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Biochemical and radiological predictors of malignant biliary strictures

World Journal of Gastroenterology 2004年第10期10卷 1504-1507页

作者： Ibrahim A.AI-Mofleh Abdulrahman M.aljebreen Saleh M.alAmri Rashed S.AJ-Rashed faleh z.al-faleh Hussein M.AJ-Freihi Ayman A.Abdo Arthur C.Isnani Gastroenterology Division department of Medicine (38)King Khalid University HospitalRiyadhKingdom of Saudi Arabia King Khalid University Hospital College of Medicine and Research Center (74)PO Box 2925Riyadh 11461Kingdom of Saudi Arabia

AIM: Differentiation of benign biliary strictures (BBS) from malignant biliary strictures (MBS) remains difficult despite improvement in imaging and endoscopic techniques. The aim of this study was to identify the clinical, biochemical and or radiological predictors of malignant biliary ***: We retrospectively reviewed all charts of patients who had biliary strictures (BS) on endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous cholangiography (PTC) in case of unsuccessful ERCP from March 1998 to August 2002. Patient characteristics, clinical features, biochemical, radiological and biopsy results were all recorded. Stricture etiology was determined based on cytology,biopsy or clinical follow-up. A receiver operator characteristic (ROC) curve was constructed to determine the optimal laboratory diagnostic criterion threshold in predicting ***: One hundred twenty six patients with biliary strictures were enrolled, of which 72 were malignant. The mean age for BBS was 53 years compared to 62.4 years for MBS (P=0.0006). Distal bile duct stricture was mainly due to a malignant process 48.6% vs 9% (P=0.001). alkaline phosphates and AST levels were more significantly elevated in MBS (P=0.0002). ROC curve showed that a bilirubin level of 84 μmol/L or more was the most predictive of MBS with a sensitivity of 98.6%, specificity of 59.3% and a positive likelihood ratio of 2.42 (95% CI=0.649-0.810). Proximal biliary dilatation was more frequently encountered in MBS compared to BBS, 73.8% vs39.5% (P=0.0001). Majority of BBS (87%) and MBS (78%) were managed ***: A serum bilirubin level of 84 μmol/L or greater is the best predictor of MBS. Older age, proximal biliary dilatation, higher levels of bilirubin, alkaline phosphatase, alT and AST are all associated with MBS. ERCP is necessary to diagnose and treat benign and malignant biliary strictures.

关键词： Biliary Tract Diseases Biliary Tract Neoplasms Constriction, Pathologic Predictive Value of Tests Age Factors Bilirubin Cholangiography Cholangiopancreatography, Endoscopic Retrograde Humans Middle Aged ROC Curve Retrospective Studies Sensitivity and Specificity

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Seroprevalence of celiac disease among healthy adolescents in Saudi Arabia

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World Journal of Gastroenterology 2013年第15期19卷 2374-2378页

作者： Abdulrahman M aljebreen Majid A almadi alwaleed alhammad faleh z.al faleh Gastroenterology Division King Khalid University HospitalKing Saud University Gastroenterology Division McGill University Health CenterMontreal General HospitalMcGill University Immunology Unit Department of PathologyKing Saud University

AIM: To identify the seroprevalence of celiac disease among healthy Saudi adolescents. METHODS: Between December 2007 and January 2008, healthy students from the 10th to 12th grades were randomly selected from three regions in Saudi Arabia. These regions included the following: (1) Aseer region, with a student population of 25512; (2) Madinah, with a student population of 23852; and (3) al-Qaseem, with a student population of 16067. Demographic data were recorded, and a venous blood sample (5-10 mL) was taken from each student. The blood samples were tested for immunoglobulin A and immunoglobulin G endomysial antibodies (EMA) by indirect ***: In total, 1167 students (614 males and 553 females) from these three regions were randomly selected. The majority of the study population was classified as lower middle class (82.7%). There were 26 (2.2%) students who had a positive anti-EMA test, including 17 females (3.1%) and 9 males (1.5%). al-Qaseem region had the highest celiac disease prevalence among the three studied regions in Saudi Arabia (3.1%). The prevalence by region was as follows: Aseer 2.1% (10/479), Madinah 1.8% (8/436), and al-Qaseem 3.2% (8/252). The prevalence in Madinah was significantly lower than the prevalence in Aseer and al-Qaseem (P=0.02). CONCLUSION: Our data suggest celiac disease prevalence might be one of the highest in the world. Further studies are needed to determine the real prevalence.

关键词： Celiac disease Saudi Arabia Prevalence Antiendomysial antibody Epidemiology

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Hepatitis B genotypes: Relation to clinical outcome in patients with chronic hepatitis B in Saudi Arabia

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World Journal of Gastroenterology 2006年第43期12卷 7019-7024页

作者： Ayman A Abdo Badr M al-Jarallah Faisal M Sanai Ahmad S Hersi Khalid al-Swat Nahla A Azzam Manal al-Dukhayil Amira al-Maarik faleh z.al-faleh Gastroenterology Division Faculty of Medicine King Saud University Riyadh Saudi Arabia Gastroenterology Unit Department of Medicine McGill University Montreal Canada Hepatology Division Department of Medicine Riyadh Military Hospital Riyadh Saudi Arabia

AIM： To identify the most common hepatitis B virus （HBV） genob/pe in Saudi Arabia, and correlate the prevailing genob/pes with the clinical outcome of patients. METHODS： Patients were consecutively recruited from the hepatology clinics of two tertiary care referral centers. Patients were categorized into 4 different groups： group 1, patients with hepatitis B and normal liver enzymes; group 2, patients with hepatitis B and abnormal liver enzymes but without cirrhosis; group 3, patients with hepatitis B and liver cirrhosis; group 4, patients with hepatitis B and hepatocellular carcinoma. all patients had a positive hepatitis B surface antigen （HBsAg）. Genob/ping of HBV was performed by nested PCR-mediated amplification of the target sequence and hybridization with sequence-specific oligonucleotides. RESULTS： Seventy patients were enrolled in this study. They were predominantly male （72.9%） in their midforty＇s （mean age 47 years）. Forty-nine （70%） patients were hepatitis B envelope antigen （HBeAg） negative. The majority of patients （64%） acquired HBV through unknown risk factors. Hepatitis B genob/ping revealed that 57 patients （81.4%） were genob/pe D, 1 patient （1.4%） had genob/pe A, 1 patient （1.4%） had genotype C, and 4 patients （5.7%） had genob/pe E, while 7 patients （10%） had mixed genob/pe （4 patients ADG, 1 patient DE, 1 patient DF, and 1 patient ADFG）. Based on univariate analysis of genob/pe D patients, significant predictors of advanced liver disease were age, gender, aspartate transaminase, alanine transaminase, albumin,bilirubin, and alkaline phosphatase （all P 〈 0.001）. In multivariate analysis decreased hemoglobin （r = -0.05; 95% CI： -0.08 to -0.03; P = 0.001） and albumin levels （r = -0.004; 95% CI： -0.007 to -0.001; P = 0.002） were highly significant predictors of advanced liver disease. In patients with HBV genotype D, HBeAg negativity was found to increase across advancing stages of liver disease （P = 0.024）. CONCLUSION： This study highlights tha

关键词： Hepatitis B virus Genotype D Cirrhosis Hepatocellular carcinoma Saudi Arabia

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