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Guideline on application of allogeneic vascular transplantation in abdominal surgery 异体血管移植在腹部外科手术中的应用指南。
IF 4.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-12-01 DOI: 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
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引用次数: 0
Thanks 谢谢
IF 4.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-12-01 DOI: 10.1016/S1499-3872(25)00209-7
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引用次数: 0
Development and validation of a nomogram for a prognostic model for resected pancreatic ductal adenocarcinoma 胰导管腺癌切除术预后模型nomogram发展与验证。
IF 4.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-12-01 DOI: 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.
背景:胰导管腺癌(Pancreatic ductal adenocarticoma, PDAC)是一种高度恶性肿瘤。手术切除是PDAC最有希望的治疗策略,如何提高生存率仍是关键。本研究旨在建立并验证预测PDAC切除预后的nomogram。方法:选取2012年1月至2022年7月在兰州大学第二医院和郑州大学第一附属医院行手术切除的PDAC患者174例。采用R软件(4.1.3版)分析临床病理特征及生存资料。采用单因素和多因素Cox回归分析临床病理特征对总生存期(OS)的影响。结果:多因素Cox回归分析显示,糖抗原19-9 (CA19-9)≥476 U/mL、糖抗原125 (CA125)≥32 U/mL、空腹血糖(FBG) < 6.86 mmol/L、天冬氨酸转氨酶(AST)≥107 U/L、手术切缘阳性、术后化疗超过4个周期是OS的独立预后因素。根据多因素Cox回归分析计算的中位风险评分将患者分为高危组和低危组。Kaplan-Meier生存曲线显示,训练队列中高危组和低危组的5年生存率分别为5.79%和24.3%,验证队列中高危组和低危组的5年生存率分别为0和19.0% (P < 0.05)。受试者工作特征(ROC)曲线分析显示,风险评分在训练集和验证集的ROC曲线下面积(AUC)分别为0.855和0.838。训练集和验证集的nomogram c -index分别为0.788 (95% CI: 0.745-0.831)和0.773 (95% CI: 0.718-0.828)。结论:我们建立了预测PDAC切除患者OS的nomogram,验证结果表明该nomogram模型具有较强的预测能力。特别是FBG < 6.86 mmol/L,术后化疗周期大于4个周期,可预测PDAC术后OS较好。
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引用次数: 0
YBX1 is required for maintaining PD-L1 expression in intrahepatic cholangiocarcinoma by regulating STAT1 stability in an m5C-dependent manner YBX1通过m5c依赖的方式调节STAT1的稳定性,维持肝内胆管癌中PD-L1的表达。
IF 4.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-12-01 DOI: 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.
背景:肝内胆管癌(ICC)是第二常见的原发性肝癌。Y-box结合蛋白1 (YBX1)参与肿瘤进展已被充分证实。然而,其在国际商会中的作用尚未得到充分认识。本研究旨在探讨YBX1在ICC中的功能和调控机制,为YBX1作为ICC免疫治疗的潜在新途径提供证据。方法:采用组织免疫组化、TCGA和GEO数据库分析YBX1在ICC中的表达。YBX1在细胞系中表达沉默和过表达。体外和体内实验均检测了抗肿瘤t细胞反应。利用放线菌素D、RNA免疫沉淀法和甲基化RNA免疫沉淀法鉴定YBX1对下游基因的作用机制。采用免疫荧光法验证临床ICC标本中YBX1与相关基因的相关性。结果:研究结果表明,ICC表现出高水平的YBX1表达,这与不良结局密切相关。YBX1通过抑制抗肿瘤t细胞反应促进肿瘤进展。YBX1通过作为5-甲基化胞嘧啶(m5C)读取器和激活STAT1/PD-L1通路,增强了转录1 (STAT1)翻译的信号换能器和激活因子。小鼠实验和ICC临床样本证实了YBX1、STAT1和PD-L1表达水平之间的强相关性。结论:YBX1以m5C依赖的方式调节STAT1的稳定性,维持ICC中PD-L1的表达。
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引用次数: 0
circ0006646 serves as a robust prognostic biomarker for post-transplant tumor recurrence and survival in hepatocellular carcinoma patients Circ0006646可作为肝细胞癌患者移植后肿瘤复发和生存的可靠预后生物标志物。
IF 4.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-12-01 DOI: 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.
背景:肿瘤复发严重影响肝细胞癌(HCC)患者肝移植的预后。我们的目标是探索新的和强大的生物标志物,以精确预测肝移植后肿瘤复发和预后。方法:研究纳入了来自三个中心的252例肝移植患者的癌组织。利用组织微阵列和原位杂交技术评估circ0006646的表达水平。采用Kaplan-Meier法和log-rank检验分析总生存率和无复发生存率。为了确定预后因素,特别是与肿瘤复发相关的因素,我们进行了单因素和多因素Cox回归分析。构建Nomogram来预测肝移植后肿瘤复发的风险,随后验证Nomogram的有效性。结果:HCC中circ0006646水平升高与肝移植后生存率降低和复发率增加相关(5年总生存率:60.4 % vs 29.2 %,P < 0.01;5年无复发生存率:63.0 % vs. 42.3 %,P < 0.001)。circ0006646高表达与Child-Pugh分级高(P = 0.040)、肿瘤总直径大(P = 0.033)、超出米兰标准(P = 0.033)显著相关。Cox回归分析显示,circ0006646表达评分、术前经动脉化疗栓塞(TACE)、HBsAg阳性、肿瘤分化差和超出杭州标准是移植后肿瘤复发的独立危险因素,因此开发了一种新的精确预测nomogram。nomogram显示了合理的预后效果(receiver operating characteristic curve下面积= 0.7636,C-index = 0.745),优于Milan标准等传统模型。此外,circ0006646的加入提高了米兰和杭州标准的精度。此外,circ0006646在甲胎蛋白(AFP)阴性的肝细胞癌移植后存活和肿瘤复发中是一种有效的生物标志物。结论:circ0006646是一种新的、可靠的预后生物标志物,可预测肝细胞癌患者移植后生存和肿瘤复发。结合circ0006646的nomogram(图)是HCC肝移植的一种有价值的预后工具。
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引用次数: 0
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 “一带一路”沿线国家胆囊和胆道癌流行病学趋势与负担:来自2021年全球疾病负担数据库的综合分析
IF 4.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-12-01 DOI: 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.
背景:随着预期寿命的延长和人口老龄化,“一带一路”沿线国家面临着不同程度的胆囊和胆道癌(GBTC)影响。本研究分析了1990年至2021年“一带一路”国家GBTC负担和趋势的差异,提供了对地理、时间和人口变化的全面了解,为有针对性的公共卫生战略提供信息。方法:利用全球疾病负担(GBD) 2021数据库,研究了153个“一带一路”国家GBTC的年龄标准化发病率、年龄标准化患病率、年龄标准化死亡率和年龄标准化残疾调整生命年率。贝叶斯年龄-时期-队列(BAPC)模型分析了1990-2021年的时间趋势,并预测了2035年的未来负担。我们评估了社会人口统计指数(SDI)与GBTC负担之间的关系,进行了性别和年龄分层分析,并评估了地理差异。结果:2021年,全球年龄标准化发病率为2.56/10万(216 768例),年龄标准化患病率为3.69/10万(314 465例),年龄标准化死亡率为2.04/10万(171 961例死亡),年龄标准化伤残调整生命年为43.2/10万(373万伤残调整生命年)。地理分析表明,泰国、韩国和智利是年龄标准化发病率和年龄标准化死亡率最高的地区。在“一带一路”沿线国家,年龄标准化残疾调整生命年率与SDI呈正相关(R = 0.38)。1990年至2021年期间,时间趋势显示全球年龄标准化死亡率和年龄标准化残疾调整生命年率下降(-24.09/10万和-26.25/10万),但南亚死亡率上升(+33.24/10万和+28.15/10万)。在全球范围内,预计到2035年,年龄标准化死亡率和年龄标准化残疾调整生命年率将继续下降。性别和年龄分层分析显示,特定年龄的发病率、患病率、死亡率和残疾调整生命年率随着年龄的增长而增加,在85-90岁时达到峰值。男性在84-94岁时发病率较高,但女性在70岁后的绝对病例、死亡和残疾调整生命年较高。结论:“一带一路”沿线国家的GBTC负担因地区、SDI、时间趋势和人口因素而异。虽然总体负担下降,但在高负担国家和人口中,解决医疗保健差距、环境风险和早期发现差距至关重要。加强“一带一路”沿线国家间合作是减轻GBTC负担和推进公共卫生倡议的关键。
{"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 ,&nbsp;Qian-Qian Feng ,&nbsp;Jian-Hui Li ,&nbsp;Hai-Yang Xie ,&nbsp;Shi-Gui Yang ,&nbsp;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}
引用次数: 0
Efficacy of regorafenib following first-line immune checkpoint inhibitor failure in patients with advanced hepatocellular carcinoma: A multicenter study 瑞非尼在一线免疫检查点抑制剂失效后对晚期肝癌患者的疗效:一项多中心研究
IF 4.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-12-01 DOI: 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。
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引用次数: 0
A novel technique of successful living-donor liver transplantation in recipients with situs inversus totalis using a modified right-lobe graft (with video) 改良右肝叶移植是一种成功的活体肝移植新技术(附视频)。
IF 4.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-29 DOI: 10.1016/j.hbpd.2025.11.007
Sung-Min Kim, Deok-Bog Moon, Woo-Hyung Kang, Gil-Chun Park, Byeong-Gon Na, Rak-Kyun Oh, Sung-Gyu Lee
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引用次数: 0
Stratification of adjuvant FOLFOX chemotherapy after liver transplantation for hepatocellular carcinoma. 肝癌肝移植后FOLFOX辅助化疗的分层。
IF 4.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-23 DOI: 10.1016/j.hbpd.2025.11.006
Feng-Qiang Gao, Li Zhuang, Li-Bin Dong, Yi-Chao Wu, Rui Wang, Shu-Sen Zheng, Kai Wang, Xiao Xu

Background: Adjuvant therapy after liver transplantation (LT) has been reported to improve survival outcomes. However, selecting appropriate candidates who may benefit from postoperative adjuvant therapy remains challenging. This study aimed to stratify recipients who underwent adjuvant FOLFOX plus lenvatinib (F-L) therapy after LT for hepatocellular carcinoma and provide clinical guidance on adjuvant therapy selection.

Methods: This study included 106 patients in the F-L group and 229 patients in the non-adjuvant (N-A) group at Shulan (Hangzhou) Hospital from January 2017 to December 2021 for analysis. A 1:1 propensity score matching (PSM) analysis was conducted to minimize group imbalances. Recurrence-free survival (RFS) and overall survival (OS) were compared among recipients. Radiomic features with predictive value for tumor recurrence were analyzed independently and in combination with prognostic clinical features to develop predictive models. The combined model was used to classify recipients in the F-L group into low and high recurrence subgroups for further analysis.

Results: The 1- and 3-year survival outcomes for LT recipients in the F-L group (RFS: 74.75 % and 60.95 %; OS: 92.93 % and 74.58 %) were significantly better than those of recipients in the N-A group after PSM (RFS: P = 0.035; OS: P = 0.002). Six predictive radiomic features were identified to establish a radiomic model in the F-L group, and with application of the prognostic clinical feature (microvascular invasion), a combined model was developed (area under the curve: 0.81). Recipients in the low recurrence and fulfilling Hangzhou criteria subgroup had significantly better RFS to those in the high recurrence and fulfilling Hangzhou criteria subgroup (P = 0.043). Meanwhile, F-L therapy was not suitable for recipients in the high recurrence and exceeding Hangzhou criteria subgroup.

Conclusions: LT recipients benefit from F-L adjuvant therapy. Integrating the combined model with existing LT criteria may aid in identifying suitable candidates for F-L therapy, thereby optimizing postoperative adjuvant therapy selection.

背景:据报道,肝移植(LT)后的辅助治疗可以改善生存结果。然而,选择合适的候选人可能受益于术后辅助治疗仍然具有挑战性。本研究旨在对肝细胞癌肝移植后接受FOLFOX + lenvatinib (F-L)辅助治疗的受者进行分层,为辅助治疗方案的选择提供临床指导。方法:本研究纳入2017年1月至2021年12月杭州舒兰医院F-L组106例患者和非辅助(N-A)组229例患者进行分析。进行了1:1倾向评分匹配(PSM)分析,以尽量减少群体失衡。比较两组患者的无复发生存期(RFS)和总生存期(OS)。独立分析具有预测肿瘤复发价值的放射学特征,并结合预后临床特征建立预测模型。采用联合模型将F-L组受者分为低复发亚组和高复发亚组进一步分析。结果:F-L组肝移植受体PSM后1年和3年生存率(RFS: 74.75%和60.95%;OS: 92.93%和74.58%)显著优于N-A组(RFS: P = 0.035; OS: P = 0.002)。在F-L组确定6个预测放射组学特征建立放射组学模型,并结合预后临床特征(微血管侵犯)建立联合模型(曲线下面积:0.81)。低复发和满足杭州标准亚组患者的RFS显著优于高复发和满足杭州标准亚组(P = 0.043)。同时,高复发率和超过杭州标准亚组不适合接受F-L治疗。结论:肝移植受者受益于F-L辅助治疗。将联合模型与现有的LT标准相结合,可能有助于确定合适的F-L治疗候选者,从而优化术后辅助治疗选择。
{"title":"Stratification of adjuvant FOLFOX chemotherapy after liver transplantation for hepatocellular carcinoma.","authors":"Feng-Qiang Gao, Li Zhuang, Li-Bin Dong, Yi-Chao Wu, Rui Wang, Shu-Sen Zheng, Kai Wang, Xiao Xu","doi":"10.1016/j.hbpd.2025.11.006","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.11.006","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant therapy after liver transplantation (LT) has been reported to improve survival outcomes. However, selecting appropriate candidates who may benefit from postoperative adjuvant therapy remains challenging. This study aimed to stratify recipients who underwent adjuvant FOLFOX plus lenvatinib (F-L) therapy after LT for hepatocellular carcinoma and provide clinical guidance on adjuvant therapy selection.</p><p><strong>Methods: </strong>This study included 106 patients in the F-L group and 229 patients in the non-adjuvant (N-A) group at Shulan (Hangzhou) Hospital from January 2017 to December 2021 for analysis. A 1:1 propensity score matching (PSM) analysis was conducted to minimize group imbalances. Recurrence-free survival (RFS) and overall survival (OS) were compared among recipients. Radiomic features with predictive value for tumor recurrence were analyzed independently and in combination with prognostic clinical features to develop predictive models. The combined model was used to classify recipients in the F-L group into low and high recurrence subgroups for further analysis.</p><p><strong>Results: </strong>The 1- and 3-year survival outcomes for LT recipients in the F-L group (RFS: 74.75 % and 60.95 %; OS: 92.93 % and 74.58 %) were significantly better than those of recipients in the N-A group after PSM (RFS: P = 0.035; OS: P = 0.002). Six predictive radiomic features were identified to establish a radiomic model in the F-L group, and with application of the prognostic clinical feature (microvascular invasion), a combined model was developed (area under the curve: 0.81). Recipients in the low recurrence and fulfilling Hangzhou criteria subgroup had significantly better RFS to those in the high recurrence and fulfilling Hangzhou criteria subgroup (P = 0.043). Meanwhile, F-L therapy was not suitable for recipients in the high recurrence and exceeding Hangzhou criteria subgroup.</p><p><strong>Conclusions: </strong>LT recipients benefit from F-L adjuvant therapy. Integrating the combined model with existing LT criteria may aid in identifying suitable candidates for F-L therapy, thereby optimizing postoperative adjuvant therapy selection.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727296","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}
引用次数: 0
Isolated pancreatic tuberculosis: A treatable diagnostic challenge. 孤立的胰腺结核:一个可治疗的诊断挑战。
IF 4.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-11-23 DOI: 10.1016/j.hbpd.2025.11.008
David Bernal-Bello, David Serantes-Gómez, Álvaro Ricardo Llerena-Riofrío, Antonio Guardiola-Arévalo, Juan José Ortiz-Zapata, Alejandro Morales-Ortega
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引用次数: 0
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Hepatobiliary & Pancreatic Diseases International
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