中华肝脏病杂志最新文献

Tumor-associated macrophages (TAMs) are abundant immune cell content in the tumor microenvironment of hepatocellular carcinoma and are associated with tumor progression and therapeutic resistance. This article describes novel TAM subpopulations and potential targets in hepatocellular carcinoma that have been identified based on single-cell and spatial omics technologies. Additionally, it proposes TAMs' classification according to their functions into immunosuppressive, lipid-metabolizing, angiogenic, liver-resident, and immune-stimulating types and summarizes four major therapeutic strategies targeting TAMs, providing a reference for novel TAM-targeted therapies.

Neuroendocrine tumors are rare, low-grade malignant tumors with a gradually increasing incidence rate in recent years, with gastroenteropancreatic neuroendocrine tumors being the most common among them. The majority of gastropancreatic neuroendocrine tumors have already metastasized to the liver at the time of initial diagnosis; therefore, treatment targeting liver metastases is crucial. The most effective treatment for hepatic metastases of gastropancreatic neuroendocrine tumors is surgical resection. However, 60%-70% of patients are ineligible for radical resection due to diffuse liver involvement. Thus, an alternative treatment option offered for these patients is liver transplantation. Liver transplantation is considered an indication for well-differentiated, unresectable hepatic metastases of gastropancreatic neuroendocrine tumors because of the tumor's low invasiveness, slow growth, and the fact that the liver is often the only distant metastasis site. This article reviews the research progress of liver transplantation therapy for hepatic metastases in gastropancreatic neuroendocrine tumors.

Hepatic fibrosis is a common chronic liver disease, and its pathogenesis and influencing factors exhibit diverse characteristics. Pharmacological intervention is currently the main therapeutic approach for hepatic fibrosis. Quercetin is a flavonoid compound with multiple biological activities, which can inhibit inflammatory responses, reduce oxidative stress, suppress hepatic stellate cell activation and excessive collagen deposition, and regulate hepatic lipid metabolism, thus exerting anti-hepatic fibrosis effects. Quercetin delays the progression of fibrosis via regulating signaling pathways such as Rac1/NOX1 and transforming growth factor-β1/Smad, thereby diminishing the activity of hepatic stellate cells and their accumulation in the extracellular matrix. Quercetin can also enhance the activity of antioxidant enzymes (such as superoxide dismutase and glutathione peroxidase) and reduce the damage of oxidative free radicals to hepatocytes by regulating the nuclear factor E2-related factor 2/antioxidant response element signaling pathway. Furthermore, it can inhibit the activation of the Toll-like receptor 4/nuclear factor-κB pathway and reduce the expression of pro-inflammatory factors, thus alleviating the inflammatory response. Concurrently, quercetin plays an active role in terms of regulating liver lipid metabolism, reducing abnormal lipid accumulation, and lessening the burden on hepatocytes. The multi-target and multi-pathway functional properties of quercetin render it highly promising in alleviating the pathological progression of liver fibrosis. This article summarizes the signaling pathways and target roles of quercetin in the treatment of liver fibrosis, providing an important reference for clinical intervention strategies and novel drug research and development.

Objective: To reveal the role of dietary composition in the onset and prognosis of patients with liver cirrhosis by analyzing, exploring, and observing the correlational features between dietary composition and clinical indicators and mortality. Methods: A cirrhosis population was obtained from the National Health and Nutrition Examination survey from 2001 to 2018. Patients with cirrhosis (155 cases) were matched with healthy controls (615 cases) in accordance with a 1:4 ratio. Data on 37 food patterns, clinical indicators such as personal medical history and laboratory tests, and the status and cause of death of patients were obtained from the database. Univariate and logistic regression analyses were used to identify influencing factors. Kaplan-Meier survival curves were used to examine the impact of specific dietary intake on patient mortality. Results: Multivariate analysis revealed that patients with cirrhosis had higher daily alcohol consumption than healthy controls (OR=1.11, 95%CI: 1.03-1.19, P<0.01), while there was no statistically significant difference in food intake (P>0.05). Total starchy vegetable intake was lower in patients with cirrhosis than in controls (OR=0.38, 95%CI: 0.17-0.88, P=0.02) among the subgroup of patients with cirrhosis who drank alcohol. Total starchy vegetable intake was higher in patients with cirrhosis than in controls (OR=1.55, 95%CI: 1.01-2.38, P=0.04) among the subgroup of patients with cirrhosis who did not drink alcohol. Subgroup analysis by gender revealed that male patients with cirrhosis consumed less dark green vegetables (OR=0.24, 95%CI: 0.06-0.96, P=0.04), while female patients consumed more meat (OR=1.28, 95%CI: 1.05-1.54, P=0.01). Spearman analysis revealed no statistically significant correlation between any dietary composition and the aspartate aminotransferase-to-platelet ratio index and mortality. Conclusion: Excessive intake of starchy vegetables and meat and insufficient intake of dark green vegetables may be associated with the onset of cirrhosis in non-drinking female and male populations, respectively, suggesting the potential significance of dietary factors in the course of cirrhotic diseases.

Gadoxetate disodium (Gd-EOB-DTPA), as a hepatocyte-specific MRI contrast agent, plays a key role in the early-stage diagnosis, differential diagnosis, and treatment evaluation of liver diseases. Gd-EOB-DTPA-enhanced MRI has been recommended as a first-line imaging diagnostic method for the diagnosis of liver lesions by clinical guidelines in many countries and regions. However, there is currently a lack of standardized management consensus to guide the clinical practice of Gd-EOB-DTPA-enhanced MRI examinations. Therefore, there is an urgent need to establish a scientifically based, full-process management protocol to improve image quality and professional standards and ensure the effectiveness of examinations. The "Expert Consensus on Standardized Management of Gadoxetate Disodium-Enhanced MRI Examinations (version 2026)" integrates the latest evidence-based data and clinical experience to standardize the entire process-from contrast agent storage management, pre-examination assessment and preparation, and operational coordination during the examination to post-examination observation guidance. In addition, it aims to enhance the professional competence and emergency response level of radiology medical personnel, thereby improving patient compliance, diminishing the incidence rate of adverse events, and providing a scientific and reliable clinical practice basis for the standardized implementation and technical promotion of Gd-EOB-DTPA-enhanced MRI examination in clinical practice.

Liver nodules are one of the common and complex clinical conditions, with certain ones developing into malignant lesions, hence significantly affecting patient prognosis. The detection rate of liver nodules has significantly improved with advances in modern imaging technology; however, there is still a lack of unified guidance on their diagnosis, treatment, and management. The "Expert Consensus on the Diagnosis, Treatment, and Management of Liver Nodules (version 2026)" systematically summarizes and standardizes aspects of liver nodules, including definition, classification, screening, diagnosis, treatment, and follow-up, through multidisciplinary collaboration based on the latest domestic and international research findings and expert clinical experience. This article emphasizes the importance of multidimensional assessment for liver nodules, including quantity, size, liver imaging reports, classification in data management systems, and pathological type. The implementation of individualized screening in high-risk populations is recommended at least once every six months starting at age 40, while for those with liver cirrhosis, malignant liver nodules, or a family history of liver cancer, screening should begin at age 30. The diagnostic strategy integrates systematic medical history, physical examination, imaging, and the detection of multiple serum marker collections. The usage of scoring models such as aMAP, GALAD, and GAAD highlights the diagnostic value of liver pathology and advocates a multidisciplinary team approach for risk assessment. Treatment plans emphasize individualization and involve etiological treatment, surgical therapy, interventional therapy, radiotherapy and systemic therapy. The aim of this consensus is to standardize the diagnosis and treatment of liver nodules, enhance precision, implement graded management, enable early differentiation between benign and malignant liver nodules, and improve patient prognosis.