Pub Date : 2025-11-17DOI: 10.1016/j.hbpd.2025.11.005
Bi-Qing Huang , Yi-Xiao Tian , Lan-Juan Li
Background
Giant cell arteritis (GCA), the most common systemic vasculitis affecting elderly individuals, currently lacks specific therapies. This study aimed to systematically identify therapeutic targets for GCA through integration of large-scale multi-omics datasets.
Methods
We constructed a multi-stage analytical framework encompassing 32 proteomic datasets (covering 2914 unique plasma proteins) and 6 transcriptomic datasets. Multi-omics integration strategies, including two-sample Mendelian randomization, colocalization analysis, and functional enrichment analysis, were employed to identify and validate causal relationships between candidate targets and GCA risk across 4 independent European-ancestry GCA cohorts. Single-cell RNA sequencing analysis of peripheral blood mononuclear cells from untreated GCA patients was performed to characterize hub gene-immune cell relationships.
Results
We identified 43 plasma proteins causally associated with GCA [false discovery rate (FDR) < 0.05], with 17 representing novel therapeutic targets. Through dual validation using proteome-wide association studies and transcriptome-wide association studies, we identified 13 high-confidence candidate targets with distinct tissue-specific expression patterns. Unc-51 like kinase 3 (ULK3) emerged as the strongest protective factor (odds ratio = 0.47, 95% confidence interval: 0.37–0.71) through autophagy regulation, while SLAMF7 represents an immediate drug repositioning opportunity as the target of food and drug administration-approved elotuzumab. Five targets have existing approved drugs (SLAMF7, ICAM1, IL18, IL6ST, CTSS). Single-cell analysis revealed profound disruption of hub gene-immune cell relationships in untreated GCA patients, with cell-type-specific alterations in inflammatory gene expression, and TYMP as the most critical hub gene.
Conclusions
This study provides a clinically-actionable atlas of 43 potential therapeutic targets in GCA, identifying novel mechanisms including autophagy modulation and metabolic reprogramming, with immediate drug repositioning opportunities and precision medicine strategies based on tissue-specific and cell-type-specific expression patterns. These findings require experimental validation before clinical translation.
{"title":"Identification of therapeutic targets for giant cell arteritis through integrated analysis of multi-omics datasets","authors":"Bi-Qing Huang , Yi-Xiao Tian , Lan-Juan Li","doi":"10.1016/j.hbpd.2025.11.005","DOIUrl":"10.1016/j.hbpd.2025.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Giant cell arteritis (GCA), the most common systemic vasculitis affecting elderly individuals, currently lacks specific therapies. This study aimed to systematically identify therapeutic targets for GCA through integration of large-scale multi-omics datasets.</div></div><div><h3>Methods</h3><div>We constructed a multi-stage analytical framework encompassing 32 proteomic datasets (covering 2914 unique plasma proteins) and 6 transcriptomic datasets. Multi-omics integration strategies, including two-sample Mendelian randomization, colocalization analysis, and functional enrichment analysis, were employed to identify and validate causal relationships between candidate targets and GCA risk across 4 independent European-ancestry GCA cohorts. Single-cell RNA sequencing analysis of peripheral blood mononuclear cells from untreated GCA patients was performed to characterize hub gene-immune cell relationships.</div></div><div><h3>Results</h3><div>We identified 43 plasma proteins causally associated with GCA [false discovery rate (FDR) < 0.05], with 17 representing novel therapeutic targets. Through dual validation using proteome-wide association studies and transcriptome-wide association studies, we identified 13 high-confidence candidate targets with distinct tissue-specific expression patterns. Unc-51 like kinase 3 (ULK3) emerged as the strongest protective factor (odds ratio = 0.47, 95% confidence interval: 0.37–0.71) through autophagy regulation, while SLAMF7 represents an immediate drug repositioning opportunity as the target of food and drug administration-approved elotuzumab. Five targets have existing approved drugs (SLAMF7, ICAM1, IL18, IL6ST, CTSS). Single-cell analysis revealed profound disruption of hub gene-immune cell relationships in untreated GCA patients, with cell-type-specific alterations in inflammatory gene expression, and TYMP as the most critical hub gene.</div></div><div><h3>Conclusions</h3><div>This study provides a clinically-actionable atlas of 43 potential therapeutic targets in GCA, identifying novel mechanisms including autophagy modulation and metabolic reprogramming, with immediate drug repositioning opportunities and precision medicine strategies based on tissue-specific and cell-type-specific expression patterns. These findings require experimental validation before clinical translation.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"25 1","pages":"Pages 62-75"},"PeriodicalIF":4.4,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642838","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 : 2025-11-12DOI: 10.1016/j.hbpd.2025.11.004
Wen-Lin Zhang , Xue-Jun Shao , Xuan-Yuan Dong , Hong-Ting Shao , Guang-Chao Li , Zhen Li , Ning Zhong , Rui Ji
Background
Biliary stent placement during endoscopic retrograde cholangiopancreatography (ERCP) is important for drainage in common bile duct (CBD) strictures, while the stent length is associated with many stent-related complications. We aimed to develop an artificial intelligence (AI) model for stent length selection during ERCP.
Methods
Images of the patients who underwent ERCP and were diagnosed with CBD strictures were collected. Training involved identifying and delineating the duodenoscope, CBD and guidewire, calculating the pixel distance of the target guidewire and determining the required biliary stent length based on the diameter of the duodenoscope. The performance of the model, accuracy for length calculation and the assistance for endoscopists were validated using the testing set.
Results
A total of 794 images from 431 patients were included and data augmentation was conducted. The mean intersection over union (mIoU) for duodenoscope, CBD and guidewire were 90.46%, 84.79% and 84.64%, respectively. The accuracy in identifying the strictures was 97.58% (121/124). The accuracy for stent length calculation achieved 85.95% (104/121) with an error margin of ± 1 cm. The mean absolute error (MAE) and mean relative error (MRE) of the AI model was 0.81 cm and 0.13, respectively. The AI model could reduce approximately 202 mGycm2 of the radiation exposure for each patient. It significantly improved both MAE and MRE for less experienced endoscopists (P = 0.01 and P = 0.02, respectively).
Conclusions
The AI model could accurately identify duodenoscope, CBD and guidewire, enabling accurate strictures identification and stent length selection.
{"title":"Artificial intelligence-assisted biliary stent length selection for common bile duct strictures in endoscopic retrograde cholangiopancreatography: Model development and validation","authors":"Wen-Lin Zhang , Xue-Jun Shao , Xuan-Yuan Dong , Hong-Ting Shao , Guang-Chao Li , Zhen Li , Ning Zhong , Rui Ji","doi":"10.1016/j.hbpd.2025.11.004","DOIUrl":"10.1016/j.hbpd.2025.11.004","url":null,"abstract":"<div><h3>Background</h3><div>Biliary stent placement during endoscopic retrograde cholangiopancreatography (ERCP) is important for drainage in common bile duct (CBD) strictures, while the stent length is associated with many stent-related complications. We aimed to develop an artificial intelligence (AI) model for stent length selection during ERCP.</div></div><div><h3>Methods</h3><div>Images of the patients who underwent ERCP and were diagnosed with CBD strictures were collected. Training involved identifying and delineating the duodenoscope, CBD and guidewire, calculating the pixel distance of the target guidewire and determining the required biliary stent length based on the diameter of the duodenoscope. The performance of the model, accuracy for length calculation and the assistance for endoscopists were validated using the testing set.</div></div><div><h3>Results</h3><div>A total of 794 images from 431 patients were included and data augmentation was conducted. The mean intersection over union (mIoU) for duodenoscope, CBD and guidewire were 90.46%, 84.79% and 84.64%, respectively. The accuracy in identifying the strictures was 97.58% (121/124). The accuracy for stent length calculation achieved 85.95% (104/121) with an error margin of ± 1 cm. The mean absolute error (MAE) and mean relative error (MRE) of the AI model was 0.81 cm and 0.13, respectively. The AI model could reduce approximately 202 mGycm<sup>2</sup> of the radiation exposure for each patient. It significantly improved both MAE and MRE for less experienced endoscopists (<em>P</em> = 0.01 and <em>P</em> = 0.02, respectively).</div></div><div><h3>Conclusions</h3><div>The AI model could accurately identify duodenoscope, CBD and guidewire, enabling accurate strictures identification and stent length selection.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"25 1","pages":"Pages 76-82"},"PeriodicalIF":4.4,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574812","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 : 2025-11-04DOI: 10.1016/j.hbpd.2025.11.001
Mo-Dan Yang , Jian-Yong Zhuo , Guo-Ying Wang , Li Zhuang , Xiao Xu , Shu-Sen Zheng , Yang Yang , Di Lu
Background
Liver transplantation (LT) provides an option to radically eliminate hepatocellular carcinoma (HCC) on the premise that recipients are thoroughly evaluated for posttransplant tumor recurrence risk before operation. This study aimed to optimize the Milan criteria (MC) by combining circulating prognostic markers, including interleukin-6 (IL-6) and alpha-fetoprotein (AFP).
Methods
We retrospectively enrolled 449 HCC cases receiving LT in three medical centers in China and divided them into the training cohort (n = 254) and the validation cohort (n = 195). Cox regression analysis was applied to identify recurrence-related risk factors based on patients’ clinical and pathological characteristics, pretransplant plasma IL-6 and AFP levels. The collaborative prediction method was presented in the form of a decision tree. Kaplan-Meier analysis showed the predictive results of independent risk factors and the newly established prediction tree.
Results
In the training cohort (n = 254), we established a predictive decision tree based on three independent risk factors: pretransplant plasma IL-6 (> 15 pg/mL), AFP (> 60 ng/mL), and the MC (beyond the MC), and named it as MIA (MC-IL-6-AFP) tree. According to the MIA tree, patients beyond the MC but with IL-6 ≤ 15 pg/mL and AFP ≤ 60 ng/mL (n = 39) had comparable 3-year recurrence-free survival (RFS) rates as patients within the MC (n = 121): 66.8% vs. 74.7% (P = 0.520). Likely, in the validation cohort (n = 195), the 3-year RFS rates of patients beyond the MC but with IL-6 ≤ 15 pg/mL and AFP ≤ 60 ng/mL (n = 26) were close to those of patients within the MC (n = 87): 71.8% vs. 76.6% (P = 0.660).
Conclusions
We proposed that pretransplant plasma IL-6 and AFP were valid prognostic biomarkers for HCC-related LT. The MIA tree could refine the MC by combining IL-6 and AFP and define an extra subset of eligible candidates without significant sacrifice in RFS.
{"title":"A non-invasive decision tree predicting recurrence-free survival after liver transplantation for hepatocellular carcinoma","authors":"Mo-Dan Yang , Jian-Yong Zhuo , Guo-Ying Wang , Li Zhuang , Xiao Xu , Shu-Sen Zheng , Yang Yang , Di Lu","doi":"10.1016/j.hbpd.2025.11.001","DOIUrl":"10.1016/j.hbpd.2025.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Liver transplantation (LT) provides an option to radically eliminate hepatocellular carcinoma (HCC) on the premise that recipients are thoroughly evaluated for posttransplant tumor recurrence risk before operation. This study aimed to optimize the Milan criteria (MC) by combining circulating prognostic markers, including interleukin-6 (IL-6) and alpha-fetoprotein (AFP).</div></div><div><h3>Methods</h3><div>We retrospectively enrolled 449 HCC cases receiving LT in three medical centers in China and divided them into the training cohort (<em>n</em> = 254) and the validation cohort (<em>n</em> = 195). Cox regression analysis was applied to identify recurrence-related risk factors based on patients’ clinical and pathological characteristics, pretransplant plasma IL-6 and AFP levels. The collaborative prediction method was presented in the form of a decision tree. Kaplan-Meier analysis showed the predictive results of independent risk factors and the newly established prediction tree.</div></div><div><h3>Results</h3><div>In the training cohort (<em>n</em> = 254), we established a predictive decision tree based on three independent risk factors: pretransplant plasma IL-6 (> 15 pg/mL), AFP (> 60 ng/mL), and the MC (beyond the MC), and named it as MIA (MC-IL-6-AFP) tree. According to the MIA tree, patients beyond the MC but with IL-6 ≤ 15 pg/mL and AFP ≤ 60 ng/mL (<em>n</em> = 39) had comparable 3-year recurrence-free survival (RFS) rates as patients within the MC (<em>n</em> = 121): 66.8% vs. 74.7% (<em>P</em> = 0.520). Likely, in the validation cohort (<em>n</em> = 195), the 3-year RFS rates of patients beyond the MC but with IL-6 ≤ 15 pg/mL and AFP ≤ 60 ng/mL (<em>n</em> = 26) were close to those of patients within the MC (<em>n</em> = 87): 71.8% vs. 76.6% (<em>P</em> = 0.660).</div></div><div><h3>Conclusions</h3><div>We proposed that pretransplant plasma IL-6 and AFP were valid prognostic biomarkers for HCC-related LT. The MIA tree could refine the MC by combining IL-6 and AFP and define an extra subset of eligible candidates without significant sacrifice in RFS.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"25 1","pages":"Pages 23-31"},"PeriodicalIF":4.4,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514503","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 : 2025-11-04DOI: 10.1016/j.hbpd.2025.11.003
Rui Tang, Guang-Dong Wu, Ang Li, Yu-Cheng Hou, Xuan Tong, Qian Lu
For early hepatocellular carcinoma (HCC), curative therapies include surgical excision and radiofrequency ablation. Other treatment modes for advanced HCC involve transarterial chemoembolization. For HCC patients who do not fit the Milan criteria or are waiting for liver transplantation (LT), studies of transarterial radioembolization with Yttrium-90 (Y-90) demonstrated that Y-90 may accomplish a good downstaging or bridging effect before LT and can even achieve complete pathological necrosis. The present review discussed Y-90 radioembolization as a local regional treatment option for advanced and unresectable HCC, with a focus on neoadjuvant intervention before LT.
{"title":"Yttrium-90 radioembolization therapy prior to liver transplantation for hepatocellular carcinoma improves patient outcomes","authors":"Rui Tang, Guang-Dong Wu, Ang Li, Yu-Cheng Hou, Xuan Tong, Qian Lu","doi":"10.1016/j.hbpd.2025.11.003","DOIUrl":"10.1016/j.hbpd.2025.11.003","url":null,"abstract":"<div><div>For early hepatocellular carcinoma (HCC), curative therapies include surgical excision and radiofrequency ablation. Other treatment modes for advanced HCC involve transarterial chemoembolization. For HCC patients who do not fit the Milan criteria or are waiting for liver transplantation (LT), studies of transarterial radioembolization with Yttrium-90 (Y-90) demonstrated that Y-90 may accomplish a good downstaging or bridging effect before LT and can even achieve complete pathological necrosis. The present review discussed Y-90 radioembolization as a local regional treatment option for advanced and unresectable HCC, with a focus on neoadjuvant intervention before LT.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"25 1","pages":"Pages 4-14"},"PeriodicalIF":4.4,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662601","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}
Background: Sarcopenia is associated with poor prognosis in liver transplantation, but the prognostic value of broader body composition indicators in patients undergoing liver transplantation for hepatocellular carcinoma requires further investigation. This study aimed to explore their critical role in the precision evaluation system.
Methods: Consecutive cases from four centers between January 2015 and January 2022 were included. Pre-transplant abdominal computed tomography images were analyzed to assess body composition indicators, including skeletal muscle index (SMI), skeletal muscle radiation attenuation (SMRA), visceral adipose tissue index (VATI), and subcutaneous adipose tissue index (SATI). Survival analysis and Cox regression were performed to investigate the predictive efficacy of body compositions in recurrence-free survival (RFS), with interaction terms for Milan criteria status. A scoring model was developed using Framingham Heart Study methodology.
Results: A total of 700 male recipients were enrolled. Among all body composition indicators, low SMI (called sarcopenia) and low SMRA (called myosteatosis) were associated with worse 2-year RFS regardless of Milan criteria status, whereas low VATI (P = 0.002) and low SATI (P = 0.001) were associated with worse RFS only in recipients exceeding the Milan criteria. These body composition indicators exhibited cumulative adverse effects on outcomes. Further analysis revealed significant interactions between Milan criteria status and sarcopenia, as well as low SATI. A body composition-based scoring model was developed, defining three risk classes with a C-index of 0.70 [95 % confidence interval (CI): 0.67-0.72], which significantly improved the predictive efficacy for recurrence compared to conventional criteria. Notably, using marginal liver was a risk factor for RFS in moderate risk patients (62.8 % vs. 48.8 %, P = 0.024).
Conclusions: This model highlights the prognostic value of body composition in liver transplantation for hepatocellular carcinoma and provides a refined predictive model to enhance recurrence risk assessment. The findings offer valuable insights for defining marginal liver utilization and developing effective treatment strategies.
{"title":"Body composition predicts prognosis of patients with hepatocellular carcinoma after liver transplantation: A multicenter study.","authors":"Zu-Yuan Lin, Di Lu, Sheng-Dong Wu, Zhi-Hang Hu, Xu-Dong Yang, Peng Liu, Shu-Qi Mao, Yu-Ying Shan, Hao Chen, Chi-Yu He, Hui-Gang Li, Xin-Yu Yang, Jian-Yong Zhuo, Wei Shen, Kai Wang, Si-Yi Dong, Jin-Yan Chen, Xu-Yong Wei, Li Zhuang, Jin-Zhen Cai, Cai-De Lu, Shu-Sen Zheng, Xiao Xu","doi":"10.1016/j.hbpd.2025.11.002","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.11.002","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is associated with poor prognosis in liver transplantation, but the prognostic value of broader body composition indicators in patients undergoing liver transplantation for hepatocellular carcinoma requires further investigation. This study aimed to explore their critical role in the precision evaluation system.</p><p><strong>Methods: </strong>Consecutive cases from four centers between January 2015 and January 2022 were included. Pre-transplant abdominal computed tomography images were analyzed to assess body composition indicators, including skeletal muscle index (SMI), skeletal muscle radiation attenuation (SMRA), visceral adipose tissue index (VATI), and subcutaneous adipose tissue index (SATI). Survival analysis and Cox regression were performed to investigate the predictive efficacy of body compositions in recurrence-free survival (RFS), with interaction terms for Milan criteria status. A scoring model was developed using Framingham Heart Study methodology.</p><p><strong>Results: </strong>A total of 700 male recipients were enrolled. Among all body composition indicators, low SMI (called sarcopenia) and low SMRA (called myosteatosis) were associated with worse 2-year RFS regardless of Milan criteria status, whereas low VATI (P = 0.002) and low SATI (P = 0.001) were associated with worse RFS only in recipients exceeding the Milan criteria. These body composition indicators exhibited cumulative adverse effects on outcomes. Further analysis revealed significant interactions between Milan criteria status and sarcopenia, as well as low SATI. A body composition-based scoring model was developed, defining three risk classes with a C-index of 0.70 [95 % confidence interval (CI): 0.67-0.72], which significantly improved the predictive efficacy for recurrence compared to conventional criteria. Notably, using marginal liver was a risk factor for RFS in moderate risk patients (62.8 % vs. 48.8 %, P = 0.024).</p><p><strong>Conclusions: </strong>This model highlights the prognostic value of body composition in liver transplantation for hepatocellular carcinoma and provides a refined predictive model to enhance recurrence risk assessment. The findings offer valuable insights for defining marginal liver utilization and developing effective treatment strategies.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":4.4,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514616","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 : 2025-10-28DOI: 10.1016/j.hbpd.2025.10.010
Xiang-Yan Liu , Jian-Fang Lu , Zhuo-Yi Wang , Shu-Sen Zheng
Liver is prone to viral infection. Viral hepatitis can be roughly divided into hepatitis A, B, C, D and E. Accurate diagnosis of viral hepatitis is crucial for accurate treatments. Different types of biomarkers, including non-invasive biomarkers have been explored for the diagnosis of viral hepatitis. With the fast development of multi-omics technology, non-invasive biomarkers can be detected from blood, saliva, urine, stool, and other body fluids. The advantages of non-invasive biomarkers are: 1) non-invasive; 2) convenient to test and 3) repeatable. The application of non-invasive biomarkers significantly improves the diagnostic accuracy of viral hepatitis. The non-invasive biomarkers can be sugars, proteins, nucleic acids, and even microorganisms. In this review, we summarized recent advances in identifying non-invasive biomarkers using multi-omics technology and discussed their potential diagnostic values for viral hepatitis.
{"title":"Non-invasive diagnostic biomarkers of viral hepatitis based on multi-omics technology: Recent advances and challenges","authors":"Xiang-Yan Liu , Jian-Fang Lu , Zhuo-Yi Wang , Shu-Sen Zheng","doi":"10.1016/j.hbpd.2025.10.010","DOIUrl":"10.1016/j.hbpd.2025.10.010","url":null,"abstract":"<div><div>Liver is prone to viral infection. Viral hepatitis can be roughly divided into hepatitis A, B, C, D and E. Accurate diagnosis of viral hepatitis is crucial for accurate treatments. Different types of biomarkers, including non-invasive biomarkers have been explored for the diagnosis of viral hepatitis. With the fast development of multi-omics technology, non-invasive biomarkers can be detected from blood, saliva, urine, stool, and other body fluids. The advantages of non-invasive biomarkers are: 1) non-invasive; 2) convenient to test and 3) repeatable. The application of non-invasive biomarkers significantly improves the diagnostic accuracy of viral hepatitis. The non-invasive biomarkers can be sugars, proteins, nucleic acids, and even microorganisms. In this review, we summarized recent advances in identifying non-invasive biomarkers using multi-omics technology and discussed their potential diagnostic values for viral hepatitis.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"25 1","pages":"Pages 15-22"},"PeriodicalIF":4.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496338","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}
Minimally invasive distal pancreatectomy (MIDP) is increasingly being used, although its oncologic safety for pancreatic ductal adenocarcinoma (PDAC) remains controversial. In Japan, MIDP for PDAC has limited endorsement due to insufficient data. This study aimed to compare the perioperative and long-term outcomes of open distal pancreatectomy (ODP) and MIDP for PDAC.
Methods
We retrospectively analyzed patients with resectable pancreatic body and tail cancer treated with ODP or MIDP (laparoscopic or robotic) between January 2007 and July 2022. The surgical procedures (ODP and MIDP) were compared and the patient characteristics, perioperative outcomes, and long-term outcomes were analyzed. We also compared the outcomes of patients with neoadjuvant chemotherapy (NAC) and without NAC.
Results
A total of 72 distal pancreatectomies were performed (37 ODPs and 35 MIDPs). In the upfront group, MIDP resulted in significantly less blood loss than ODP (P < 0.01), despite similar operative time. There was no statistically significant difference in the 2-year recurrence-free survival (RFS) rates between ODP and MIDP (39.7% vs. 57.8%, P = 0.60) or in the overall survival (OS) rates (66.7% vs. 74.1%, P = 0.43). Similarly, in the NAC group, MIDP resulted in significantly less blood loss than ODP (P = 0.01); ODP and MIDP had similar 2-year RFS rates (41.7% and 60.0%, P = 0.75) and OS rates (50.0% and 70.0%, P = 0.36). The interval from surgery to adjuvant chemotherapy initiation did not significantly differ between the ODP and MIDP subgroups in both the upfront group (P = 0.13) and the NAC group (P = 0.14). The incidence of recurrence was 64.8% for ODP and 42.8% for MIDP (P = 0.06). Both procedures showed similar distributions of local and distant recurrence.
Conclusions
MIDP caused less blood loss and had similar oncologic safety compared with ODP. MIDP could become a feasible, minimally invasive option with sufficient oncologic safety for pancreatic body and tail cancers.
背景：微创远端胰腺切除术（MIDP）越来越多地被应用，尽管其在胰腺导管腺癌（PDAC）中的肿瘤学安全性仍存在争议。在日本，由于数据不足，MIDP对PDAC的认可有限。本研究旨在比较开放式远端胰腺切除术（ODP）和MIDP治疗PDAC的围手术期和远期疗效。方法：回顾性分析2007年1月至2022年7月期间采用ODP或MIDP（腹腔镜或机器人）治疗的可切除胰腺体尾癌患者。比较两种手术方式（ODP和MIDP），分析患者特征、围手术期结局和远期结局。我们还比较了接受新辅助化疗（NAC）和未接受新辅助化疗的患者的预后。结果：共行72例远端胰腺切除术（odp 37例，midp 35例）。在前期组，尽管手术时间相似，但MIDP导致的出血量明显少于ODP （P < 0.01）。ODP和MIDP的2年无复发生存率（RFS） （39.7% vs. 57.8%, P = 0.60）和总生存率（OS） （66.7% vs. 74.1%, P = 0.43）差异无统计学意义。同样，在NAC组中，MIDP导致的失血量明显少于ODP (P = 0.01)；ODP和MIDP的2年RFS率（41.7%和60.0%,P = 0.75）和OS率（50.0%和70.0%,P = 0.36）相似。术前组（P = 0.13）和NAC组（P = 0.14）的ODP和MIDP亚组之间从手术到辅助化疗开始的时间间隔无显著差异。ODP和MIDP的复发率分别为64.8%和42.8% （P = 0.06）。两种手术均表现出相似的局部和远处复发分布。结论：与ODP相比，MIDP的失血量更少，肿瘤安全性相似。MIDP可能成为一种可行的、微创的选择，对胰腺体癌和尾癌具有足够的肿瘤学安全性。
{"title":"Safety and oncologic outcomes of open versus minimally invasive distal pancreatectomy for resectable pancreatic body and tail cancer","authors":"Hajime Imamura, Tomohiko Adachi, Ayaka Kinoshita, Takashi Hamada, Hajime Matsushima, Takanobu Hara, Akihiko Soyama, Susumu Eguchi","doi":"10.1016/j.hbpd.2025.10.007","DOIUrl":"10.1016/j.hbpd.2025.10.007","url":null,"abstract":"<div><h3>Background</h3><div>Minimally invasive distal pancreatectomy (MIDP) is increasingly being used, although its oncologic safety for pancreatic ductal adenocarcinoma (PDAC) remains controversial. In Japan, MIDP for PDAC has limited endorsement due to insufficient data. This study aimed to compare the perioperative and long-term outcomes of open distal pancreatectomy (ODP) and MIDP for PDAC.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients with resectable pancreatic body and tail cancer treated with ODP or MIDP (laparoscopic or robotic) between January 2007 and July 2022. The surgical procedures (ODP and MIDP) were compared and the patient characteristics, perioperative outcomes, and long-term outcomes were analyzed. We also compared the outcomes of patients with neoadjuvant chemotherapy (NAC) and without NAC.</div></div><div><h3>Results</h3><div>A total of 72 distal pancreatectomies were performed (37 ODPs and 35 MIDPs). In the upfront group, MIDP resulted in significantly less blood loss than ODP (<em>P</em> < 0.01), despite similar operative time. There was no statistically significant difference in the 2-year recurrence-free survival (RFS) rates between ODP and MIDP (39.7% vs. 57.8%, <em>P</em> = 0.60) or in the overall survival (OS) rates (66.7% vs. 74.1%, <em>P</em> = 0.43). Similarly, in the NAC group, MIDP resulted in significantly less blood loss than ODP (<em>P</em> = 0.01); ODP and MIDP had similar 2-year RFS rates (41.7% and 60.0%, <em>P</em> = 0.75) and OS rates (50.0% and 70.0%, <em>P</em> = 0.36). The interval from surgery to adjuvant chemotherapy initiation did not significantly differ between the ODP and MIDP subgroups in both the upfront group (<em>P</em> = 0.13) and the NAC group (<em>P</em> = 0.14). The incidence of recurrence was 64.8% for ODP and 42.8% for MIDP (<em>P</em> = 0.06). Both procedures showed similar distributions of local and distant recurrence.</div></div><div><h3>Conclusions</h3><div>MIDP caused less blood loss and had similar oncologic safety compared with ODP. MIDP could become a feasible, minimally invasive option with sufficient oncologic safety for pancreatic body and tail cancers.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"25 1","pages":"Pages 83-90"},"PeriodicalIF":4.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472481","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 : 2025-10-28DOI: 10.1016/j.hbpd.2025.10.009
Xing-Ru Wang , Qi-Fan Zhang , Wei Cheng , Xiao Liang , Jun Cao , Yong-Gang Wei , Jian-Wei Li , Hong-Guang Wang , Chinese Research Group for Minimally Invasive Anatomical Liver Resection (The Workshop of Liver Future [W.O.L.F.])
Background
Laparoscopic anatomic hepatectomy of segment 7 (LAH-S7) is a challenging surgery. In this study we aimed to investigate surgical and oncological outcomes of various approaches of LAH-S7 in patients with hepatocellular carcinoma (HCC). A particular focus was placed on identifying the Glissonean pedicle of segment 7 (G7) and the intersegmental plane. Given the scarcity of comprehensive reviews or comparative studies on clinical outcomes, we also sought to analyze the experiences and advantages associated with different approaches in relation to the anatomic variations of G7.
Methods
The clinical data of 124 patients who underwent LAH-S7 for HCC across seven tertiary referral medical centers in China were retrospectively analyzed. Three surgical approaches were categorized based on the procedures used for G7 identification: the indocyanine green (ICG) fluorescence positive staining approach (IFPA), the Glissonean approach (GA), and the hepatic vein-guided approach (HVGA). Subsequently, the postoperative short-term results and oncological outcomes of the three different approaches were compared.
Results
The distribution of surgical approaches among the patients was as follows: IFPA in 16 (12.9%), GA in 62 (50.0%), and HVGA in 46 (37.1%) patients. Complications were observed in 27 (21.8%) patients. The 1-, 3-, and 5-year overall survival (OS) rates were 99.1%, 89.2%, and 84.7%, respectively. The 1-, 3-, and 5-year recurrence-free survival (RFS) rates were 99.0%, 84.7%, and 69.3%, respectively. The OS and RFS rates were comparable across the three approaches.
Conclusions
Following a standardized surgical procedure, LAH-S7 is demonstrated to be safe and yields favorable oncological outcomes. Surgeons performing LAH-S7 should select the appropriate surgical approach based on the anatomical characteristics and variations of G7.
{"title":"Different approaches of laparoscopic anatomic hepatectomy of segment 7 for hepatocellular carcinoma: A multicenter study","authors":"Xing-Ru Wang , Qi-Fan Zhang , Wei Cheng , Xiao Liang , Jun Cao , Yong-Gang Wei , Jian-Wei Li , Hong-Guang Wang , Chinese Research Group for Minimally Invasive Anatomical Liver Resection (The Workshop of Liver Future [W.O.L.F.])","doi":"10.1016/j.hbpd.2025.10.009","DOIUrl":"10.1016/j.hbpd.2025.10.009","url":null,"abstract":"<div><h3>Background</h3><div>Laparoscopic anatomic hepatectomy of segment 7 (LAH-S7) is a challenging surgery. In this study we aimed to investigate surgical and oncological outcomes of various approaches of LAH-S7 in patients with hepatocellular carcinoma (HCC). A particular focus was placed on identifying the Glissonean pedicle of segment 7 (G7) and the intersegmental plane. Given the scarcity of comprehensive reviews or comparative studies on clinical outcomes, we also sought to analyze the experiences and advantages associated with different approaches in relation to the anatomic variations of G7.</div></div><div><h3>Methods</h3><div>The clinical data of 124 patients who underwent LAH-S7 for HCC across seven tertiary referral medical centers in China were retrospectively analyzed. Three surgical approaches were categorized based on the procedures used for G7 identification: the indocyanine green (ICG) fluorescence positive staining approach (IFPA), the Glissonean approach (GA), and the hepatic vein-guided approach (HVGA). Subsequently, the postoperative short-term results and oncological outcomes of the three different approaches were compared.</div></div><div><h3>Results</h3><div>The distribution of surgical approaches among the patients was as follows: IFPA in 16 (12.9%), GA in 62 (50.0%), and HVGA in 46 (37.1%) patients. Complications were observed in 27 (21.8%) patients. The 1-, 3-, and 5-year overall survival (OS) rates were 99.1%, 89.2%, and 84.7%, respectively. The 1-, 3-, and 5-year recurrence-free survival (RFS) rates were 99.0%, 84.7%, and 69.3%, respectively. The OS and RFS rates were comparable across the three approaches.</div></div><div><h3>Conclusions</h3><div>Following a standardized surgical procedure, LAH-S7 is demonstrated to be safe and yields favorable oncological outcomes. Surgeons performing LAH-S7 should select the appropriate surgical approach based on the anatomical characteristics and variations of G7.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"25 1","pages":"Pages 42-51"},"PeriodicalIF":4.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496187","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 : 2025-10-28DOI: 10.1016/j.hbpd.2025.10.008
Wen-Ya Li , Mu-Qing Yang , Jia-Hao Pei, Wei-Feng Tan
{"title":"Three-dimensional technology in biliary tract reconstruction for cholangiocarcinoma after hepatectomy","authors":"Wen-Ya Li , Mu-Qing Yang , Jia-Hao Pei, Wei-Feng Tan","doi":"10.1016/j.hbpd.2025.10.008","DOIUrl":"10.1016/j.hbpd.2025.10.008","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"25 1","pages":"Pages 94-96"},"PeriodicalIF":4.4,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472456","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}
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