Pub Date : 2025-08-06DOI: 10.1016/j.hbpd.2025.08.001
Lin Wang , Dong-Ying Ji , Ji-Dong Jia
{"title":"Efficacy and safety of immunosuppressive therapy for autoimmune hepatitis patients with cirrhosis unsuitable for biopsy","authors":"Lin Wang , Dong-Ying Ji , Ji-Dong Jia","doi":"10.1016/j.hbpd.2025.08.001","DOIUrl":"10.1016/j.hbpd.2025.08.001","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 5","pages":"Pages 570-575"},"PeriodicalIF":4.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884319","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}
Transfer RNA-derived small RNA (tsRNA) is a novel class of small non-coding RNAs (sncRNAs) that are generated through precise enzymatic cleavage of mature tRNAs or their precursor molecules. These tsRNAs play a pivotal role in regulating cellular processes such as protein synthesis, translation, and gene expression networks. This review offers a comprehensive overview of the functional characteristics of 24 tsRNAs, highlighting significant changes in their expression profiles across various liver diseases. Notably, 13 tsRNAs are upregulated, while 4 are downregulated in liver diseases compared to healthy controls, providing new insights into their biological roles. A major focus of this review is the latest research on the involvement of tsRNAs in a range of liver diseases, including hepatitis B and C, alcoholic liver disease, metabolic dysfunction-associated steatotic liver disease (MASLD, or non-alcoholic fatty liver disease, NAFLD), and hepatocellular carcinoma (HCC). This review explored how altered expression of tsRNAs in these conditions contributes to disease progression, along with the underlying regulatory mechanisms. Beyond their molecular roles, this review also examined the potential of tsRNAs as diagnostic and prognostic biomarkers for liver diseases. Due to their unique biological characteristics and functional versatility, tsRNAs hold promise as therapeutic targets in precision medicine. By highlighting their potential for developing more effective, targeted therapies, this review paves the way for future clinical applications of tsRNAs in liver disease treatment.
转移RNA衍生小RNA （Transfer RNA-derived small RNA, tsRNA）是一类新型的非编码小RNA (sncRNAs)，它是通过对成熟tRNAs或其前体分子进行精确的酶切而产生的。这些tsRNAs在调节蛋白质合成、翻译和基因表达网络等细胞过程中起着关键作用。本文综述了24种tsRNAs的功能特征，强调了它们在各种肝脏疾病中的表达谱的显著变化。值得注意的是，与健康对照相比，13种tsRNAs在肝脏疾病中上调，而4种tsRNAs下调，这为其生物学作用提供了新的见解。本综述的主要焦点是tsRNAs在一系列肝脏疾病中的最新研究，包括乙型和丙型肝炎、酒精性肝病、代谢功能障碍相关的脂肪变性肝病（MASLD，或非酒精性脂肪性肝病，NAFLD）和肝细胞癌（HCC）。这篇综述探讨了这些疾病中tsRNAs表达的改变是如何促进疾病进展的，以及潜在的调节机制。除了它们的分子作用外，本综述还研究了tsRNAs作为肝脏疾病诊断和预后生物标志物的潜力。由于其独特的生物学特性和功能的多功能性，tsRNAs有望成为精准医学的治疗靶点。通过强调它们在开发更有效的靶向治疗方面的潜力，本综述为tsRNAs在肝脏疾病治疗中的未来临床应用铺平了道路。
{"title":"Transfer RNA-derived small RNAs in liver disease.","authors":"Qin-Yuan Huang, Zi-Yan Zhou, Yi-Le Zhang, Yang Zhou, Shi-Wei Duan, Jing-Yin Dong","doi":"10.1016/j.hbpd.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.hbpd.2025.07.001","url":null,"abstract":"<p><p>Transfer RNA-derived small RNA (tsRNA) is a novel class of small non-coding RNAs (sncRNAs) that are generated through precise enzymatic cleavage of mature tRNAs or their precursor molecules. These tsRNAs play a pivotal role in regulating cellular processes such as protein synthesis, translation, and gene expression networks. This review offers a comprehensive overview of the functional characteristics of 24 tsRNAs, highlighting significant changes in their expression profiles across various liver diseases. Notably, 13 tsRNAs are upregulated, while 4 are downregulated in liver diseases compared to healthy controls, providing new insights into their biological roles. A major focus of this review is the latest research on the involvement of tsRNAs in a range of liver diseases, including hepatitis B and C, alcoholic liver disease, metabolic dysfunction-associated steatotic liver disease (MASLD, or non-alcoholic fatty liver disease, NAFLD), and hepatocellular carcinoma (HCC). This review explored how altered expression of tsRNAs in these conditions contributes to disease progression, along with the underlying regulatory mechanisms. Beyond their molecular roles, this review also examined the potential of tsRNAs as diagnostic and prognostic biomarkers for liver diseases. Due to their unique biological characteristics and functional versatility, tsRNAs hold promise as therapeutic targets in precision medicine. By highlighting their potential for developing more effective, targeted therapies, this review paves the way for future clinical applications of tsRNAs in liver disease treatment.</p>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692502","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 : 2025-07-01DOI: 10.1016/j.hbpd.2025.06.008
Han-Ying Zhou , Ting Li , Yuan-Qiang Lu
Background
Diquat, a commonly employed bipyridyl herbicide, is recognized for its hepatotoxic effects attributed to the generation of reactive oxygen species. Baicalin (BAI), a flavonoid derivative, has garnered significant research interest for its hepatoprotective properties. Nevertheless, the clinical application of BAI is constrained by its limited water solubility and poor bioavailability. To address these challenges, BAI-nanoliposome (BAI-NL) has emerged as a novel drug delivery platform aimed at enhancing therapeutic outcomes.
Methods
We used diquat-induced liver injury mouse model and AML12 hepatocytes to test the protective effect of BAI and BAI-NL on liver inflammation, oxidative stress, and mitochondrial function. The parameters included histological, biochemical, and molecular biological analyses.
Results
In the diquat-induced model, both BAI and BAI-NL exhibited effectiveness on attenuating liver inflammation. Ex vivo analyses further indicated that BAI-NL was superior to BAI in preserving mitochondrial membrane potential, reducing oxidative stress, and modulating the phosphatase and tensin homolog-induced putative kinase 1 (PINK1)/Parkin RBR E3 ubiquitin-protein ligase (Parkin) signaling pathway. These findings enhanced mitophagy and facilitated the removal of damaged mitochondria.
Conclusions
BAI-NL exhibited superior hepatoprotective effects compared to free BAI, possibly by reducing inflammation, preserving mitochondrial homeostasis, and reinstating autophagic balance through modulation of the PINK1/Parkin signaling pathway. These outcomes indicate a groundbreaking method for addressing liver diseases and underscore the potential of nanoliposome technology in augmenting the efficacy of natural compounds.
{"title":"Baicalin and its nanoliposome ameliorate diquat-induced liver injury by promoting PINK1/Parkin-dependent mitophagy","authors":"Han-Ying Zhou , Ting Li , Yuan-Qiang Lu","doi":"10.1016/j.hbpd.2025.06.008","DOIUrl":"10.1016/j.hbpd.2025.06.008","url":null,"abstract":"<div><h3>Background</h3><div><span>Diquat, a commonly employed </span>bipyridyl<span><span> herbicide, is recognized for its hepatotoxic effects attributed to the generation of reactive oxygen species. </span>Baicalin<span> (BAI), a flavonoid derivative, has garnered significant research interest for its hepatoprotective properties. Nevertheless, the clinical application of BAI is constrained by its limited water solubility and poor bioavailability. To address these challenges, BAI-nanoliposome (BAI-NL) has emerged as a novel drug delivery platform aimed at enhancing therapeutic outcomes.</span></span></div></div><div><h3>Methods</h3><div>We used diquat-induced liver injury mouse model and AML12 hepatocytes to test the protective effect of BAI and BAI-NL on liver inflammation, oxidative stress, and mitochondrial function. The parameters included histological, biochemical, and molecular biological analyses.</div></div><div><h3>Results</h3><div>In the diquat-induced model, both BAI and BAI-NL exhibited effectiveness on attenuating liver inflammation. <em>Ex vivo</em><span><span><span><span> analyses further indicated that BAI-NL was superior to BAI in preserving mitochondrial membrane potential, reducing oxidative stress, and modulating the </span>phosphatase and </span>tensin<span> homolog-induced putative kinase 1 (PINK1)/Parkin RBR E3 ubiquitin-protein ligase (Parkin) signaling pathway. These findings enhanced </span></span>mitophagy and facilitated the removal of damaged mitochondria.</span></div></div><div><h3>Conclusions</h3><div>BAI-NL exhibited superior hepatoprotective effects compared to free BAI, possibly by reducing inflammation, preserving mitochondrial homeostasis<span>, and reinstating autophagic balance through modulation of the PINK1/Parkin signaling pathway. These outcomes indicate a groundbreaking method for addressing liver diseases and underscore the potential of nanoliposome<span> technology in augmenting the efficacy of natural compounds.</span></span></div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 5","pages":"Pages 527-534"},"PeriodicalIF":4.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627794","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 : 2025-06-23DOI: 10.1016/j.hbpd.2025.06.006
Karina Hocine , Anaïs R. Briant , Thomas Chaigneau , Wendy Kam , Thierry Collet , Jean-Jacques Parienti , Marie Astrid Piquet , Benoît Dupont
Background
Acute cholangitis is an infection due to the bile duct obstruction. Despite progress in treatment, acute cholangitis remains potentially fatal. Early diagnosis and treatment improve the patient outcomes. The present study aimed to identify clinical and biological factors at admission associated with 30-day mortality in acute cholangitis, to build an efficient prognostic score based on these parameters and to study the performances of this new score.
Methods
We enrolled all adult patients consecutively hospitalized for acute cholangitis between January 2017 and December 2021. We developed a score system named ProChol using variables significantly associated with 30-day mortality in multivariate logistic analysis and simplified this system (named sProChol) based on a simple points-based approach.
Results
In total, 528 patients were included, with an average age of 77 ± 13 years, a male predominance (54.2%) and a majority of lithiasis etiology (66.5%). Mortality in 30 days was 11.9%. In multivariate logistic analysis, tumor etiology [adjusted odds ratio (aOR) = 15.43, 95% confidence interval (CI): 5.90-40.40], stent obstruction (aOR = 5.12, 95% CI: 2.02-12.99), hypoalbuminemia (aOR = 3.50, 95% CI: 1.25-9.81), renal failure (aOR = 6.51, 95% CI: 2.62-16.18), oxygen therapy (aOR = 4.63, 95% CI: 1.02-20.92) and curative anticoagulation (aOR = 2.60, 95% CI: 1.23-5.52) were independently associated with the 30-day mortality while fever was a protective factor (aOR = 0.37, 95% CI: 0.16-0.84). ProChol score using these 7 parameters and sProChol using the 3 robust factors (etiology, renal failure and anticoagulation) presented respectively an area under receiver operating characteristic (ROC) curves (AUC) of 0.81 and 0.77, higher than Tokyo (AUC = 0.72) and Gravito-Soares et al. score (AUC = 0.71). Patients with sProChol ≥ 4 had a significantly higher risk of transfer to intensive care unit (13.3% vs. 5.1%; P < 0.001) and longer length of stay (P = 0.0006).
Conclusions
ProChol and sProChol constructed from simple clinico-biological parameters at admission, present interesting performances in predicting the 30-day mortality in acute cholangitis.
{"title":"Early prediction of mortality in acute cholangitis: Elaboration of a new simple prognostic score","authors":"Karina Hocine , Anaïs R. Briant , Thomas Chaigneau , Wendy Kam , Thierry Collet , Jean-Jacques Parienti , Marie Astrid Piquet , Benoît Dupont","doi":"10.1016/j.hbpd.2025.06.006","DOIUrl":"10.1016/j.hbpd.2025.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Acute cholangitis<span> is an infection due to the bile duct obstruction<span>. Despite progress in treatment, acute cholangitis remains potentially fatal. Early diagnosis and treatment improve the patient outcomes. The present study aimed to identify clinical and biological factors at admission associated with 30-day mortality in acute cholangitis, to build an efficient prognostic score based on these parameters and to study the performances of this new score.</span></span></div></div><div><h3>Methods</h3><div>We enrolled all adult patients consecutively hospitalized for acute cholangitis between January 2017 and December 2021. We developed a score system named ProChol using variables significantly associated with 30-day mortality in multivariate logistic analysis and simplified this system (named sProChol) based on a simple points-based approach.</div></div><div><h3>Results</h3><div><span><span>In total, 528 patients were included, with an average age of 77 ± 13 years, a male predominance (54.2%) and a majority of lithiasis etiology (66.5%). Mortality in 30 days was 11.9%. In multivariate logistic analysis, tumor etiology [adjusted odds ratio (aOR) = 15.43, 95% confidence interval (CI): 5.90-40.40], stent obstruction<span> (aOR = 5.12, 95% CI: 2.02-12.99), hypoalbuminemia (aOR = 3.50, 95% CI: 1.25-9.81), renal failure (aOR = 6.51, 95% CI: 2.62-16.18), oxygen therapy (aOR = 4.63, 95% CI: 1.02-20.92) and curative </span></span>anticoagulation<span> (aOR = 2.60, 95% CI: 1.23-5.52) were independently associated with the 30-day mortality while fever was a protective factor (aOR = 0.37, 95% CI: 0.16-0.84). ProChol<span> score using these 7 parameters and sProChol using the 3 robust factors (etiology, renal failure and anticoagulation) presented respectively an area under receiver operating characteristic (ROC) curves (AUC) of 0.81 and 0.77, higher than Tokyo (AUC = 0.72) and Gravito-Soares et al. score (AUC = 0.71). Patients with sProChol ≥ 4 had a significantly higher risk of transfer to intensive care unit (13.3% vs. 5.1%; </span></span></span><em>P</em> < 0.001) and longer length of stay (<em>P</em> = 0.0006).</div></div><div><h3>Conclusions</h3><div>ProChol and sProChol constructed from simple clinico-biological parameters at admission, present interesting performances in predicting the 30-day mortality in acute cholangitis.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 5","pages":"Pages 535-542"},"PeriodicalIF":4.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610345","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 : 2025-06-23DOI: 10.1016/j.hbpd.2025.06.007
Yeon-Ju Kim , Min Kyu Sung , Chan-Sik Kim , Jungbok Lee , Ji-Hyeon Kim , Ji-Hoon Sim , Sung-Moon Jeong
Background
Although the prognostic nutritional index (PNI) may predict surgical outcomes in certain cancers, the impact of PNI on surgical prognosis in patients undergoing pylorus-preserving pancreaticoduodenectomy (PPPD) is unclear. This study aimed to investigate the impact of preoperative PNI on mortality rate and cancer recurrence rate in patients who underwent PPPD.
Methods
A total of 718 patients who were diagnosed with periampullary or pancreatic cancer and underwent PPPD between January 2012 and December 2016 were analyzed. Patients were categorized into two groups using the optimal cut-off value for PNI, determined by calculating the receiver operating characteristic (ROC) curve and the Youden index. We performed propensity score matching (PSM) analysis to compare the mortality rate and cancer recurrence rate between the two groups. In addition, Cox regression analyses were performed to examine the association of PNI with mortality rate and cancer recurrence rate.
Results
Using the 1-year mortality as an endpoint, the area under the ROC curve for PNI was 0.620 (optimal cut-off value: 41.7). We observed significant differences in 1-year (P = 0.001), 5-year (P = 0.002), and overall (P = 0.001) mortality; 1-year (P = 0.013), 5-year (P = 0.032), and overall (P = 0.017) cancer recurrence between groups after PSM. High PNI was significantly associated with reduced 1-year [adjusted hazard ratio (HR) = 0.44, 95% confidence interval (CI): 0.26-0.74, P = 0.020], 5-year (HR = 0.66, 95% CI: 0.52-0.84, P < 0.001), and overall (HR = 0.71, 95% CI: 0.57-0.88, P = 0.002) mortality; 1-year (HR = 0.70, 95% CI: 0.52-0.93, P = 0.016), 5-year (HR = 0.78, 95% CI: 0.62-0.97, P = 0.027) and overall (HR = 0.78, 95% CI: 0.63-0.97, P = 0.024) cancer recurrence.
Conclusions
Preoperative PNI may serve as an independent factor for short- and long-term surgical prognosis in cancer patients undergoing PPPD.
背景：虽然预后营养指数（PNI）可以预测某些癌症的手术结果，但PNI对保留幽门的胰十二指肠切除术（PPPD）患者手术预后的影响尚不清楚。本研究旨在探讨术前PNI对PPPD患者死亡率和癌症复发率的影响。方法：对2012年1月至2016年12月诊断为壶腹周围癌或胰腺癌并行PPPD的718例患者进行分析。通过计算受试者工作特征（ROC）曲线和约登指数，采用PNI的最佳临界值将患者分为两组。我们采用倾向评分匹配（PSM）分析比较两组患者的死亡率和癌症复发率。此外，还进行了Cox回归分析，以检验PNI与死亡率和癌症复发率的关系。结果：以1年死亡率为终点，PNI的ROC曲线下面积为0.620（最佳截断值为41.7）。我们观察到1年（P = 0.001）、5年（P = 0.002）和总死亡率（P = 0.001）有显著差异；PSM术后1年（P = 0.013）、5年（P = 0.032）、总复发（P = 0.017）组间比较。高PNI与降低1年[校正风险比(HR) = 0.44, 95%可信区间（CI）： 0.26-0.74, P = 0.020]、5年（HR = 0.66, 95% CI: 0.52-0.84, P < 0.001）和总体（HR = 0.71, 95% CI: 0.57-0.88, P = 0.002）死亡率显著相关；1年（HR = 0.70, 95% CI: 0.52-0.93, P = 0.016）、5年（HR = 0.78, 95% CI: 0.62-0.97, P = 0.027）和总体（HR = 0.78, 95% CI: 0.63-0.97, P = 0.024）肿瘤复发率。结论：术前PNI可能是影响PPPD患者短期和长期手术预后的独立因素。
{"title":"Impact of prognostic nutritional index on survival in periampullary/pancreatic cancer patients undergoing pylorus-preserving pancreaticoduodenectomy: A propensity score-matched analysis","authors":"Yeon-Ju Kim , Min Kyu Sung , Chan-Sik Kim , Jungbok Lee , Ji-Hyeon Kim , Ji-Hoon Sim , Sung-Moon Jeong","doi":"10.1016/j.hbpd.2025.06.007","DOIUrl":"10.1016/j.hbpd.2025.06.007","url":null,"abstract":"<div><h3>Background</h3><div><span>Although the prognostic nutritional index (PNI) may predict surgical outcomes in certain cancers, the impact of PNI on surgical prognosis in patients undergoing pylorus-preserving pancreaticoduodenectomy (PPPD) is unclear. This study aimed to investigate the impact of preoperative PNI on mortality rate and </span>cancer recurrence rate in patients who underwent PPPD.</div></div><div><h3>Methods</h3><div>A total of 718 patients who were diagnosed with periampullary or pancreatic cancer<span><span> and underwent PPPD between January 2012 and December 2016 were analyzed. Patients were categorized into two groups using the optimal cut-off value for PNI, determined by calculating the receiver operating characteristic (ROC) curve and the Youden index. We performed </span>propensity score matching<span> (PSM) analysis to compare the mortality rate and cancer recurrence rate between the two groups. In addition, Cox regression analyses were performed to examine the association of PNI with mortality rate and cancer recurrence rate.</span></span></div></div><div><h3>Results</h3><div>Using the 1-year mortality as an endpoint, the area under the ROC curve for PNI was 0.620 (optimal cut-off value: 41.7). We observed significant differences in 1-year (<em>P</em> = 0.001), 5-year (<em>P</em> = 0.002), and overall (<em>P</em> = 0.001) mortality; 1-year (<em>P</em> = 0.013), 5-year (<em>P</em> = 0.032), and overall (<em>P</em> = 0.017) cancer recurrence between groups after PSM. High PNI was significantly associated with reduced 1-year [adjusted hazard ratio (HR) = 0.44, 95% confidence interval (CI): 0.26-0.74, <em>P</em> = 0.020], 5-year (HR = 0.66, 95% CI: 0.52-0.84, <em>P</em> < 0.001), and overall (HR = 0.71, 95% CI: 0.57-0.88, <em>P</em> = 0.002) mortality; 1-year (HR = 0.70, 95% CI: 0.52-0.93, <em>P</em> = 0.016), 5-year (HR = 0.78, 95% CI: 0.62-0.97, <em>P</em> = 0.027) and overall (HR = 0.78, 95% CI: 0.63-0.97, <em>P</em> = 0.024) cancer recurrence.</div></div><div><h3>Conclusions</h3><div>Preoperative PNI may serve as an independent factor for short- and long-term surgical prognosis in cancer patients undergoing PPPD.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 5","pages":"Pages 550-557"},"PeriodicalIF":4.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592900","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 : 2025-06-19DOI: 10.1016/j.hbpd.2025.06.005
Wen-Bin Zou , Sheng-Han Mao , Zhao-Shen Li
{"title":"Novel treatment strategies for pancreatitis: Current status and future prospects","authors":"Wen-Bin Zou , Sheng-Han Mao , Zhao-Shen Li","doi":"10.1016/j.hbpd.2025.06.005","DOIUrl":"10.1016/j.hbpd.2025.06.005","url":null,"abstract":"","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 4","pages":"Pages 355-358"},"PeriodicalIF":3.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531217","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 : 2025-06-18DOI: 10.1016/j.hbpd.2025.06.004
Xiao-Yu Guo , Fan Xiao , Jie Hu , Hui Lin , Zi-Jian Huang , Liang Zhang , Long Cheng , Gang Wang
Background
Hemorrhage remains a formidable complication of severe acute pancreatitis (SAP), with a high mortality rate. However, there is currently no effective method for identifying SAP patients who are at high risk for massive bleeding. The present study aimed to explore risk factors for predicting massive bleeding in SAP patients and to develop a predictive nomogram, which could facilitate early prediction, and timely appropriate interventions.
Methods
We conducted a multivariate logistic regression analysis to examine the relationship between massive bleeding and variables including patient demographics, disease severity, laboratory indexes and local pancreatic complications. A novel nomogram was constructed based on these factors, and was validated both internally and externally assessing its discrimination, calibration, and clinical applicability.
Results
The study involved 351 patients in the training cohort, 104 patients in the internal validation cohort, and 123 patients in the external validation cohort. Logistic regression analysis identified several independent risk factors for massive bleeding, including computed tomography severity index score above 8 points, Acute Physiology and Chronic Health Evaluation II score greater than 16 points, abdominal compartment syndrome, pancreatic fistula, and sepsis. The nomogram constructed from these factors yielded an area under the receiver operating characteristic curve (AUC) of 0.896 and a coefficient of determination (R²) of 0.093. The Hosmer-Lemeshow test indicated good model fitness (P = 0.654). Furthermore, the nomogram demonstrated reliable performance in both validation cohorts.
Conclusions
The nomogram showed strong predictive capability for massive bleeding and could be a valuable tool for clinicians in identifying SAP patients at high risk for this complication at an early stage.
{"title":"Development and validation of a nomogram to predict massive bleeding requiring intervention in severe acute pancreatitis","authors":"Xiao-Yu Guo , Fan Xiao , Jie Hu , Hui Lin , Zi-Jian Huang , Liang Zhang , Long Cheng , Gang Wang","doi":"10.1016/j.hbpd.2025.06.004","DOIUrl":"10.1016/j.hbpd.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Hemorrhage remains a formidable complication of severe acute pancreatitis (SAP), with a high mortality rate. However, there is currently no effective method for identifying SAP patients who are at high risk for massive bleeding. The present study aimed to explore risk factors for predicting massive bleeding in SAP patients and to develop a predictive nomogram, which could facilitate early prediction, and timely appropriate interventions.</div></div><div><h3>Methods</h3><div>We conducted a multivariate logistic regression analysis to examine the relationship between massive bleeding and variables including patient demographics, disease severity, laboratory indexes and local pancreatic complications. A novel nomogram was constructed based on these factors, and was validated both internally and externally assessing its discrimination, calibration, and clinical applicability.</div></div><div><h3>Results</h3><div>The study involved 351 patients in the training cohort, 104 patients in the internal validation cohort, and 123 patients in the external validation cohort. Logistic regression analysis identified several independent risk factors for massive bleeding, including computed tomography severity index score above 8 points, Acute Physiology and Chronic Health Evaluation II score greater than 16 points, abdominal compartment syndrome, pancreatic fistula, and sepsis. The nomogram constructed from these factors yielded an area under the receiver operating characteristic curve (AUC) of 0.896 and a coefficient of determination (R²) of 0.093. The Hosmer-Lemeshow test indicated good model fitness (<em>P</em> = 0.654). Furthermore, the nomogram demonstrated reliable performance in both validation cohorts.</div></div><div><h3>Conclusions</h3><div>The nomogram showed strong predictive capability for massive bleeding and could be a valuable tool for clinicians in identifying SAP patients at high risk for this complication at an early stage.</div></div>","PeriodicalId":55059,"journal":{"name":"Hepatobiliary & Pancreatic Diseases International","volume":"24 4","pages":"Pages 388-395"},"PeriodicalIF":3.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531216","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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