Pub Date : 2025-12-01DOI: 10.1016/j.hbpd.2025.09.006
Chang-Yi Ji , Meng-Meng Gu , Lan Huang , Jian Wu , Hong-Tao Wang
Background
Hepatitis E virus (HEV) may induce acute self-limiting illnesses or persistent infections. Chronic hepatitis E frequently occurs in immunocompromised persons, including organ transplant recipients, HIV-positive patients, and those with hematological malignancies. It poses a risk of liver fibrosis and cirrhosis.
Data sources
Relevant articles published till September 2024 were located using PubMed searches. The further search terms utilized were: “immunocompromised”, “solid organ transplant”, “HIV”, “hematological malignancy”, and “hepatitis E virus”. A manual search of references from pivotal articles extended further publications. The search parameters encompass publications in English.
Results
The epidemiology, clinical manifestations, diagnostic measures, and therapeutic modalities of chronic hepatitis E were discussed. Immunocompromised individuals who are infected with HEV are at an increased risk of developing chronic infections, which may progress to liver fibrosis and cirrhosis. Current understanding of HEV is still limited, and there is no medicine that specifically targets hepatitis E. Consequently, the prevention and management of hepatitis E continue to present a significant challenge.
Conclusions
Chronic hepatitis E patients need special attention in clinical practice. The relevant risk factors must be identified to facilitate accurate diagnosis and the implementation of more effective preventive measures, thereby enhancing the monitoring, treatment, and prevention of immunocompromised individuals.
{"title":"Chronic hepatitis E: The neglected liver killer","authors":"Chang-Yi Ji , Meng-Meng Gu , Lan Huang , Jian Wu , Hong-Tao Wang","doi":"10.1016/j.hbpd.2025.09.006","DOIUrl":"10.1016/j.hbpd.2025.09.006","url":null,"abstract":"<div><h3>Background</h3><div>Hepatitis E virus (HEV) may induce acute self-limiting illnesses or persistent infections. Chronic hepatitis E frequently occurs in immunocompromised persons, including organ transplant recipients, HIV-positive patients, and those with hematological malignancies. It poses a risk of liver fibrosis and cirrhosis.</div></div><div><h3>Data sources</h3><div>Relevant articles published till September 2024 were located using PubMed searches. The further search terms utilized were: “immunocompromised”, “solid organ transplant”, “HIV”, “hematological malignancy”, and “hepatitis E virus”. A manual search of references from pivotal articles extended further publications. The search parameters encompass publications in English.</div></div><div><h3>Results</h3><div>The epidemiology, clinical manifestations, diagnostic measures, and therapeutic modalities of chronic hepatitis E were discussed. Immunocompromised individuals who are infected with HEV are at an increased risk of developing chronic infections, which may progress to liver fibrosis and cirrhosis. Current understanding of HEV is still limited, and there is no medicine that specifically targets hepatitis E. Consequently, the prevention and management of hepatitis E continue to present a significant challenge.</div></div><div><h3>Conclusions</h3><div>Chronic hepatitis E patients need special attention in clinical practice. The relevant risk factors must be identified to facilitate accurate diagnosis and the implementation of more effective preventive measures, thereby enhancing the monitoring, treatment, and prevention of immunocompromised individuals.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 607-615"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.hbpd.2025.09.011
Ren Lang , Shao-Cheng Lyu , Tong Zhang , Di Lu , Zhao-Xu Yang , Jin-Zhen Cai , Zheng Chen , Ying Cheng , Jian Dou , Guo-Sheng Du , Hua Fan , Zhi-Ren Fu , Jie Gao , Wei Gao , Jian-Ping Gong , Wen-Zhi Guo , Ya-Xun Huang , Jian-Tao Kou , Qi-Yong Li , Xian-Liang Li , Qiang He
{"title":"Guideline on application of allogeneic vascular transplantation in abdominal surgery","authors":"Ren Lang , Shao-Cheng Lyu , Tong Zhang , Di Lu , Zhao-Xu Yang , Jin-Zhen Cai , Zheng Chen , Ying Cheng , Jian Dou , Guo-Sheng Du , Hua Fan , Zhi-Ren Fu , Jie Gao , Wei Gao , Jian-Ping Gong , Wen-Zhi Guo , Ya-Xun Huang , Jian-Tao Kou , Qi-Yong Li , Xian-Liang Li , Qiang He","doi":"10.1016/j.hbpd.2025.09.011","DOIUrl":"10.1016/j.hbpd.2025.09.011","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 591-597"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.hbpd.2025.04.005
Tian-Liang Song , Fan Zhang , Chong Zhang , Hui-Juan Cheng , Ewetse Paul Maswikiti , Cheng-Yang Ji , Hao Chen , Fu-Tian Tang , Wen-Zhi Guo , Wen-Long Zhai , Yu-Min Li
Background
Pancreatic ductal adenocarcinoma (PDAC) is a highly malignant tumor. Surgical resection is the most promising therapeutic strategy for PDAC, and how to improve the survival rate remains a vital key point. This study aimed to establish and validate a nomogram for predicting the prognosis of resected PDAC.
Methods
A total of 174 patients with PDAC who underwent surgical resection at Lanzhou University Second Hospital and the First Affiliated Hospital of Zhengzhou University from January 2012 to July 2022 were enrolled. The clinicopathological characteristics and survival data were analyzed by R software (version 4.1.3). Univariate and multivariate Cox regression analyses were used to analyze the effects of clinicopathological characteristics on overall survival (OS).
Results
Multivariate Cox regression showed that carbohydrate antigen 19-9 (CA19-9) ≥ 476 U/mL, carbohydrate antigen 125 (CA125) ≥ 32 U/mL, fasting blood glucose (FBG) < 6.86 mmol/L, aspartate aminotransferase (AST) ≥ 107 U/L, positive surgical margin, and more than 4 cycles of postoperative chemotherapy were independent prognostic factors for OS. Patients were divided into the high-risk and low-risk groups based on the median risk score calculated by multivariate Cox regression analysis. Kaplan-Meier survival curves revealed that the 5-year survival rates of the high-risk and low-risk groups in the training cohort were 5.8% and 24.3%, respectively, and those in the validation cohort were 0 and 19.0%, respectively (P < 0.05). Receiver operating characteristic (ROC) curve analysis revealed that area under the ROC curve (AUC) of the risk score in the training set and the validation set were 0.855 and 0.838, respectively. The C-indexes of the nomogram in the training set and validation set were 0.788 (95% CI: 0.745-0.831) and 0.773 (95% CI: 0.718-0.828), respectively.
Conclusions
We developed a nomogram that predicts OS in patients with resected PDAC, and the validation results showed that the nomogram model had a strong predictive ability. Particularly, FBG < 6.86 mmol/L and more than 4 cycles of postoperative chemotherapy can predict better OS of PDAC after surgery.
{"title":"Development and validation of a nomogram for a prognostic model for resected pancreatic ductal adenocarcinoma","authors":"Tian-Liang Song , Fan Zhang , Chong Zhang , Hui-Juan Cheng , Ewetse Paul Maswikiti , Cheng-Yang Ji , Hao Chen , Fu-Tian Tang , Wen-Zhi Guo , Wen-Long Zhai , Yu-Min Li","doi":"10.1016/j.hbpd.2025.04.005","DOIUrl":"10.1016/j.hbpd.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>Pancreatic ductal adenocarcinoma<span> (PDAC) is a highly malignant tumor. Surgical resection is the most promising therapeutic strategy for PDAC, and how to improve the survival rate remains a vital key point. This study aimed to establish and validate a nomogram for predicting the prognosis of resected PDAC.</span></div></div><div><h3>Methods</h3><div><span>A total of 174 patients with PDAC who underwent surgical resection at Lanzhou University Second Hospital and the First Affiliated Hospital of Zhengzhou University from January 2012 to July 2022 were enrolled. The clinicopathological characteristics and survival data were analyzed by R software (version 4.1.3). Univariate and multivariate Cox regression analyses were used to analyze the effects of clinicopathological characteristics on </span>overall survival (OS).</div></div><div><h3>Results</h3><div><span>Multivariate Cox regression showed that carbohydrate antigen<span><span><span> 19-9 (CA19-9) ≥ 476 U/mL, carbohydrate antigen 125 (CA125) ≥ 32 U/mL, fasting </span>blood glucose<span> (FBG) < 6.86 mmol/L, aspartate aminotransferase (AST) ≥ 107 U/L, positive surgical margin, and more than 4 cycles of postoperative chemotherapy were independent </span></span>prognostic factors for OS. Patients were divided into the high-risk and low-risk groups based on the median risk score calculated by multivariate Cox regression analysis. Kaplan-Meier survival curves revealed that the 5-year survival rates of the high-risk and low-risk groups in the training cohort were 5.8% and 24.3%, respectively, and those in the validation cohort were 0 and 19.0%, respectively (</span></span><em>P</em> < 0.05). Receiver operating characteristic (ROC) curve analysis revealed that area under the ROC curve (AUC) of the risk score in the training set and the validation set were 0.855 and 0.838, respectively. The C-indexes of the nomogram in the training set and validation set were 0.788 (95% CI: 0.745-0.831) and 0.773 (95% CI: 0.718-0.828), respectively.</div></div><div><h3>Conclusions</h3><div>We developed a nomogram that predicts OS in patients with resected PDAC, and the validation results showed that the nomogram model had a strong predictive ability. Particularly, FBG < 6.86 mmol/L and more than 4 cycles of postoperative chemotherapy can predict better OS of PDAC after surgery.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 676-683"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.hbpd.2025.05.001
Xiang-Yi Sun , Bo Yu , Jia Yu , Yuan-Pei Wang , Xian-Bin Li , Ran-Ran Sun , Xin Tian , Quan-Cheng Kan
Background
Intrahepatic cholangiocarcinoma (ICC) is the second most frequent primary liver cancer. The involvement of Y-box binding protein 1 (YBX1) in tumor advancement is well-documented. However, its function in ICC is not fully understood. This study aimed to explore the function and regulatory mechanism of YBX1 in ICC and provide evidence for YBX1 as a potential new approach for immunotherapy in ICC.
Methods
Tissue immunohistochemistry, TCGA, and GEO databases were used to analyze the expression of YBX1 in ICC. The expression of YBX1 was silenced and overexpressed in cell lines. Both in vitro and in vivo assays were conducted to examine the antitumor T-cell responses. Actinomycin D, RNA immunoprecipitation, and methylated RNA immunoprecipitation assays were used to identify mechanism of YBX1 on downstream genes. Immunofluorescence assay was used to validate the association between YBX1 and relevant genes in clinical specimens of ICC.
Results
The research findings indicated that ICC exhibited high levels of YBX1 expression, which was strongly associated with unfavorable outcomes. YBX1 promoted tumor progression by suppressing antitumor T-cell responses. YBX1 enhanced signal transducer and activator of transcription 1 (STAT1) translation by serving as a 5-methylated cytosine (m5C) reader and activating the STAT1/PD-L1 pathway. Mouse experiments and clinical samples of ICC confirmed the strong correlation between the levels of YBX1, STAT1, and PD-L1 expression.
Conclusions
YBX1 regulates STAT1 stability in an m5C dependent manner and maintains PD-L1 expression in ICC.
{"title":"YBX1 is required for maintaining PD-L1 expression in intrahepatic cholangiocarcinoma by regulating STAT1 stability in an m5C-dependent manner","authors":"Xiang-Yi Sun , Bo Yu , Jia Yu , Yuan-Pei Wang , Xian-Bin Li , Ran-Ran Sun , Xin Tian , Quan-Cheng Kan","doi":"10.1016/j.hbpd.2025.05.001","DOIUrl":"10.1016/j.hbpd.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div><span>Intrahepatic cholangiocarcinoma (ICC) is the second most frequent primary liver cancer. The involvement of Y-box binding protein 1 (YBX1) in tumor advancement is well-documented. However, its function in ICC is not fully understood. This study aimed to explore the function and regulatory mechanism of YBX1 in ICC and provide evidence for YBX1 as a potential new approach for </span>immunotherapy in ICC.</div></div><div><h3>Methods</h3><div><span>Tissue immunohistochemistry<span><span>, TCGA, and </span>GEO databases were used to analyze the expression of YBX1 in ICC. The expression of YBX1 was silenced and overexpressed in cell lines. Both </span></span><em>in vitro</em> and <em>in vivo</em><span><span> assays were conducted to examine the antitumor T-cell responses. Actinomycin D<span>, RNA </span></span>immunoprecipitation<span><span>, and methylated RNA immunoprecipitation assays were used to identify mechanism of YBX1 on downstream genes. </span>Immunofluorescence assay was used to validate the association between YBX1 and relevant genes in clinical specimens of ICC.</span></span></div></div><div><h3>Results</h3><div>The research findings indicated that ICC exhibited high levels of YBX1 expression, which was strongly associated with unfavorable outcomes. YBX1 promoted tumor progression by suppressing antitumor T-cell responses. YBX1 enhanced signal transducer and activator of transcription 1<span> (STAT1) translation by serving as a 5-methylated cytosine (m5C) reader and activating the STAT1/PD-L1 pathway. Mouse experiments and clinical samples of ICC confirmed the strong correlation between the levels of YBX1, STAT1, and PD-L1 expression.</span></div></div><div><h3>Conclusions</h3><div>YBX1 regulates STAT1 stability in an m5C dependent manner and maintains PD-L1 expression in ICC.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 643-655"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.hbpd.2025.07.002
Rong-Gao Chen , Guan-Rong Chen , Xiao-Xiao Jiang , Ying-Chen Huang , Xin Hu , Wei-Liang Xia , Qi-Yang Cheng , Kun Wang , Xiao Xu , Shu-Sen Zheng
Background
Tumor recurrence severely impacts the prognosis of hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT). We aimed to explore novel and robust biomarkers for precise prediction of tumor recurrence and prognosis following LT.
Methods
Cancerous tissues of 252 HCC patients who underwent LT across three centers were included in the study. Tissue microarrays and in situ hybridization were utilized to assess the circ0006646 level. Kaplan-Meier method along with the log-rank test was performed to analyze overall survival and recurrence-free survival. To identify prognostic factors, particularly related to tumor recurrence, we conducted univariate and multivariate Cox regression analyses. Nomogram was constructed to predict the risk of tumor recurrence after LT and subsequently the efficacy of the nomogram was validated.
Results
Elevated circ0006646 levels in HCC were associated with reduced survival and increased recurrence rates following LT (5-year overall survival: 29.2% vs. 60.4%, P < 0.01; 5-year recurrence-free survival: 42.3% vs. 63.0%, P < 0.001). High circ0006646 expression was significantly correlated with higher Child-Pugh grade (P = 0.040), larger total tumor diameter (P = 0.033), and beyond the Milan criteria (P = 0.033). Cox regression analysis unveiled that circ0006646 expression score, preoperative transarterial chemoembolization (TACE), positive HBsAg status, poor tumor differentiation and beyond the Hangzhou criteria were independent risk factors for post-transplant tumor recurrence, leading to the development of a novel nomogram for precise prediction. The nomogram demonstrated a reasonable prognostic effectiveness (area under the receiver operating characteristic curve = 0.7636, C-index = 0.745) and outperformed conventional models like the Milan criteria. Besides, the inclusion of circ0006646 enhanced the precision of the Milan and Hangzhou criteria. Moreover, circ0006646 served as a potent biomarker in alpha-fetoprotein (AFP)-negative HCC undergoing LT.
Conclusions
circ0006646 is a novel and robust prognostic biomarker for predicting post-transplant survival and tumor recurrence in HCC patients. A nomogram integrating circ0006646 stands as a valuable prognostic instrument in LT for HCC.
{"title":"circ0006646 serves as a robust prognostic biomarker for post-transplant tumor recurrence and survival in hepatocellular carcinoma patients","authors":"Rong-Gao Chen , Guan-Rong Chen , Xiao-Xiao Jiang , Ying-Chen Huang , Xin Hu , Wei-Liang Xia , Qi-Yang Cheng , Kun Wang , Xiao Xu , Shu-Sen Zheng","doi":"10.1016/j.hbpd.2025.07.002","DOIUrl":"10.1016/j.hbpd.2025.07.002","url":null,"abstract":"<div><h3>Background</h3><div>Tumor recurrence severely impacts the prognosis of hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT). We aimed to explore novel and robust biomarkers for precise prediction of tumor recurrence and prognosis following LT.</div></div><div><h3>Methods</h3><div>Cancerous tissues of 252 HCC patients who underwent LT across three centers were included in the study. Tissue microarrays and <em>in situ</em> hybridization were utilized to assess the circ0006646 level. Kaplan-Meier method along with the log-rank test was performed to analyze overall survival and recurrence-free survival. To identify prognostic factors, particularly related to tumor recurrence, we conducted univariate and multivariate Cox regression analyses. Nomogram was constructed to predict the risk of tumor recurrence after LT and subsequently the efficacy of the nomogram was validated.</div></div><div><h3>Results</h3><div>Elevated circ0006646 levels in HCC were associated with reduced survival and increased recurrence rates following LT (5-year overall survival: 29.2% vs. 60.4%, <em>P</em> < 0.01; 5-year recurrence-free survival: 42.3% vs. 63.0%, <em>P</em> < 0.001). High circ0006646 expression was significantly correlated with higher Child-Pugh grade (<em>P</em> = 0.040), larger total tumor diameter (<em>P</em> = 0.033), and beyond the Milan criteria (<em>P</em> = 0.033). Cox regression analysis unveiled that circ0006646 expression score, preoperative transarterial chemoembolization (TACE), positive HBsAg status, poor tumor differentiation and beyond the Hangzhou criteria were independent risk factors for post-transplant tumor recurrence, leading to the development of a novel nomogram for precise prediction. The nomogram demonstrated a reasonable prognostic effectiveness (area under the receiver operating characteristic curve = 0.7636, C-index = 0.745) and outperformed conventional models like the Milan criteria. Besides, the inclusion of circ0006646 enhanced the precision of the Milan and Hangzhou criteria. Moreover, circ0006646 served as a potent biomarker in alpha-fetoprotein (AFP)-negative HCC undergoing LT.</div></div><div><h3>Conclusions</h3><div>circ0006646 is a novel and robust prognostic biomarker for predicting post-transplant survival and tumor recurrence in HCC patients. A nomogram integrating circ0006646 stands as a valuable prognostic instrument in LT for HCC.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 616-624"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.hbpd.2025.08.004
Hao Wu , Qian-Qian Feng , Jian-Hui Li , Hai-Yang Xie , Shi-Gui Yang , Shu-Sen Zheng
Background
With increasing life expectancy and aging populations, Belt and Road Initiative (BRI) countries face various levels of gallbladder and biliary tract cancer (GBTC) impact. This study analyzed differences in the burden and trends of GBTC in BRI countries from 1990 to 2021, providing a comprehensive understanding of geographic, temporal, and demographic variations to inform targeted public health strategies.
Methods
Using the Global Burden of Disease (GBD) 2021 database, we examined age-standardized incidence rate, age-standardized prevalence rate, age-standardized mortality rate, and age-standardized disability-adjusted life year rate of GBTC across 153 BRI countries. A Bayesian Age-Period-Cohort (BAPC) model analyzed temporal trends (1990-2021) and projected future burden (2035). We assessed the relationship between sociodemographic index (SDI) and GBTC burden, conducted sex- and age-stratified analyses, and evaluated geographic disparities.
Results
In 2021, global age-standardized incidence rate was 2.56/100 000 (216 768 cases), with age-standardized prevalence rate 3.69/100 000 (314 465 cases), age-standardized mortality rate 2.04/100 000 (171 961 deaths), and age-standardized disability-adjusted life year rate 43.2/100 000 (3.73 million disability-adjusted life years). Geographic analysis identified Thailand, Korea, and Chile as regions with the highest age-standardized incidence rate and age-standardized mortality rate. Age-standardized disability-adjusted life year rate correlated positively with SDI (R = 0.38) across BRI countries. Between 1990 and 2021, temporal trends showed age-standardized mortality rate and age-standardized disability-adjusted life year rate declined globally (-24.09/100 000 and -26.25/100 000), but South Asia showed increased mortality rate (+33.24/100 000 and +28.15/100 000). Globally, age-standardized mortality rate and age-standardized disability-adjusted life year rate are projected to continue declining through 2035. Sex- and age-stratified analyses revealed that age-specific incidence, prevalence, mortality, and disability-adjusted life year rates increased with age, peaking at 85-90 years. Males had higher rates at 84-94 years, but absolute cases, deaths and disability-adjusted life years were higher in females after 70 years.
Conclusions
GBTC burden in BRI countries varies by regions, SDI, temporal trends, and demographic factors. While overall burden declines, addressing healthcare disparities, environmental risks, and early detection gaps is crucial in high-burden countries and populations. Strengthening collaboration among BRI countries is key to mitigating GBTC burden and advancing public health initiatives.
{"title":"Epidemiological trends and burden of gallbladder and biliary tract cancer in Belt and Road Initiative countries: A comprehensive analysis from the Global Burden of Disease 2021 database","authors":"Hao Wu , Qian-Qian Feng , Jian-Hui Li , Hai-Yang Xie , Shi-Gui Yang , Shu-Sen Zheng","doi":"10.1016/j.hbpd.2025.08.004","DOIUrl":"10.1016/j.hbpd.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>With increasing life expectancy and aging populations, Belt and Road Initiative (BRI) countries face various levels of gallbladder and biliary tract cancer (GBTC) impact. This study analyzed differences in the burden and trends of GBTC in BRI countries from 1990 to 2021, providing a comprehensive understanding of geographic, temporal, and demographic variations to inform targeted public health strategies.</div></div><div><h3>Methods</h3><div>Using the Global Burden of Disease (GBD) 2021 database, we examined age-standardized incidence rate, age-standardized prevalence rate, age-standardized mortality rate, and age-standardized disability-adjusted life year rate of GBTC across 153 BRI countries. A Bayesian Age-Period-Cohort (BAPC) model analyzed temporal trends (1990-2021) and projected future burden (2035). We assessed the relationship between sociodemographic index (SDI) and GBTC burden, conducted sex- and age-stratified analyses, and evaluated geographic disparities.</div></div><div><h3>Results</h3><div>In 2021, global age-standardized incidence rate was 2.56/100 000 (216 768 cases), with age-standardized prevalence rate 3.69/100 000 (314 465 cases), age-standardized mortality rate 2.04/100 000 (171 961 deaths), and age-standardized disability-adjusted life year rate 43.2/100 000 (3.73 million disability-adjusted life years). Geographic analysis identified Thailand, Korea, and Chile as regions with the highest age-standardized incidence rate and age-standardized mortality rate. Age-standardized disability-adjusted life year rate correlated positively with SDI (<em>R</em> = 0.38) across BRI countries. Between 1990 and 2021, temporal trends showed age-standardized mortality rate and age-standardized disability-adjusted life year rate declined globally (-24.09/100 000 and -26.25/100 000), but South Asia showed increased mortality rate (+33.24/100 000 and +28.15/100 000). Globally, age-standardized mortality rate and age-standardized disability-adjusted life year rate are projected to continue declining through 2035. Sex- and age-stratified analyses revealed that age-specific incidence, prevalence, mortality, and disability-adjusted life year rates increased with age, peaking at 85-90 years. Males had higher rates at 84-94 years, but absolute cases, deaths and disability-adjusted life years were higher in females after 70 years.</div></div><div><h3>Conclusions</h3><div>GBTC burden in BRI countries varies by regions, SDI, temporal trends, and demographic factors. While overall burden declines, addressing healthcare disparities, environmental risks, and early detection gaps is crucial in high-burden countries and populations. Strengthening collaboration among BRI countries is key to mitigating GBTC burden and advancing public health initiatives.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 666-675"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.hbpd.2025.09.004
Yuan Cheng , Jun-Ying Wang , You Lu , Yong-Xiang Xia , Hui Zhao , Qi Wang , Xiao-Li Zhu , Qing-Quan Zu , Hui-Kai Li , Zhong Chen , Xiang-Cheng Li , China Liver Cancer Study Group Young Investigators (CLEAP)
Background
Hepatocellular carcinoma (HCC) remains a significant global health challenge. While first-line treatments with immune checkpoint inhibitors (ICIs) have improved patient outcomes, the selection of effective second-line therapies remains unclear. This study evaluated the efficacy and safety of regorafenib as a second-line option in advanced HCC patients post-progression on ICI-based therapies.
Methods
Advanced HCC patients from eight hospitals in China who received regorafenib after progression on first-line ICI therapies, alone or combined with ICIs were enrolled. Clinical data were collected, and propensity score matching (PSM) was used to ensure comparability between treatment groups. The primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events. The study was registered at www.chictr.org.cn (ChiCTR2400091318).
Results
A total of 149 patients were included: 113 in the combination therapy group (Rego-ICI group) and 36 in the regorafenib monotherapy group (Rego group). After PSM, the Rego-ICI group showed significantly improved OS [19.0 vs. 11.0 months, hazard ratio (HR) = 0.426, 95% confidence interval (CI): 0.235–0.772, P = 0.005] and PFS (4.0 vs. 3.0 months, HR = 0.539, 95% CI: 0.337–0.863, P = 0.010) compared to the Rego group. Differences in ORR and DCR were not statistically significant (ORR: 19.4% vs. 9.7%, P = 0.226; DCR: 64.2% vs. 48.4%, P = 0.139), but the Rego-ICI group showed better disease control. Regorafenib plus ICI improved both OS and PFS with no new safety signals.
Conclusions
The combination of ICIs and regorafenib significantly enhances OS in advanced HCC patients post-progression on first-line ICI treatments. These findings support the potential of regorafenib plus ICIs as an effective second-line therapy.
背景：肝细胞癌（HCC）仍然是一个重大的全球健康挑战。虽然使用免疫检查点抑制剂（ICIs）的一线治疗改善了患者的预后，但选择有效的二线治疗仍不清楚。本研究评估了regorafenib作为晚期HCC患者在ci基础治疗进展后的二线选择的有效性和安全性。方法：纳入来自中国8家医院的晚期HCC患者，这些患者在一线ICI治疗进展后接受瑞非尼治疗，单独或联合ICI治疗。收集临床资料，采用倾向评分匹配（PSM）确保治疗组间的可比性。主要终点是总生存期（OS）。次要终点为无进展生存期（PFS）、客观缓解率（ORR）、疾病控制率（DCR）和治疗相关不良事件。该研究已在www.chictr.org.cn注册（ChiCTR2400091318）。结果：共纳入149例患者：联合治疗组113例（雷戈- ici组），瑞非尼单药治疗组36例（雷戈组）。PSM后，Rego- ici组与Rego组相比，OS (19.0 vs. 11.0个月，风险比（HR) = 0.426, 95%可信区间（CI）： 0.235 ~ 0.772, P = 0.005）和PFS （4.0 vs. 3.0个月，HR = 0.539, 95% CI: 0.337 ~ 0.863, P = 0.010）明显改善。ORR与DCR差异无统计学意义（ORR: 19.4% vs. 9.7%, P = 0.226; DCR: 64.2% vs. 48.4%, P = 0.139），但Rego-ICI组疾病控制较好。Regorafenib + ICI改善了OS和PFS，没有新的安全信号。结论：ICI联合瑞非尼可显著提高一线ICI治疗进展的晚期HCC患者的OS。这些发现支持瑞非尼加ICIs作为有效二线治疗的潜力。
{"title":"Efficacy of regorafenib following first-line immune checkpoint inhibitor failure in patients with advanced hepatocellular carcinoma: A multicenter study","authors":"Yuan Cheng , Jun-Ying Wang , You Lu , Yong-Xiang Xia , Hui Zhao , Qi Wang , Xiao-Li Zhu , Qing-Quan Zu , Hui-Kai Li , Zhong Chen , Xiang-Cheng Li , China Liver Cancer Study Group Young Investigators (CLEAP)","doi":"10.1016/j.hbpd.2025.09.004","DOIUrl":"10.1016/j.hbpd.2025.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Hepatocellular carcinoma (HCC) remains a significant global health challenge. While first-line treatments with immune checkpoint inhibitors (ICIs) have improved patient outcomes, the selection of effective second-line therapies remains unclear. This study evaluated the efficacy and safety of regorafenib as a second-line option in advanced HCC patients post-progression on ICI-based therapies.</div></div><div><h3>Methods</h3><div>Advanced HCC patients from eight hospitals in China who received regorafenib after progression on first-line ICI therapies, alone or combined with ICIs were enrolled. Clinical data were collected, and propensity score matching (PSM) was used to ensure comparability between treatment groups. The primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events. The study was registered at <span><span>www.chictr.org.cn</span><svg><path></path></svg></span> (ChiCTR2400091318).</div></div><div><h3>Results</h3><div>A total of 149 patients were included: 113 in the combination therapy group (Rego-ICI group) and 36 in the regorafenib monotherapy group (Rego group). After PSM, the Rego-ICI group showed significantly improved OS [19.0 vs. 11.0 months, hazard ratio (HR) = 0.426, 95% confidence interval (CI): 0.235–0.772, <em>P</em> = 0.005] and PFS (4.0 vs. 3.0 months, HR = 0.539, 95% CI: 0.337–0.863, <em>P</em> = 0.010) compared to the Rego group. Differences in ORR and DCR were not statistically significant (ORR: 19.4% vs. 9.7%, <em>P</em> = 0.226; DCR: 64.2% vs. 48.4%, <em>P</em> = 0.139), but the Rego-ICI group showed better disease control. Regorafenib plus ICI improved both OS and PFS with no new safety signals.</div></div><div><h3>Conclusions</h3><div>The combination of ICIs and regorafenib significantly enhances OS in advanced HCC patients post-progression on first-line ICI treatments. These findings support the potential of regorafenib plus ICIs as an effective second-line therapy.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 6","pages":"Pages 656-665"},"PeriodicalIF":4.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号