚乙二醇可提供相当的整体肠道清洁，同时减少不良事件并提高患者接受度。重要的是，与3-L PEG相比，2-L PEG加利那洛肽并不差，而3-L PEG加利那洛肽比单独使用3-L PEG优越，支持其在小容量肠准备策略中的应用。

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引用次数: 0

Dynamic Relevance Between Reflux Events and Esophageal Motility in Patients With Proton Pump Inhibitor-Refractory Gastroesophageal Reflux Disease 质子泵抑制剂难治性胃食管反流病患者反流事件与食管运动的动态相关性

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2025-09-01 DOI: 10.1111/1751-2980.70007

Si Hui Lin, Zhi Feng Wang, Hua Li, Xiao Hong Sun, Xiao Qing Li, Gui Jun Fei, Wei Guang Chen, Tao Guo, Mei Yun Ke, Xiu Cai Fang

Objectives

The association between reflux events and esophageal motility abnormality is unclear. We aimed to determine the relevance between reflux events and esophageal motility in proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD).

Methods

Patients with PPI-refractory or PPI-responsive GERD were enrolled. Ambulatory 24-h esophageal pH–impedance–pressure monitoring was performed. Reflux symptoms, reflux events, and esophageal motility during acid reflux episodes were recorded and compared between the two groups.

Results

Sixty patients with PPI-refractory GERD and 18 with PPI-responsive GERD were included, all of whom had pathological gastroesophageal reflux. There were no significant differences in the major acid reflux parameters (DeMeester score and proportion of patients with acid exposure time > 6%) between the two groups. However, the number of long acid reflux episodes and the time length of the longest reflux episodes were significantly higher in the PPI-refractory GERD group than in the PPI-responsive GERD group (both p < 0.05). Moreover, patients with PPI-refractory GERD had higher rates of ineffective primary (62.0% vs. 36.0%, p < 0.001) and secondary peristalsis (83.5% vs. 57.0%, p = 0.001) during long acid exposure (LAE) than those with PPI-responsive GERD. Patients with PPI-refractory GERD having LAE had a significantly lower frequency of primary and secondary peristalsis per minute and required a longer time to initiate secondary peristalsis than those without during their longest acid reflux period in the upright position (all p < 0.001).

Conclusion

Longer acid reflux episodes in patients with PPI-refractory GERD might result from frequent ineffective primary esophageal peristalsis and delayed initiation of effective secondary peristalsis.

目的：反流事件与食管运动异常之间的关系尚不清楚。我们旨在确定质子泵抑制剂（PPI）难治性胃食管反流病（GERD）中反流事件与食管运动之间的相关性。方法：纳入ppi难治性或ppi反应性胃食管反流患者。进行24小时食管ph -阻抗-压力动态监测。记录反流症状、反流事件和胃酸反流发作时的食管运动，并对两组进行比较。结果：纳入60例ppi难治性胃食管反流患者和18例ppi反应性胃食管反流患者，均为病理性胃食管反流。两组患者的主要胃酸反流参数（DeMeester评分和酸暴露时间患者比例bbb6%）无显著差异。然而，ppi难治性GERD组胃酸反流的长时间发作次数和最长反流发作时间明显高于ppi反应性GERD组(均为p结论：ppi难治性GERD患者胃酸反流发作时间较长可能是由于频繁的原发性食管蠕动无效和有效的继发性蠕动延迟开始所致。

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引用次数: 0

Chinese Consensus on Clinical Diagnosis and Management of Covert Hepatic Encephalopathy 中国隐蔽性肝性脑病临床诊断与治疗共识。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2025-09-01 DOI: 10.1111/1751-2980.70005

Chinese Society of Gastroenterology, Chinese Medical Association

Covert hepatic encephalopathy (CHE) is one of the important entities of hepatic encephalopathy (HE). In contrast to those with overt hepatic encephalopathy (OHE), patients with CHE have no readily identifiable clinical symptoms and signs, such as disorientation and asterixis, but present with neurocognitive abnormalities detected by neuropsychological and/or neurophysiological tests. Some patients may experience mild cognitive impairment, euphoria, or anxiety, and decreased attention and calculation abilities. CHE is not only prone to OHE development, but also has harmful impacts on fitness to drive and fine operation ability, impairs health-related quality of life, and increases the risk of accidental injury, thereby resulting in worse financial status and a heavy burden to both the family and society as well as reducing the survival of cirrhotic patients. To further improve the understanding of CHE and standardize its clinical diagnosis and management, the Chinese Society of Gastroenterology, Chinese Medical Association organized experts to establish a consensus based on the updated relevant guidelines, expert consensus, research advance in the diagnosis and management of the disease, and clinical practice in China. This consensus contains 19 statements on the definition, epidemiology, etiology, precipitating factors, pathogenesis, clinical manifestations, diagnosis, treatment, prognosis, and chronic disease management of CHE. This consensus may provide the best available evidence to guide clinical practice in the diagnosis and management of patients with CHE.

隐匿性肝性脑病（CHE）是肝性脑病（HE）的重要形式之一。与显性肝性脑病（OHE）患者相比，CHE患者没有容易识别的临床症状和体征，如定向障碍和星形移位，但存在神经心理学和/或神经生理学检查检测到的神经认知异常。一些患者可能会出现轻度认知障碍、欣快感或焦虑，注意力和计算能力下降。CHE不仅容易发生OHE的发展，还会对驾驶能力和精细操作能力产生不利影响，损害健康相关生活质量，增加意外伤害的风险，使肝硬化患者的经济状况恶化，给家庭和社会带来沉重负担，降低患者的生存率。为了进一步提高对CHE的认识，规范其临床诊断和管理，中国消化学会、中华医学会组织专家根据最新的相关指南、专家共识、疾病诊断和管理的研究进展以及中国的临床实践，建立了共识。该共识包含19项关于CHE的定义、流行病学、病因学、诱发因素、发病机制、临床表现、诊断、治疗、预后和慢性疾病管理的声明。这一共识可能为指导CHE患者的诊断和管理的临床实践提供最好的证据。

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引用次数: 0

Chinese Expert Consensus on Standardized Surgical Management of Gastrointestinal Stromal Tumors (2025 Edition) 中国胃肠间质瘤规范化手术治疗专家共识（2025年版）。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2025-08-27 DOI: 10.1111/1751-2980.70003

Expert Working Group on Diagnosis and Treatment of Gastrointestinal Stromal Tumors, Chinese College of Surgeons, Chinese Medical Doctor Association

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal (GI) tract and has been regarded as one of the most successful models of targeted therapy in solid tumors to date. In recent years, a deeper understanding of GIST biology, coupled with innovations in molecular pathology, imaging studies, endoscopic and minimally invasive techniques, as well as the development of targeted medications, has led to the evolution of the treatment paradigm into a multidisciplinary approach centered around surgery, which involves pathology, gastroenterology (including endoscopy), oncology, radiology, and interventional radiology, etc. Among all these modalities, surgical resection remains the primary and most effective treatment modality. Surgeons are expected to play a leading role in the comprehensive management of patients with GISTs. Recently, the Expert Working Group on Diagnosis and Treatment of Gastrointestinal Stromal Tumors under the Chinese College of Surgeons, Chinese Medical Doctor Association has released the Chinese Expert Consensus on Standardized Surgical Management of Gastrointestinal Stromal Tumors (2025 Edition), integrating the latest evidence and clinical insights to provide authoritative guidance for the surgical treatment of GISTs in clinical practice.

胃肠道间质瘤（GIST）是最常见的胃肠道间质肿瘤，被认为是迄今为止实体瘤靶向治疗最成功的模式之一。近年来，随着对GIST生物学认识的深入，加上分子病理学、影像学研究、内镜和微创技术的创新，以及靶向药物的发展，使得GIST的治疗模式演变为以外科为中心的多学科治疗模式，涉及病理学、胃肠病学（包括内镜）、肿瘤学、放射学和介入放射学等。在所有这些方式中，手术切除仍然是主要和最有效的治疗方式。外科医生有望在胃肠道间质瘤患者的综合管理中发挥主导作用。近日，中华医师协会中华外科医师学会胃肠道间质瘤诊疗专家工作组发布了《中国胃肠间质瘤手术规范化管理专家共识（2025年版）》，整合最新证据和临床见解，为临床对胃肠道间质瘤的手术治疗提供权威指导。

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引用次数: 0

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2025-08-19 DOI: 10.1111/1751-2980.70006

Han Tao Yang, Qing Jing Zhao, Shu Wen Han, Hui Chao Wu

This case report highlights a rare presentation of IgG4-related autoimmune pancreatitis with honeycomb-like cystic lesions in the pancreatic parenchyma. It discusses differential diagnoses such as VHL syndrome, emphasizing the need for clinical evaluation and corticosteroid responsiveness, which may offer insights for clinicians when managing such cases.

本病例报告强调了一个罕见的igg4相关的自身免疫性胰腺炎，胰腺实质有蜂窝状囊性病变。它讨论了鉴别诊断，如VHL综合征，强调临床评估和皮质类固醇反应的必要性，这可能为临床医生在处理此类病例时提供见解。

引用次数: 0

Declining Bowel Surgery Rates and Predictors for Surgery of Crohn's Disease: A Prospective Inception Cohort in Eastern China 下降的肠手术率和克罗恩病手术的预测因素：中国东部地区的前瞻性队列研究

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2025-08-19 DOI: 10.1111/1751-2980.70002

Wen Hu, Shu Yan Li, Jin Jin Luo, Jiao Jiao Xin, Dong Yan Shi, Jing Jiang, Ze Xin Chen, Yue Yu, Xiu Jun Liao, Ke Ren Shen, Jia Kai Luo, Ze Lin Yan, Qiu Zhi Wang, Shi Yuan Lu, Ding Ting Xu, Qiao Yu, Han Yun Zhang, Xiao Ying Wang, Jun Li, Yan Chen

Objective

To investigate the rate of Crohn's disease (CD)-related bowel surgery within an inception cohort in Eastern China in the era of evolving diagnostic and therapeutic expertise.

Methods

A single-center, prospective cohort study was conducted from July 2019 to June 2022 in China. Patients with newly diagnosed CD were followed annually. Risk factors of bowel surgery for complications such as obstruction, fistula, perforation, and bleeding were evaluated.

Results

The cohort consisted of 438 patients with newly diagnosed CD, with a male predominance (73.5%) and a median age of 28 years. Of these, 68 patients underwent bowel surgery, with the 1-, 2-, and 3-year cumulative surgery rates being 11.8%, 14.3%, and 15.4%. Multivariate analysis identified patient enrollment in the third year (adjusted hazard ratio [aHR] 0.45, 95% confidence interval [CI] 0.21–0.99), smoking (aHR 3.57, 95% CI 1.70–7.47), stricturing (aHR 31.38, 95% CI 10.93–90.07) or penetrating behavior (aHR 39.83, 95% CI 13.16–120.58), and hypoalbuminemia (aHR 1.95, 95% CI 1.12–3.38) as independent predictors. Patients enrolled in 2019–2020, 2020–2021, and 2021–2022 had 1-year surgery rates of 18.4%, 14.2%, and 5.3%, respectively. Significant differences were observed among the three cohorts in age at diagnosis, onset symptoms, disease location, and behavior.

Conclusions

Disease behavior, year of enrollment, smoking, and hypoalbuminemia were independent factors related to bowel surgery in CD. First-year bowel surgery rate and age at diagnosis decreased over the 3 years, while the proportions of patients with onset perianal symptoms, inflammatory behavior, and perianal disease increased.

目的：在诊断和治疗技术不断发展的时代，调查中国东部地区克罗恩病（CD）相关肠道手术的发生率。方法：2019年7月至2022年6月在中国进行单中心前瞻性队列研究。每年对新诊断的乳糜泻患者进行随访。评估肠手术并发症的危险因素，如梗阻、瘘、穿孔和出血。结果：该队列包括438例新诊断的CD患者，男性占主导地位（73.5%），中位年龄为28岁。其中，68例患者接受了肠道手术，1年、2年和3年累计手术率分别为11.8%、14.3%和15.4%。多因素分析确定第三年患者入组（校正风险比[aHR] 0.45, 95%可信区间[CI] 0.21-0.99）、吸烟（aHR 3.57, 95% CI 1.70-7.47）、狭窄（aHR 31.38, 95% CI 10.93-90.07）或穿透行为（aHR 39.83, 95% CI 13.16-120.58）和低白蛋白血症（aHR 1.95, 95% CI 1.12-3.38）为独立预测因素。2019-2020年、2020-2021年和2021-2022年入组的患者1年手术率分别为18.4%、14.2%和5.3%。三个队列在诊断年龄、发病症状、疾病部位和行为方面观察到显著差异。结论：疾病行为、入组年份、吸烟和低白蛋白血症是与CD患者肠手术相关的独立因素。3年来，第一年肠手术率和诊断年龄下降，而发病肛周症状、炎症行为和肛周疾病的患者比例增加。

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引用次数: 0

Tegoprazan as First- and Second-Line Therapy for Eradication of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis 替戈拉赞作为根除幽门螺杆菌感染的一线和二线治疗：系统回顾和荟萃分析。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2025-08-18 DOI: 10.1111/1751-2980.70004

Sujata Purja, Yousong Lee, Eunyoung Kim

Objective

To evaluate the efficacy and safety of tegoprazan (TPZ) compared to conventional proton pump inhibitors (PPIs) for Helicobacter pylori eradication as first- and second-line therapies.

Methods

Four databases were searched for randomized controlled trials (RCTs) and retrospective studies comparing TPZ- and PPI-based regimens for H. pylori eradication published until October 15, 2024. A random-effects model was used to calculate pooled odds ratio (OR) and 95% confidence interval (CI) based on intention-to-treat and per-protocol analyses. The PROSPERO registration number of the study is CRD42024622705.

Results

Nine studies (three RCTs and six retrospective studies) involving 5228 treatment-naïve patients were included. TPZ was non-inferior to PPIs as a first-line therapy (intention-to-treat: odds ratio [OR] 1.066, 95% confidence interval [CI] 0.929–1.224; per-protocol: OR 1.142, 95% CI: 0.967–1.349). Subgroup analyses showed no significant differences based on study design, therapeutic regimen, or treatment duration. In patients with clarithromycin-resistant strains confirmed by 23S rRNA sequencing, TPZ achieved a higher eradication rate (OR 4.961, 95% CI 1.024–24.030). TPZ was associated with significantly lower odds of abdominal discomfort compared to PPIs (OR 0.490, 95% CI 0.268–0.897). Regarding treatment duration, a 14-day regimen was linked to a lower risk of diarrhea, while a 7-day regimen was associated with a higher risk of abdominal pain. No significant differences were observed in second-line therapeutic outcomes.

Conclusions

TPZ represents a non-inferior alternative to PPIs for H. pylori eradication, with potential benefits in clarithromycin-resistant infections and favorable safety profiles. Future studies are warranted to assess higher dosages and address pharmacokinetic limitations.

目的：评价替戈拉赞（TPZ）与常规质子泵抑制剂（PPIs）作为一线和二线治疗幽门螺杆菌的疗效和安全性。方法：检索四个数据库，检索截至2024年10月15日发表的比较TPZ和ppi根除幽门螺杆菌方案的随机对照试验（rct）和回顾性研究。采用随机效应模型计算基于意向治疗和方案分析的合并优势比（OR）和95%置信区间（CI）。本次研究的PROSPERO注册号为CRD42024622705。结果：纳入9项研究（3项随机对照试验和6项回顾性研究），涉及5228例treatment-naïve患者。TPZ作为一线治疗不低于PPIs（意向治疗：优势比[OR] 1.066, 95%可信区间[CI] 0.929-1.224；方案：OR: 1.142, 95% CI: 0.967-1.349）。亚组分析显示，基于研究设计、治疗方案或治疗持续时间，无显著差异。在经23S rRNA测序证实的克拉霉素耐药菌株患者中，TPZ的根除率更高（OR 4.961, 95% CI 1.024-24.030）。与ppi相比，TPZ与腹部不适的发生率显著降低（OR 0.490, 95% CI 0.268-0.897）。关于治疗时间，14天的治疗方案与腹泻的风险较低有关，而7天的治疗方案与腹痛的风险较高有关。二线治疗结果无显著差异。结论：TPZ是PPIs根除幽门螺杆菌的一种非劣选择，对克拉霉素耐药感染有潜在的益处，并且具有良好的安全性。未来的研究需要评估更高的剂量和解决药代动力学限制。

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引用次数: 0

CXCL13 as a Prognostic Biomarker and Modulator of the Tumor Microenvironment in Colorectal Cancer CXCL13作为结直肠癌预后生物标志物和肿瘤微环境调节剂

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2025-08-13 DOI: 10.1111/1751-2980.70001

Fang Fang Guo, Yu Qing Yan, Wei Wei Chen, Yao Cheng, Rui Zhang, Chao Qin Shen, Yun Cui, Yan Shen Peng, Hao Yan Chen, Lin Hua Ji, Bao Qin Xuan, Xiao Qiang Zhu

Objectives

Immunotherapy yields limited results in patients with colorectal cancer (CRC), emphasizing the need for a deeper understanding of the immune landscape within the tumor microenvironment. Although the C-X-C motif chemokine ligand 13 (CXCL13) recruits B cells and promotes tertiary lymphoid structure (TLS) formation, its immune function and prognostic value in CRC remain unclear. This study investigated the impact of CXCL13 on patient outcomes and CRC immune landscape.

Methods

Four independent cohorts were recruited in this study. The Cancer Genome Atlas Program (TCGA) cohort evaluated survival differences as well as immune contexture associated with CXCL13 expression in CRC. Immunohistochemistry (IHC) in the Renji Hospital (RJ) cohort was used to validate CXCL13 and CD8 levels, while multiplex IHC assessed their spatial correlation. Two single-cell RNA sequencing (scRNA-seq) cohorts were used for evaluating the potential roles of CXCL13 and CXCL13⁺CD8⁺T cells in the immune context of CRC.

Results

Our study revealed a positive correlation between CXCL13 expression and improved survival among CRC patients. Elevated CXCL13 levels and CXCL13⁺CD8⁺T cells were linked to a favorable immune context that impeded tumor growth in CRC. Moreover, CXCL13 expression was more prevalent in microsatellite instability-high (MSI-H)/mismatch repair-deficient (MMRd) tumors, demonstrating its potential role in enhancing the response to anti-programmed death-1 ligand (PD-L1) treatment.

Conclusions

CXCL13 plays a critical role in shaping a favorable immune tumor microenvironment in CRC. Further research should elucidate how CXCL13 modulates CD8⁺T cell function to improve antitumor immunity.

目的：免疫治疗在结直肠癌（CRC）患者中的效果有限，强调需要更深入地了解肿瘤微环境中的免疫景观。虽然C-X-C基序趋化因子配体13 （CXCL13）募集B细胞并促进三级淋巴结构（TLS）的形成，但其在结直肠癌中的免疫功能和预后价值尚不清楚。本研究探讨了CXCL13对患者预后和CRC免疫景观的影响。方法：本研究招募了4个独立的队列。癌症基因组图谱计划（TCGA）队列评估了CRC中与CXCL13表达相关的生存差异以及免疫环境。利用仁济医院（RJ）队列的免疫组化（IHC）验证CXCL13和CD8水平，而多重免疫组化（IHC）评估它们的空间相关性。两个单细胞RNA测序（scRNA-seq）队列用于评估CXCL13和CXCL13+CD8+T细胞在CRC免疫背景下的潜在作用。结果：我们的研究揭示了CXCL13的表达与CRC患者生存率的提高呈正相关。升高的CXCL13水平和CXCL13+CD8+T细胞与抑制结直肠癌肿瘤生长的有利免疫环境有关。此外，CXCL13的表达在微卫星不稳定性高(MSI-H)/错配修复缺陷（MMRd）肿瘤中更为普遍，表明其在增强抗程序性死亡-1配体（PD-L1）治疗的应答中具有潜在作用。结论：在结直肠癌中，CXCL13在形成良好的肿瘤免疫微环境中起关键作用。进一步的研究应阐明CXCL13如何调节CD8+T细胞功能以提高抗肿瘤免疫。

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引用次数: 0

Recurrent Liver Dysfunction in Erythropoietic Protoporphyria: A Case With Compound Heterozygous FECH Mutations 红细胞生成性原卟啉症复发性肝功能障碍：复合杂合FECH突变1例。

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of Digestive Diseases

Pub Date : 2025-08-06 DOI: 10.1111/1751-2980.70000

Ya Jun Zhang, Shao Ping Huang, Zhi Yin Shang, Min Liu, Chuan Tao Tu

引用次数: 0