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Blood-Based Biomarkers for HCC Surveillance: Ready for the Center Stage? 用于HCC监测的血液生物标志物:准备好进入中心阶段了吗?
IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-01 Epub Date: 2023-10-05 DOI: 10.14309/ajg.0000000000002539
Amit G Singal, Ju Dong Yang, Neehar D Parikh
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引用次数: 0
A Population-Based Matched Cohort Study of Digestive System Cancer Incidence and Mortality in Individuals With and Without Inflammatory Bowel Disease. 基于人群的炎症性肠病患者与非炎症性肠病患者消化系统癌症发病率和死亡率匹配队列研究》(A Population-Based Matched Cohort Study of Digestive System Cancer Incidence and Mortality in Individual With and Without Inflammatory Bowel Disease)。
IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-01 Epub Date: 2024-06-25 DOI: 10.14309/ajg.0000000000002900
Sanjay K Murthy, Parul Tandon, Priscilla Matthews, Faria Ahmed, Michael Pugliese, Monica Taljaard, Gilaad G Kaplan, Stephanie Coward, Charles Bernstein, Eric I Benchimol, M Ellen Kuenzig, Laura E Targownik, Harminder Singh

Introduction: To study digestive system cancer risks in individuals with inflammatory bowel diseases (IBDs) in the biologic era.

Methods: We used population-level administrative and cancer registry data from Ontario, Canada, (1994-2020) to compare people with IBD to matched controls (1:10 by sex and birth year) on trends in age-sex standardized cancer incidence and risk ratios of incident cancers and cancer-related deaths.

Results: Among 110,919 people with IBD and 1,109,190 controls, colorectal cancer incidence (per 100,000 person-years) declined similarly in people with ulcerative colitis (average annual percentage change [AAPC] -1.81; 95% confidence interval [CI] -2.48 to -1.156) and controls (AAPC -2.79; 95% CI -3.44 to -2.14), while small bowel cancer incidence rose faster in those with Crohn's disease (AAPC 9.68; 95% CI 2.51-17.3) than controls (AAPC 3.64; 95% CI 1.52-5.80). Extraintestinal digestive cancer incidence rose faster in people with IBD (AAPC 3.27; 95% CI 1.83-4.73) than controls (AAPC -1.87; 95% CI -2.33 to -1.42), particularly for liver (IBD AAPC 8.48; 95% CI 4.11-13.1) and bile duct (IBD AAPC 7.22; 95% CI 3.74-10.8) cancers. Beyond 2010, the incidences (and respective mortality rates) of colorectal (1.60; 95% CI 1.46-1.75), small bowel (4.10; 95% CI 3.37-4.99), bile duct (2.33; 95% CI 1.96-2.77), and pancreatic (1.19; 95% CI 1.00-1.40) cancers were higher in people with IBD.

Discussion: Cancer incidence is declining for colorectal cancer and rising for other digestive cancers in people with IBD. Incidence and mortality remain higher in people with IBD than controls for colorectal, small bowel, bile duct, and pancreatic cancers.

简介:研究生物时代炎症性肠病(IBD)的消化系统癌症风险:研究生物时代炎症性肠病(IBD)的消化系统癌症风险:我们利用加拿大安大略省(1994 - 2020 年)的人口级行政和癌症登记数据,比较了 IBD 患者与匹配对照组(按性别和出生年份为 1:10)的年龄-性别标准化癌症发病率趋势以及癌症发病和癌症相关死亡的风险比:在 110,919 名 IBD 患者和 1,109,190 名对照组患者中,溃疡性结肠炎患者的结直肠癌 (CRC) 发病率(每 100,000 人-年)下降幅度相似(平均年百分比变化 (AAPC) -1.81; 95% CI, -2.48,-1.156)和对照组(AAPC -2.79;95% CI,-3.44,-2.14),而克罗恩病患者的小肠癌发病率(AAPC 9.68;95% CI,2.51,17.3)比对照组(AAPC 3.64;95% CI,1.52,5.80)上升得更快。与对照组(AAPC-1.87;95% CI,-2.33,-1.42)相比,IBD 患者肠道外消化系统癌症发病率上升较快(AAPC 3.27;95% CI,1.83,4.73),尤其是肝癌(IBD AAPC 8.48;95% CI,4.11,13.1)和胆管癌(IBD AAPC 7.22;95 % CI,3.74,10.8)。2010 年以后,IBD 患者的结直肠癌(1.60;95% CI,1.46,1.75)、小肠癌(4.10;95% CI,3.37,4.99)、胆管癌(2.33;95% CI,1.96,2.77)和胰腺癌(1.19;95% CI,1.00,1.40)的发病率(及相应的死亡率)均较高:讨论:在IBD患者中,CRC的癌症发病率正在下降,而其他消化系统癌症的发病率正在上升。在结直肠癌、小肠癌、胆管癌和胰腺癌方面,IBD患者的发病率和死亡率仍高于对照组。
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引用次数: 0
Pharyngeal Anomaly: As Rare as We Thought? 咽部异常--像我们想象的那样罕见?
IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-01 Epub Date: 2024-03-14 DOI: 10.14309/ajg.0000000000002757
Jessica W Gregor
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引用次数: 0
Mortality in Acute Severe Ulcerative Colitis - Still an Alarming and Real Complication in the Era of Advanced Therapies. 急性重度溃疡性结肠炎的死亡率--在先进疗法时代仍是一个令人担忧的现实并发症。
IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-16 DOI: 10.14309/ajg.0000000000002917
Brigid Pinnuck, Kate D Lynch
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引用次数: 0
Multicenter, Prospective Trial of Nonendoscopic Biomarker-Driven Detection of Barrett's Esophagus and Esophageal Adenocarcinoma. 非内窥镜生物标记物驱动的巴雷特食管和食管腺癌检测多中心前瞻性试验。
IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-01 Epub Date: 2024-04-30 DOI: 10.14309/ajg.0000000000002850
Helen R Moinova, Suman Verma, John Dumot, Ashley Faulx, Prasad G Iyer, Marcia Irene Canto, Jean S Wang, Nicholas J Shaheen, Prashanthi N Thota, Lishan Aklog, Joseph E Willis, Sanford D Markowitz, Amitabh Chak

Introduction: Preliminary data suggest that an encapsulated balloon (EsoCheck), coupled with a 2 methylated DNA biomarker panel (EsoGuard), detects Barrett's esophagus (BE) and esophageal adenocarcinoma (EAC) with high accuracy. The initial assay requires sample freezing upon collection. The purpose of this study was to assess a next-generation EsoCheck sampling device and EsoGuard assay in a much-enlarged multicenter study clinically enhanced by using a Clinical Laboratory Improvement Amendments of 1988-compliant assay and samples maintained at room temperature.

Methods: Cases with nondysplastic BE (NDBE), dysplastic BE (indefinite for dysplasia, low-grade dysplasia, high-grade dysplasia), EAC, junctional adenocarcinoma, plus endoscopy controls without esophageal intestinal metaplasia, were prospectively enrolled. Medical assistants at 6 institutions delivered the encapsulated balloon per orally with inflation in the stomach. The inflated balloon sampled the distal 5 cm of the esophagus and then was deflated and retracted into the capsule, preventing sample contamination. EsoGuard bisulfite sequencing assayed levels of methylated vimentin and methylated cyclin A1.

Results: A total of 243 evaluable patients-88 cases (median age 68 years, 78% men, 92% White) and 155 controls (median age 57 years, 41% men, 88% White)-underwent adequate EsoCheck sampling. The mean procedural time was approximately 3 minutes. Cases included 31 with NDBE, 16 with indefinite for dysplasia/low-grade dysplasia, 23 with high-grade dysplasia, and 18 with EAC/junctional adenocarcinoma. Thirty-seven NDBE and dysplastic BE cases (53%) were short-segment BE (<3 cm). Overall sensitivity was 85% (95% confidence interval 0.78-0.93) and specificity was 85% (95% confidence interval 0.79-0.90). Sensitivity for NDBE was 84%. EsoCheck/EsoGuard detected 100% of cancers (n = 18).

Discussion: EsoCheck/EsoGuard demonstrated high sensitivity and specificity in detecting BE and BE-related neoplasia.

背景:初步数据表明,封装气球(EsoCheckTM)与两个甲基化 DNA 生物标记物面板(EsoGuardTM)相结合,可高精度检测巴雷特食管(BE)和食管腺癌(EAC)。目的:在一项规模更大的多中心研究中评估新一代 EsoCheck 采样设备和 EsoGuard 检测方法,通过使用符合 CLIA 标准的检测方法和室温保存样本,提高临床检测效果:方法:前瞻性地纳入了非增生异常BE(NDBE)、增生异常BE(不定期=IND、低度增生异常=LGD、高度增生异常=HGD)、EAC、交界性腺癌(JAC)病例,以及无食管肠化生的内镜对照病例。六家机构的医疗助理口服封装球囊,在胃部充气。充气球囊在食管远端 5 厘米处取样,然后放气并缩回囊中,以防止样本污染。EsoGuard 亚硫酸氢盐测序法测定了甲基化波形蛋白(mVIM)和甲基化细胞周期蛋白 A1(mCCNA1)的水平:共有 243 名可评估患者接受了充分的 EsoCheck 采样,其中包括 88 名病例(中位年龄 68 岁,78% 为男性,92% 为白人)和 155 名对照组(中位年龄 57 岁,41% 为男性,88% 为白人)。平均手术时间约为 3 分钟。病例包括 31 例 NDBE、16 例 IND/LGD、23 例 HGD 和 18 例 EAC/JAC。37例(53%)非增生异常和增生异常BE为短节段BE(SSBE;小于3厘米)。总体敏感性为 85%(95% CI=0.78-0.93),特异性为 85%(95% CI=0.79-0.90)。对 NDBE 的敏感性为 84%。EsoCheck/EsoGuard检测出100%的癌症(18例):结论:EsoCheck/EsoGuard检测BE和BE相关肿瘤的灵敏度和特异性都很高。
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引用次数: 0
Continuing Medical Education Questions: November 2024. 继续医学教育问题:2024 年 11 月。
IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-05 DOI: 10.14309/ajg.0000000000003112
Mashal A Batheja

Article Title: Early Diagnostic Paracentesis Improves Outcomes of Hospitalized Patients With Cirrhosis and Ascites: A Systematic Review and Meta-Analysis.

文章标题:早期诊断性腹腔穿刺术可改善肝硬化腹水住院患者的预后:系统回顾和元分析》。
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引用次数: 0
Risk of Pancreatitis After Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Cystic Lesions: A Systematic Review and Meta-Analysis. 内镜超声引导下胰腺囊性病变细针抽吸术后发生胰腺炎的风险:系统回顾与元分析》。
IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-05 DOI: 10.14309/ajg.0000000000002942
Patrick T Magahis, Ankit Chhoda, Tyler M Berzin, James J Farrell, Drew N Wright, Anam Rizvi, Mark Hanscom, David L Carr-Locke, Kartik Sampath, Reem Z Sharaiha, SriHari Mahadev

Introduction: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is frequently used to risk-stratify pancreatic cystic lesions (PCLs). Rising PCL incidence and developments in tissue acquisition and specimen analysis necessitate updated appraisal of EUS-FNA safety, particularly the risk of postprocedure pancreatitis, the most common EUS-FNA-related adverse event. Our systematic review aims to accurately quantify the risk of EUS-FNA-related pancreatitis to best inform decisions regarding EUS-FNA's optimal role in PCL workup.

Methods: We performed systematic searches in 4 databases from inception to April 2024 for original English-language studies investigating EUS-FNA-related pancreatitis. We extracted data on demographics and EUS-FNA-related pancreatitis risk, severity, and risk factors. These were meta-analyzed through the DerSimonian Laird Method using a random-effects model. Meta-regression of pancreatitis risk was performed to delineate associations with clinical and procedural characteristics.

Results: Sixty-four studies comprised 8,086 patients and reported 110 EUS-FNA-related pancreatitis events. Pooled risk of EUS-FNA-related pancreatitis was 1.4% (95% confidence intervals, -0.8% to 3.5%; I2 = 0.00), which was predominantly of mild severity (67%) and uniformly nonfatal. Pancreatitis risk lacked significant association with sample size, age, sex, cyst size, needle caliber, or passes, although we noted trends toward higher risk in studies published after 2015, those using higher gauge needles (19 G vs 22 G/25 G), and those performing EUS-guided through-the-needle biopsy.

Discussion: We note with high certainty that pancreatitis after EUS-FNA of PCLs is infrequent and mild in severity with no mortality in the included cohort. EUS-guided through-the-needle biopsy may serve as a significant risk factor for EUS-FNA-related pancreatitis risk; however, further studies are needed to delineate other predisposing characteristics.

背景:内镜超声引导下细针抽吸术(EUS-FNA)常用于对胰腺囊性病变(PCL)进行风险分级。PCL 发病率的上升以及组织采集和标本分析的发展要求对 EUS-FNA 的安全性进行最新评估,尤其是术后胰腺炎的风险,这是 EUS-FNA 相关不良事件中最常见的一种。我们的系统性综述旨在准确量化 EUS-FNA 相关胰腺炎的风险,为 EUS-FNA 在 PCL 检查中的最佳作用提供最佳参考:我们在四个数据库中系统检索了从开始到 2024 年 4 月调查 EUS-FNA 相关胰腺炎的原始英文研究。我们提取了有关人口统计学、EUS-FNA 相关胰腺炎风险、严重程度和风险因素的数据。我们采用随机效应模型,通过 DerSimonian Laird 方法对这些数据进行了元分析。对胰腺炎风险进行了元回归,以确定与临床和手术特征的关联:64项研究包括8086名患者,报告了110起EUS-FNA相关胰腺炎事件。EUS-FNA 相关胰腺炎的汇总风险为 1.4% [95% CI, -0.8-3.5%; I2 = 0.00],主要为轻度(67%),且均不致命。胰腺炎风险与样本大小、年龄、性别、囊肿大小、针头口径或通过率无明显关联,但我们注意到2015年后发表的研究、使用较高规格针头(19G vs. 22G/25G)的研究以及进行EUS-TTNB的研究存在风险较高的趋势:我们非常肯定地注意到,在纳入的队列中,PCL 的 EUS-FNA 术后胰腺炎并不常见,且严重程度较轻,无死亡病例。EUS-TTNB可能是EUS-FNA相关胰腺炎风险的一个重要风险因素;但是,还需要进一步的研究来确定其他易感特征。
{"title":"Risk of Pancreatitis After Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Cystic Lesions: A Systematic Review and Meta-Analysis.","authors":"Patrick T Magahis, Ankit Chhoda, Tyler M Berzin, James J Farrell, Drew N Wright, Anam Rizvi, Mark Hanscom, David L Carr-Locke, Kartik Sampath, Reem Z Sharaiha, SriHari Mahadev","doi":"10.14309/ajg.0000000000002942","DOIUrl":"10.14309/ajg.0000000000002942","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is frequently used to risk-stratify pancreatic cystic lesions (PCLs). Rising PCL incidence and developments in tissue acquisition and specimen analysis necessitate updated appraisal of EUS-FNA safety, particularly the risk of postprocedure pancreatitis, the most common EUS-FNA-related adverse event. Our systematic review aims to accurately quantify the risk of EUS-FNA-related pancreatitis to best inform decisions regarding EUS-FNA's optimal role in PCL workup.</p><p><strong>Methods: </strong>We performed systematic searches in 4 databases from inception to April 2024 for original English-language studies investigating EUS-FNA-related pancreatitis. We extracted data on demographics and EUS-FNA-related pancreatitis risk, severity, and risk factors. These were meta-analyzed through the DerSimonian Laird Method using a random-effects model. Meta-regression of pancreatitis risk was performed to delineate associations with clinical and procedural characteristics.</p><p><strong>Results: </strong>Sixty-four studies comprised 8,086 patients and reported 110 EUS-FNA-related pancreatitis events. Pooled risk of EUS-FNA-related pancreatitis was 1.4% (95% confidence intervals, -0.8% to 3.5%; I2 = 0.00), which was predominantly of mild severity (67%) and uniformly nonfatal. Pancreatitis risk lacked significant association with sample size, age, sex, cyst size, needle caliber, or passes, although we noted trends toward higher risk in studies published after 2015, those using higher gauge needles (19 G vs 22 G/25 G), and those performing EUS-guided through-the-needle biopsy.</p><p><strong>Discussion: </strong>We note with high certainty that pancreatitis after EUS-FNA of PCLs is infrequent and mild in severity with no mortality in the included cohort. EUS-guided through-the-needle biopsy may serve as a significant risk factor for EUS-FNA-related pancreatitis risk; however, further studies are needed to delineate other predisposing characteristics.</p>","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141557820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role of Biliary Stent in Recurrence Recurrent Biliary Events Postendoscopic Retrograde Cholangiopancreatography: A Comment. 胆道支架在内镜逆行胰胆管造影术后胆道事件复发中的作用:评论。
IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-01 Epub Date: 2024-08-13 DOI: 10.14309/ajg.0000000000002894
Tao He, Jieyu Zou
{"title":"Role of Biliary Stent in Recurrence Recurrent Biliary Events Postendoscopic Retrograde Cholangiopancreatography: A Comment.","authors":"Tao He, Jieyu Zou","doi":"10.14309/ajg.0000000000002894","DOIUrl":"10.14309/ajg.0000000000002894","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fecal Microbiota Transplantation in the Treatment of Severe Constipation in Children: Is It the Future? 粪便微生物群移植治疗儿童严重便秘:它是未来的趋势吗?
IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-25 DOI: 10.14309/ajg.0000000000002985
Michele Di Stefano
{"title":"Fecal Microbiota Transplantation in the Treatment of Severe Constipation in Children: Is It the Future?","authors":"Michele Di Stefano","doi":"10.14309/ajg.0000000000002985","DOIUrl":"10.14309/ajg.0000000000002985","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Comprehensive Comparative Study of Potassium-Competitive Acid Blockers Is Necessary. 有必要对钾竞争性酸阻滞剂进行全面的比较研究。
IF 8 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-11-01 Epub Date: 2024-07-12 DOI: 10.14309/ajg.0000000000002896
Sang Kil Lee
{"title":"A Comprehensive Comparative Study of Potassium-Competitive Acid Blockers Is Necessary.","authors":"Sang Kil Lee","doi":"10.14309/ajg.0000000000002896","DOIUrl":"10.14309/ajg.0000000000002896","url":null,"abstract":"","PeriodicalId":7608,"journal":{"name":"American Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":8.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
American Journal of Gastroenterology
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