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Utility of FibroScan-based scoring systems to narrow the risk group of nonalcoholic fatty liver disease with comorbidities

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World Journal of Gastrointestinal Pathophysiology 2022年第3期13卷 96-106页

作者： Kouichi Miura Hiroshi Maeda Naoki Morimoto Shunji Watanabe Mamiko Tsukui Yoshinari Takaoka hiroaki nomoto Rie Goka Kazuhiko Kotani Hironori Yamamoto Department of Medicine Division of GastroenterologyJichi Medical University School of Medicine3311-1 YakushijiShimotsuke 329-0498TochigiJapan Division of Community and Family Medicine Center for Community MedicineJichi Medical University3311-1 YakushijiShimotsuke 329-0498Japan

BACKGROUND Vibration-controlled transient elastography(VCTE)is proposed as a second step of examination to assess liver fibrosis in patients with nonalcoholic fatty liver disease(NAFLD)after triaging by the fibrosis-4(FIB-4)***,VCTEbased scoring systems,including FibroScan-AST(FAST),Agile 3+,and Agile 4,emerged to determine the status of ***,the significance of these scoring systems remains unknown in narrowing the high-risk group of NAFLD patients with comorbidities,including hepatocellular carcinoma(HCC)and esophagogastric varices(EGV).AIM To clarify the significance of VCTE-based scoring systems to narrow the high-risk group of NAFLD patients with *** We performed a cross-sectional study to investigate the usefulness of VCTE-based scoring systems and other fibrosis markers to narrow the high-risk group of patients with ***-4 index was used for the first *** groups of FAST,Agile 3+,and Agile 4 were stratified according to the published *** the 191 patients with NAFLD,there were 26(14%)and 25 patients(13%)with HCC and EGV,*** When 1.3 was used as a cutoff value,the FIB-4 index narrowed the risk group to 120 patients,in which all patients with HCC and/or EGV were *** risk group of Agile 3+could subsequently narrow the risk *** prevalence of HCC and EGV at this step were 33%(26/80)and 31%(25/80),*** further narrowing of EGV,Agile 4 aggregated the patients with EGV into 43 patients,of whom 23(53%)had *** failed to narrow the risk group of patients with *** 2.6 was used as a cutoff value of the FIB-4 index,three patients with HCC and two patients with EGV were missed at the first *** Agile 3+and Agile 4 are useful to narrow the NAFLD patient group,in which patients may have HCC and/or EGV.

关键词： Nonalcoholic fatty liver disease Vibration controlled transient elastography Non-invasive test Hepatocellular carcinoma Varix

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Obstructive jaundice caused by secondary pancreatic tumor from malignant solitary fibrous tumor of pleura:A case report

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World Journal of Gastroenterology 2006年第30期12卷 4922-4926页

作者： Norie Yamada Chiaki Okuse Masahito nomoto Mayu Orita Yoshiki Katakura Toshiya Ishii Takuo Shinmyo hiroaki Osada Ichiro Maeda Hiroshi Yotsuyanagi Michihiro Suzuki Fumio Itoh Division of Gastroenterology and Hepatology Department of Internal Medicine St. Marianna University School of Medicine 2-16-1 Sugao Miyamae-ku Kawasaki 216-8511 Japan Department of Chest Surgery St. Marianna University School of Medicine 2-16-1 Sugao Miyamae-ku Kawasaki 216-8511 Japan Department of Diagnostic Pathology St. Marianna University School of Medicine 2-16-1 Sugao Miyamae-ku Kawasaki 216-8511 Japan Division of Infectious Diseases Department of Internal Medicine University of Tokyo 7-3-1 Hongo Bunkyo-ku Tokyo 113-0033 Japan

A 77-year-old man on systemic chemotherapy against postoperative bilateral multiple lung metastases of malignant solitary fibrous tumor of the pleura suffered from pruritus and jaundice. Blood examination showed elevated levels of hepatobiliary enzymes. Abdominal computed tomography showed a tumor with peripheral enhancement in the pancreatic head, accompanied with the dilatation of intra- and extra-hepatic bile ducts. He was diagnosed as having obstructive jaundice caused by a pancreatic head tumor. The pancreatic head tumor was presumably diagnosed as the metastasis of malignant solitary fibrous tumor of the pleura, because the findings on the pancreatic head tumor on abdominal CT were similar to those on the primary lung lesion of malignant solitary fibrous tumor of the pleura. The pancreatic tumor grew rapidly after the implantation of metallic stent in the inferior part of the common bile duct. The patient died of lymphangitis carcinomatosa of the lungs. Autopsy revealed a tumor that spread from the pancreatic head to the hepatic hilum. Microscopically, spindle-shaped cells exhibiting nuclear atypicality or division together with collagen deposition were observed. Immunohistochemically the pancreatic head tumor cells were negative for staining of α-smooth muscle actin （α-SMA） or CD117, but positive for vimentin, CD34 and CD99. These findings are consistent with those on malignant solitary fibrous tumor of the pleura. We report the first case of obstructive jaundice caused by a secondary pancreatic tumor from malignant solitary fibrous tumor of the pleura.

关键词： Malignant solitary fibrous tumor of the pleura Secondary pancreatic tumor Obstructive jaundice

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