Frontiers in gastroenterology (Lausanne, Switzerland)最新文献_第8页

The putative role of gut microbiota in cancer: Cysteine is a pivotal coin 肠道微生物群在癌症中的假定作用：半胱氨酸是一个关键的硬币

Frontiers in gastroenterology (Lausanne, Switzerland)

Pub Date : 2022-08-05 DOI: 10.3389/fgstr.2022.966957

J. Serpa

Tumor metabolism is mandatory for the proper adaptation of malignant cells to the microenvironment and the acquisition of crucial cellular skills supporting the systemic spread of cancer. Throughout this journey, the contribution of the gut microbiota to the bioavailability of nutrients supporting the bioenergetic and biosynthetic requirements of malignant cells is an issue. This review will focus on the role of cysteine as a coin that mediates the metabolic crosstalk between microbiota and cancer. The key points enclose the way cysteine can be made available by the microbiota, by degradation of more complex compounds or by de novo synthesis, in order to contribute to the enrichment of the colonic microenvironment as well to the increase of cysteine systemic bioavailability. In addition, the main metabolic pathways in cancer that rely on cysteine as a source of energy and biomass will be pointed out and how the interspecific relationship with the microbiota and its dynamics related to aging may be relevant points to explore, contributing to a better understanding of cancer biology.

肿瘤代谢对于恶性细胞对微环境的适当适应和获得支持癌症全身扩散的关键细胞技能是强制性的。在整个过程中，肠道微生物群对支持恶性细胞生物能量和生物合成需求的营养物质的生物利用度的贡献是一个问题。这篇综述将集中于半胱氨酸作为一种硬币的作用，它介导微生物群和癌症之间的代谢串扰。关键点包括微生物群、更复杂化合物的降解或从头合成半胱氨酸的方式，以促进结肠微环境的富集以及半胱氨酸系统生物利用度的提高。此外，还将指出癌症中依赖半胱氨酸作为能量和生物量来源的主要代谢途径，以及与微生物群的种间关系及其与衰老相关的动力学可能是相关的探索点，有助于更好地理解癌症生物学。

引用次数: 1

Real-word evaluation of differences in bowel preparation for colonoscopy between the digestive and the non-digestive physicians: A retrospective study 消化道医生和非消化道医生结肠镜检查肠道准备差异的真实评估：一项回顾性研究

Frontiers in gastroenterology (Lausanne, Switzerland)

Pub Date : 2022-07-28 DOI: 10.3389/fgstr.2022.946459

Cenqin Liu, Xin Yuan, Hui Gao, Zhixin Zhang, Weihong Wang, Jiarong Xie, Hongpeng Lu, Jing Chen, Chaohui Yu, Lei Xu

Introduction Using real-world data, we compared the quality of bowel preparation instructed by the digestive and non-digestive physicians in outpatients for colonoscopy and identified potential risk factors. Methods This was a retrospective study based on real-world data, which were collected from the Ningbo First Hospital in China from December 2019 to October 2020. Outpatients included were classified into the digestive and the non-digestive physician groups according to the referring physician. The primary outcome was adequate bowel preparation measured by the Boston Bowel Preparation Scale (BBPS), namely, a BBPS score of 2 or higher in any colonic segment and a total score ≥ 6. Secondary outcomes included the total mean BBPS scores and possible risk factors associated with poor bowel preparation. Results There were 671 outpatients included, with 392 in the digestive physician group and 279 in the non-digestive physician group. Adequate bowel preparation was 84.2% in the digestive physician group and 71.0% in the non-digestive physician group (odds ratio [OR]: 1.50, p < 0.001), and the latter had lower total mean BBPS scores (6.12 ± 1.33 vs. 6.66 ± 1.29, p < 0.001). The non-digestive physician was an independent risk factor according to the multivariate logistic regression analysis (OR: 0.45, p < 0.001). Conclusion The quality of bowel preparations instructed by non-digestive physicians was inferior to digestive physicians, which was a factor potentially associated with poor bowel preparation (ClinicalTrials.gov number: NCT04738578).

引言利用真实世界的数据，我们比较了消化道和非消化道医生在门诊结肠镜检查中指导的肠道准备质量，并确定了潜在的风险因素。方法回顾性研究基于2019年12月至2020年10月在中国宁波市第一医院收集的真实世界数据。根据转诊医生，门诊患者被分为消化科和非消化科医生组。主要结果是通过波士顿肠道准备量表（BBPS）测量的充分的肠道准备，即任何结肠段的BBPS评分为2或更高，总分≥6。次要结果包括总平均BBPS评分和与肠道准备不良相关的可能风险因素。结果门诊671例，其中消化内科392例，非消化内科279例。充分的肠道准备在消化科医生组中为84.2%，在非消化科医师组中为71.0%（比值比[OR]:1.50，p<0.001），后者的总平均BBPS评分较低（6.12±1.33 vs.6.66±1.29，p＜0.001）。根据多变量逻辑回归分析，非消化科医生是一个独立的危险因素（OR：0.45，p＜001），这是一个可能与肠道准备不良有关的因素（ClinicalTrials.gov编号：NCT04738578）。

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引用次数: 0

Occult Hepatitis B Virus Infection Among Blood Donors in the Capital City of Addis Ababa, Ethiopia: Implications for Blood Transfusion Safety 埃塞俄比亚首都亚的斯亚贝巴献血者中隐性乙型肝炎病毒感染:对输血安全的影响

Frontiers in gastroenterology (Lausanne, Switzerland)

Pub Date : 2022-07-06 DOI: 10.3389/fgstr.2022.887260

G. Gemechu, Woldearegay Erku Abagez, D. Alemayehu, A. Tesfaye, Deme Tadesse, Abiy Kinfu, A. Mihret, A. Mulu

Background Occult hepatitis B virus infection (OBI) remains a potential threat to blood safety in developing countries. Nevertheless, there is no data available on the magnitude of occult hepatitis among blood donors in Ethiopia. Therefore, this study aimed to estimate the magnitude of OBI among blood donors in Ethiopia. Objectives The aim of this study is to determine the magnitude of OBI and associated risk factors among blood donors at the National Blood Bank, Addis Ababa, Ethiopia. Methods A total of 973 HBsAg-negative plasma samples were tested for anti-HBc antibody using an ELISA and viral DNA using automated ABBOTT real-time PCR. Along with plasma samples, demographic data were retrieved from the database with respect to donors. Both descriptive and inferential statistics were employed for the analysis of data by SPSS 20. p-values less than 0.05 were considered as statistically significant. Results Of the total of 973 study participants, 445 (45.7%) were female with a mean age of 26.5 years. A total of 144 (14.8%) blood samples were anti-HBc antibody reactive. Four (0.41% of all samples, and 2.8% of anti-HBc-positive samples) samples were confirmed to have OBI by DNA detection. The mean viral load among the confirmed OBI samples was 31 IU/ml with ±12 SD, suggesting true occult hepatitis BV infections. Age was found to be a risk factor for anti-core positivity and was statically significant at p = 0.0001. Conclusion About four out of 1,000 blood donors screened negative with HBsAg had occult HBV infection. This shows that there could be a risk of HBV transmission through blood transfusion in Ethiopia. Therefore, there is a need for further investigation and action to revise the existing blood screening strategy by including anti-HBc and HBV nucleic acid testing.

隐匿性乙型肝炎病毒感染(OBI)仍然是发展中国家血液安全的潜在威胁。然而，目前尚无关于埃塞俄比亚献血者中隐匿性肝炎发病率的数据。因此，本研究旨在估计埃塞俄比亚献血者中OBI的程度。本研究的目的是确定埃塞俄比亚亚的斯亚贝巴国家血库献血者中OBI的程度和相关危险因素。方法采用ELISA法检测973例hbsag阴性血浆样本的抗hbc抗体，采用全自动ABBOTT实时PCR法检测病毒DNA。除了血浆样本外，还从数据库中检索了有关献血者的人口统计数据。采用SPSS 20对数据进行描述性统计和推断性统计。p值小于0.05被认为具有统计学意义。结果973名研究参与者中，445名(45.7%)为女性，平均年龄26.5岁。144例(14.8%)血液样本呈抗hbc抗体阳性。4个样本(占所有样本的0.41%，占抗hbc阳性样本的2.8%)通过DNA检测确认为OBI。确诊OBI样本的平均病毒载量为31 IU/ml，±12 SD，提示真正的隐匿性乙型肝炎感染。年龄是抗核阳性的危险因素，p = 0.0001，具有统计学意义。结论在1000名HBsAg筛查阴性的献血者中，约有4人存在隐匿性HBV感染。这表明在埃塞俄比亚可能存在通过输血传播乙肝病毒的风险。因此，需要进一步的研究和行动来修改现有的血液筛查策略，包括抗hbc和HBV核酸检测。

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引用次数: 2

Dynamics in Circulating y -55Proinflammatory Biomarkers for Prognostic Assessment of Patients With Advanced HCC – A Substudy From the SORAMIC Trial 循环y-55促炎性生物标志物对晚期HCC患者预后评估的动力学——SORAMIC试验的一项子研究

Frontiers in gastroenterology (Lausanne, Switzerland)

Pub Date : 2022-07-05 DOI: 10.3389/fgstr.2022.939192

K. Schütte, J. Kupčinskas, Egidijus Morkūnas, O. Öcal, R. Schinner, M. Seidensticker, E. D. De Toni, N. Ben Khaled, M. Pech, D. Palmer, T. Berg, C. Sengel, B. Basu, J. Valle, J. Benckert, A. Gasbarrini, B. Sangro, P. Malfertheiner, J. Ricke

Introduction Prediction of response to treatment in patients with advanced hepatocellular carcinoma (HCC) may assist in the selection of personalized management. Objective This exploratory analysis of the palliative arm of the SORAMIC trial (ClinicalTrials.gov NCT01126645) evaluated the prognostic potential of basal and dynamic changes in systemic levels of interleukin 6 (IL-6), interleukin 8 (IL-8), systemic vascular endothelial growth factor (VEGF), and lipopolysaccharide (LPS). Methods We evaluated the correlations between overall survival (OS) and concentrations of IL-6, IL-8, VEGF, and LPS at follow-up approximately 7-9 weeks after treatment initialization (FU) compared to baseline (BL) in 90 patients treated either with 90Yttrium (90Y) microspheres combined with sorafenib (n = 44) or with sorafenib (n = 46) alone. Results Changes in IL-6 concentration during treatment showed correlations with the outcome. An increase in IL-6 concentration of less than 16.8 pg/mL over baseline readings was associated with better survival [median OS 16.3 months compared with 8.9 months (p = 0.0354)]. Correlations with survival were not observed for VEGF or LPS concentrations at baseline, at FU, or changes between these time points. Conclusions Changes in IL 6 serum levels at 7-9 weeks after treatment initialization but not in IL 8, VEGF, or LPS add important information on the outcome of advanced HCC patients treated palliatively within the SORAMIC trial.

引言预测晚期肝细胞癌（HCC）患者的治疗反应可能有助于选择个性化治疗。目的对SORAMIC试验（ClinicalTrials.gov NCT01126645）的姑息组进行探索性分析，评估全身白细胞介素6（IL-6）、白细胞介素8（IL-8）、全身血管内皮生长因子（VEGF）和脂多糖（LPS）水平的基础和动态变化的预后潜力。方法我们评估了90名患者在治疗开始后约7-9周的随访中，与基线（BL）相比，总生存期（OS）与IL-6、IL-8、VEGF和LPS浓度之间的相关性，这些患者要么接受90Y（90Y）微球联合索拉非尼（n=44）治疗，要么单独接受索拉非尼治疗（n=46）。结果治疗过程中IL-6浓度的变化与疗效相关。IL-6浓度比基线读数增加小于16.8 pg/mL与更好的生存率相关[中位OS 16.3个月，而8.9个月（p=0.0354）]。基线、FU时VEGF或LPS浓度或这些时间点之间的变化与生存率没有相关性。结论在SORAMIC试验中，治疗开始后7-9周血清IL-6水平的变化，而不是IL-8、VEGF或LPS的变化，为晚期HCC患者的预后提供了重要信息。

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引用次数: 0

Future of Colorectal Cancer Screening: From One-Size-FITs-All to Tailor-Made 结直肠癌癌症筛查的未来：从一次全科到量体裁衣

Frontiers in gastroenterology (Lausanne, Switzerland)

Pub Date : 2022-06-23 DOI: 10.3389/fgstr.2022.906052

Tim L Kortlever, M. van der Vlugt, E. Dekker

Screening for colorectal cancer (CRC) and its precursor lesions, advanced adenomas (AA), has been shown to effectively reduce CRC-related mortality. However, the method of CRC screening varies among countries. Primary colonoscopy screening is the most effective screening option from an individual point of view, but it is costly and population-wide participation rates are relatively low. Repeated screening with a fecal immunochemical test (FIT) is a non-invasive and inexpensive way to select individuals at high risk for CRC for colonoscopy. Despite its widespread use and mostly high participation rates, FIT is not perfect. Its sensitivity for advanced neoplasia (AN) is low. Besides, the false positivity rate of FIT is relatively high. This leads to unnecessary colonoscopies, anxiety, and risks among FIT-positives. New strategies need to be developed to improve CRC screening. In the past years, much research has been undertaken on risk-based screening or risk models. These include tests consisting of multiple risk factors and/or biomarkers that either assess the risk of disease at a single point in time (cross-sectional risk models) or predict the risk of developing CRC in the future (longitudinal risk models). We provide an overview of the developments on risk models for CRC screening and discuss some of the obstacles that need to be overcome to enable widespread implementation in existing CRC screening programs.

对癌症（CRC）及其前病变、晚期腺瘤（AA）进行筛查已被证明可有效降低CRC相关死亡率。然而，CRC筛查的方法因国家而异。从个人角度来看，初级结肠镜筛查是最有效的筛查选择，但成本高昂，而且全人群的参与率相对较低。粪便免疫化学测试（FIT）的重复筛查是一种非侵入性且廉价的方法，可以选择CRC高危人群进行结肠镜检查。尽管FIT的使用范围很广，参与率也很高，但它并不完美。其对晚期肿瘤（AN）的敏感性较低。此外，FIT的假阳性率相对较高。这会导致不必要的结肠镜检查、焦虑和FIT阳性的风险。需要制定新的战略来改进CRC筛查。在过去几年中，对基于风险的筛查或风险模型进行了大量研究。其中包括由多种风险因素和/或生物标志物组成的测试，这些测试要么评估单个时间点的疾病风险（横断面风险模型），要么预测未来发展为CRC的风险（纵向风险模型）。我们概述了CRC筛查风险模型的发展，并讨论了需要克服的一些障碍，以使现有CRC筛查计划能够广泛实施。

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引用次数: 0

Endoscopic Submucosal Dissection of Deeply Invasive Colorectal Cancers Using the Pocket-Creation Method: Analysis of Vertical Margins 内镜下粘膜下夹层术在深度浸润性结直肠癌中的应用:垂直边缘分析

Frontiers in gastroenterology (Lausanne, Switzerland)

Pub Date : 2022-05-13 DOI: 10.3389/fgstr.2022.879615

T. Morikawa, Y. Hayashi, H. Fukuda, Hiroaki Ishii, Tatsuma Nomura, Eriko Ikeda, M. Kitamura, Yuka Kagaya, M. Okada, T. Takezawa, K. Sunada, A. Lefor, N. Fukushima, H. Yamamoto

Background and aims The standard treatment for stage T1b colorectal cancers with 1,000µm or greater submucosal invasion is surgical resection. However, the risk of lymph node metastases is only 1-2% when excluding risk factors for metastases other than depth of submucosal invasion. The number of elderly patients with significant comorbidities is increasing with societal aging in Japan. Therefore, local endoscopic resection of T1b colorectal cancers needs more consideration in the future. We previously showed that the pocket-creation method (PCM) for endoscopic submucosal dissection (ESD) is useful regardless of the morphology, including large sessile tumors with submucosal fibrosis, or location of the colorectal tumor. However, some T1b colorectal cancers have pathologically positive margins even when using the PCM. We retrospectively investigated the causes of failure to achieve negative vertical margins. Methods We retrospectively analyzed 953 colorectal tumors in 886 patients resected with the PCM. Finally, 65 pathological T1b colorectal cancers after en bloc resection were included in this study. ESD specimens and recorded procedure videos of T1b cancer resections with pathologically positive vertical margins were reviewed. Results The 65 cancers were divided into positive vertical margin (VM+ group) and negative vertical margin (VM- group) groups with 10 [10/65 (15%)] and 55 [55/65 (85%)] patients in each group, respectively. There was a significant difference in the rate of submucosal fibrosis (P=0.012) and dissection speed (P=0.044). There were no significant differences between the two groups in other regards. When verifying 8/10 available videos in the VM+ group, endoscopic technical factors led to positive vertical margins in five patients, and essential pathological factors of ESD led to positive vertical margins in the other three. Six of these eight patients underwent additional surgical resection. No residual tumor was identified in six T1b cancers. None of these six resected specimens contained lymph node metastases on pathological examination. Conclusion The PCM resulted in a high rate of negative-vertical-margin resections. The PCM resulted in complete resection of T1b cancers when examining additional surgical specimens. ESD using the PCM is a viable option for the endoscopic treatment of T1b colorectal cancers.

背景与目的T1b期结直肠癌粘膜下浸润大于等于1000µm的标准治疗是手术切除。然而，当排除除粘膜下浸润深度以外的转移危险因素时，淋巴结转移的风险仅为1-2%。随着日本社会的老龄化，患有严重合并症的老年患者数量正在增加。因此，T1b结直肠癌的内镜局部切除在未来需要更多的考虑。我们之前的研究表明，无论形态如何，包括粘膜下纤维化的大肿瘤或结直肠肿瘤的位置，用于内镜下粘膜下剥离(ESD)的口袋创建方法(PCM)都是有用的。然而，即使使用PCM，一些T1b结直肠癌的病理边缘也呈阳性。我们回顾性地调查了未能达到负垂直边缘的原因。方法回顾性分析886例经PCM切除的953例结直肠肿瘤。最后，本研究纳入了65例整体切除后的病理T1b结直肠癌。我们回顾了具有垂直边缘病理阳性的T1b癌切除术的ESD标本和手术录像。结果65例肿瘤分为垂直切缘阳性组(VM+组)和垂直切缘阴性组(VM-组)，每组分别有10例[10/65(15%)]和55例[55/65(85%)]。两组间粘膜下纤维化率(P=0.012)和剥离速度(P=0.044)差异有统计学意义。两组在其他方面无显著差异。在对VM+组8/10可用视频进行验证时，内镜技术因素导致5例患者垂直切缘阳性，ESD本质病理因素导致3例患者垂直切缘阳性。这8名患者中有6名接受了额外的手术切除。6例T1b癌未发现残留肿瘤。这6例切除标本病理检查均无淋巴结转移。结论PCM具有较高的垂直切缘阴性率。当检查额外的手术标本时，PCM导致T1b肿瘤完全切除。使用PCM的ESD是内镜治疗T1b结直肠癌的可行选择。

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引用次数: 0

Change of Left Ventricular Myocardial Contractility in Speckle Tracking Echocardiography After Transjugular Intrahepatic Portosystemic Shunt Predicts Survival 斑点跟踪超声心动图显示经颈静脉肝内门静脉系统分流术后左室心肌收缩力的变化预测生存

Frontiers in gastroenterology (Lausanne, Switzerland)

Pub Date : 2022-04-12 DOI: 10.3389/fgstr.2022.860800

C. Jansen, Pia Nordmann, Carla Cremonese, M. Praktiknjo, Johannes Chang, J. Lehmann, D. Thomas, G. Nickenig, M. Weber, E. Stöhr, C. Öztürk, C. Zachoval, C. Hammerstingl, C. Strassburg, C. Meyer, J. Trebicka

Background Left ventricular global longitudinal strain (LV-GLS) has been shown to better reflect the left cardiac contractility in cirrhosis than other investigations and might bear prognostic value. The aim of this study was to investigate the evolution of myocardial contractility assessed by speckle tracking echocardiography (STE) after transjugular intrahepatic portosystemic shunt (TIPS) placement and its prognostic value in outcome. Methods In this study, 206 (126 males) patients with liver cirrhosis receiving TIPS were included. In all study patients, conventional transthoracic echocardiography (TTE) was performed before and in the first weeks after TIPS placement to assess left and right ventricular volume, planar and functional parameters. Also, LV-GLS was measured by STE to assess left ventricular contractility as surrogate for myocardial dysfunction. Hemodynamic and clinical parameters were assessed before TIPS and during follow-up. Results As expected, most conventional parameters of TTE showed a significant change after TIPS placement. However, neither the absolute values, nor the changes of conventional cardiac parameters of TTE before and after TIPS insertion were associated with survival. By contrast, an increase in contractility of more than 20% using STE after TIPS was an independent predictor of mortality. Conclusion These results demonstrate that an increase of left ventricular contractility of more than 20% after TIPS insertion is an independent predictor of survival and this may identify patients at risk and in need of closer follow-up care.

背景左心室整体纵向应变（LV-GLS）已被证明比其他研究更能反映肝硬化患者的左心收缩力，并可能具有预后价值。本研究的目的是研究经颈静脉肝内门体分流术（TIPS）后斑点跟踪超声心动图（STE）评估的心肌收缩力的演变及其对预后的价值。方法本研究纳入206例（126例男性）接受TIPS治疗的肝硬化患者。在所有研究患者中，在TIPS放置前和放置后的前几周进行常规经胸超声心动图（TTE），以评估左心室和右心室容积、平面和功能参数。此外，通过STE测量LV-GLS，以评估作为心肌功能障碍替代品的左心室收缩力。在TIPS之前和随访期间评估血液动力学和临床参数。结果不出所料，经胸超声心动图的大多数常规参数在TIPS置入后显示出显著变化。然而，无论是TTE的绝对值，还是TIPS插入前后常规心脏参数的变化，都与生存率无关。相比之下，TIPS后使用STE收缩力增加20%以上是死亡率的独立预测因素。结论这些结果表明，TIPS插入后左心室收缩力增加20%以上是生存的独立预测因素，这可能会确定有风险和需要更密切随访的患者。

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引用次数: 0

Case Report: Molecular Diagnosis Revealing an Intestinal Infection of a Hybridized Tapeworm (Taenia saginata and Taenia asiatica) to Human in Yunnan, China 病例报告：分子诊断显示中国云南一种人类杂交锥虫（牛带绦虫和亚洲带绦虫）肠道感染

Frontiers in gastroenterology (Lausanne, Switzerland)

Pub Date : 2022-02-21 DOI: 10.3389/fgstr.2022.845850

Kan-Kan Chu, Ye Qiu, Ce-Heng Liao, Zhi You, Zuo-Shun He, W. Fang, Hong-Ying Li, P. Daszak, Jun-Jie Hu, Yunzhi Zhang, Xingyi Ge

Human taeniasis caused by tapeworms is an intestinal disease prevalent in many countries around the world. Taenia asiatica, Taenia saginata, and Taenia solium are the most common pathogens causing human taeniasis. Among the three species of tapeworms, T. saginata and T. asiatica share high similarity in their genomes and have been reported to be capable of hybridization with each other. Here, we reported a case of an 18-year-old male patient hospitalized in Yunnan Province, China, in 2019. Due to long-lasting abdominal distension and white tapeworm segments in the feces, the patient was diagnosed with taeniasis. He was treated with traditional Chinese medicine, and a tapeworm approximately 2.7 m long was expelled. The morphology of the eggs and gravid proglottids of the tapeworm was observed. Interestingly, the tapeworm was identified as a hybrid between T. saginata and T. asiatica according to molecular and phylogenetic analyses. This case is the first documented case of human taeniasis caused by a T. saginata and T. asiatica hybrid in Yunnan Province. Molecular evidence suggests that the hybrid of T. saginata and T. asiatica may have caused widespread infection in rural areas of Western China, and further investigation and research on these parasites in Western China are needed. The method described in this case may be helpful for future research.

由绦虫引起的人绦虫病是一种流行于全球许多国家的肠道疾病。亚洲带绦虫、牛带绦虫和猪带绦虫是引起人类带绦虫病最常见的病原体。在这三种绦虫中，saginata绦虫和asiatica绦虫在基因组上具有很高的相似性，并且有报道称它们能够相互杂交。我们报告了2019年在中国云南省住院的一名18岁男性患者。由于长期腹胀，粪便中有白色绦虫片段，患者被诊断为绦虫病。他接受了中药治疗，并排出了一条长约2.7米的绦虫。观察了绦虫卵和受精卵的形态。有趣的是，根据分子和系统发育分析，该绦虫被鉴定为saginata绦虫和asiatica绦虫的杂种。本病例是云南省第一例记录在案的由saginata T.和亚洲T.杂交体引起的人带绦虫病病例。分子生物学证据表明，saginata与asiatica的杂交寄生物可能在中国西部农村造成了广泛的感染，还需要进一步的调查和研究。本案例所描述的方法可能对未来的研究有所帮助。

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引用次数: 0

Sex-specific association between alcohol consumption and liver cirrhosis: An updated systematic review and meta-analysis. 饮酒与肝硬化之间的性别相关性：最新的系统综述和荟萃分析。

Frontiers in gastroenterology (Lausanne, Switzerland)

Pub Date : 2022-01-01 Epub Date: 2022-10-13 DOI: 10.3389/fgstr.2022.1005729

Laura Llamosas-Falcón, Charlotte Probst, Charlotte Buckley, Huan Jiang, Aurélie M Lasserre, Klajdi Puka, Alexander Tran, Jürgen Rehm

Different studies have shown that females develop liver diseases at lower levels of alcohol consumption than males. Our aim was to quantify the dose-response relationship between alcohol consumption and the risk of liver cirrhosis by sex and identify the differences between females and males. A systematic review was conducted using PubMed/Medline and Embase to identify longitudinal and case-control studies that analyzed the relationship between the level of alcohol use and liver cirrhosis (LC) incidence, and mortality (ICD-8 and ICD-9 codes 571 and ICD-10 codes K70, K73, K74). Pooled relative risks (RR) were calculated by random effects models. Restricted cubic splines were used to model the dose-response relationship. A total of 24 studies were included in the analysis. There were collectively 2,112,476 females and 924,853 males, and a total of 4,301 and 4,231 cases of LC for females and males, respectively. We identified a non-linear dose-response relationship. Females showed a higher risk for LC compared to males with the same amount of alcohol consumed daily. For instance, drinking 40 g/day showed RRs of 9.35 (95% CI 7.64-11.45) in females and 2.82 (95% CI 2.53-3.14) in males, while drinking 80 g/day presented RRs of 23.32 (95% CI 18.24-29.82) in females and 7.93 (95% CI 7.12-8.83) in males. Additional analyses showed that a higher risk for females was found for morbidity and for mortality. Understanding the influence of sex on the association of alcohol consumption and the risk of LC is needed to develop recommendations and clinical guidelines for prevention and treatment.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022299680, identifier CRD42022299680.

不同的研究表明，与男性相比，女性在较低的酒精摄入量下就会罹患肝病。我们的目的是按性别量化酒精消耗量与肝硬化风险之间的剂量-反应关系，并确定女性与男性之间的差异。我们使用PubMed/Medline和Embase进行了系统性回顾，以确定分析饮酒水平与肝硬化（LC）发病率和死亡率（ICD-8和ICD-9代码571和ICD-10代码K70、K73、K74）之间关系的纵向和病例对照研究。采用随机效应模型计算汇总相对风险（RR）。剂量-反应关系采用限制性三次样条模型。共有 24 项研究被纳入分析。共有 2,112,476 名女性和 924,853 名男性，女性和男性的 LC 病例数分别为 4,301 和 4,231 例。我们发现了一种非线性的剂量-反应关系。在每日饮酒量相同的情况下，女性患低血糖症的风险高于男性。例如，每天饮酒 40 克，女性的 RR 值为 9.35（95% CI 7.64-11.45），男性为 2.82（95% CI 2.53-3.14），而每天饮酒 80 克，女性的 RR 值为 23.32（95% CI 18.24-29.82），男性为 7.93（95% CI 7.12-8.83）。其他分析表明，女性发病和死亡的风险较高。需要了解性别对饮酒与 LC 风险关系的影响，以制定预防和治疗建议及临床指南。系统综述注册：https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022299680，标识符为 CRD42022299680。

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引用次数: 0

Primary sclerosing cholangitis and pancreatic cancer: A retrospective cohort study of United States veterans. 原发性硬化性胆管炎和胰腺癌:美国退伍军人的回顾性队列研究

Frontiers in gastroenterology (Lausanne, Switzerland)

Pub Date : 2022-01-01 Epub Date: 2023-01-24 DOI: 10.3389/fgstr.2022.1076788

Anita Nguyen, Babak Torabi Sagvand, Madeline Alizadeh, Cydney Nguyen, William Scott, Erik C von Rosenvinge

Primary sclerosing cholangitis (PSC) is associated with hepatobiliary and colorectal cancers, but it remains uncertain if PSC increases the risk for pancreatic cancer. While some European studies have suggested an increased risk of pancreatic cancer in PSC patients, other studies have not. And these studies did not well account for presence or absence of concomitant inflammatory bowel disease (IBD). The purpose of this study is to investigate the prevalence of pancreatic cancer in United States veterans with PSC both with and without IBD.

Methods: This retrospective study used International Classification of Diseases, Tenth Revision (ICD-10) codes to identify patients with PSC, IBD, and pancreatic cancer from the Veterans Affairs (VA) Corporate Data Warehouse. The prevalence of pancreatic cancer in patients with PSC only, IBD only, PSC with IBD, and neither PSC nor IBD were compared. Logistic regression was used to control for age, gender, chronic pancreatitis, diabetes mellitus, and tobacco and alcohol use.

Results: A total of 946 patients with PSC were identified from a population of over 9 million veterans. 486 (51.4%) of these had concurrent IBD. Additionally 112,653 patients with IBD without PSC were identified. When adjusted for confounding factors, patients with PSC had a significantly higher prevalence of pancreatic cancer compared to the general population and those with IBD without PSC (2.4% vs. 0.2% and 0.5%, respectively).

Conclusions: Veterans with PSC, particularly those without concomitant IBD, have a high prevalence of pancreatic cancer compared to the general veteran population. Our findings support the need for multicenter prospective studies investigating the benefits of screening for pancreatic cancer in patients with PSC.

原发性硬化性胆管炎（PSC）与肝癌和结直肠癌相关，但PSC是否会增加胰腺癌症的风险仍不确定。虽然一些欧洲研究表明PSC患者患胰腺癌症的风险增加，但其他研究没有。这些研究并不能很好地解释是否存在伴随的炎症性肠病（IBD）。本研究的目的是调查患有PSC的美国退伍军人中患有和不患有IBD的胰腺癌症的患病率。方法本回顾性研究使用国际疾病分类第十版（ICD-10）代码从退伍军人事务（VA）公司数据仓库中识别PSC、IBD和胰腺癌症患者。比较单纯PSC患者、单纯IBD患者、PSC伴IBD患者以及PSC和IBD患者的胰腺癌症患病率。Logistic回归用于控制年龄、性别、慢性胰腺炎、糖尿病以及吸烟和饮酒。结果在900多万退伍军人中，共发现946例PSC患者。486例（51.4%）并发IBD。此外，还发现了112653名没有PSC的IBD患者。当对混杂因素进行调整时，与普通人群和无PSC的IBD患者相比，PSC患者的胰腺癌症患病率显著较高（分别为2.4%、0.2%和0.5%）。结论与一般退伍军人相比，患有PSC的退伍军人，尤其是没有伴有IBD的退伍军人，胰腺癌症的患病率较高。我们的研究结果支持多中心前瞻性研究的必要性，这些研究旨在调查PSC患者筛查癌症的益处。

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