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Hepatocellular carcinoma surveillance:An evidence-based approach

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World Journal of Gastroenterology 2019年第13期25卷 1550-1559页

作者： Patrick S Harris Ross M Hansen Meagan E Gray Omar I Massoud Brendan M McGuire mohamed G shoreibah Tinsley Harrison Internal Medicine Residency Program Department of Medicine University of Alabama at Birmingham Division of Gastroenterology and Hepatology Department of Medicine University of Alabama at Birmingham

Hepatocellular carcinoma(HCC) makes up 75%-85% of all primary liver cancers and is the fourth most common cause of cancer related death worldwide. Chronic liver disease is the most significant risk factor for HCC with 80%-90% of new cases occurring in the background of cirrhosis. Studies have shown that early diagnosis of HCC through surveillance programs improve prognosis and availability of curative therapies. All patients with cirrhosis and high-risk hepatitis B patients are at risk for HCC and should undergo surveillance. The recommended surveillance modality is abdominal ultrasound(US) given that it is cost effective and noninvasive with good sensitivity. However, US is limited in obese patients and those with non-alcoholic fatty liver disease(NAFLD). With the current obesity epidemic and rise in the prevalence of NAFLD, abdominal computed tomography or magnetic resonance imaging may be indicated as the primary screening modality in these patients. The addition of alpha-fetoprotein to a surveillance regimen is thought to improve the sensitivity of HCC *** investigation of serum biomarkers is needed. Semiannual screening is the suggested surveillance interval. Surveillance for HCC is underutilized and low adherence disproportionately affects certain demographics such as nonCaucasian race and low socioeconomic status.

关键词： Liver cancer Hepatocellular carcinoma Surveillance

A focused review on recent advances in diagnosis and management of fibrolamellar hepatocellular carcinoma

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Hepatoma Research 2022年第1期8卷 284-300页

作者： Mahmoud Aryan Nicholas Forrister Nishah Panchani Bijal Vashi Zahara Chowdhury Haider A.Mejbel mohamed shoreibah Tinsley Harrison Internal Medicine Residency Department of MedicineUniversity of Alabama at Birmingham17202nd Avenue SouthBDB 327BirminghamAL 35294USA University of Alabama at Birmingham School of Medicine Department of Medicine17202nd Ave S.BirminghamAL 35294USA University of Mississippi Medical Center School of Medicine Department of Medicine2500 N State St.JacksonMS 39213USA Division of Surgical and Molecular Genetics Pathology Department of PathologyUniversity of Alabama at Birmingham61919th St SBirminghamAL 35233USA Division of Gastroenterology and Hepatology Department of MedicineUniversity of Alabama at Birmingham18087th Avenue SouthBDB 391BirminghamAL 35294USA

Fibrolamellar hepatocellular carcinoma(FHCC)is a rare primary malignancy of the liver for which data remain *** tumor is more often diagnosed in younger patient populations in the absence of underlying cirrhosis and *** lesions can be diagnosed on computed tomography scan or magnetic resonance imaging with common findings including central calcifications,a central stellate scar,and radiating fibrotic *** markers have not proved useful for diagnosis;however,pathologic analysis can be implemented to aid in diagnosis with findings including ample granular eosinophilic cytoplasm,nuclei with open chromatin and prominent macronuclei,hyaline and pale bodies,and dense lamellar fibrosis that divides the cells into cords or *** demonstrates aggressive malignant potential with nodal *** patterns have remained mainly surgical;however,systemic therapies have been implemented and are under further investigation with clinical *** therapies and radiation therapies have been trialed *** this focused review,we discuss the most up-to-date perspective on epidemiology,clinical presentation,diagnostic approach,differential diagnosis,treatment regimens,prognosis,and future directions of FHCC.

关键词： Fibrolamellar hepatocellular carcinoma diagnosis treatment surgery systemic histology review

Diabetes Mellitus Predicts Occurrence of Cirrhosis and Hepatocellular Cancer in Alcoholic Liver and Non-alcoholic Fatty Liver Diseases

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Journal of Clinical and Translational Hepatology 2015年第1期3卷 9-16页

作者： Evan J.Raff Donny Kakati Joseph R.Bloomer mohamed shoreibah Khalid Rasheed Ashwani K.Singal Department of Internal Medicine UAB Birmingham AL USA Division of Gastroenterology and Hepatology UAB BirminghamAL USA Department of Internal Medicine UAB Montgomery Program Huntsville AL USA

Background and Aims:Alcohol abuse and nonalcoholic fatty liver disease (NAFLD) are common causes of liver *** mellitus (DM) is a common comorbidity among NAFLD *** performed this study with the specific aim to examine the impact of DM on progression of alcoholic liver disease (ALD) liver and ***:Medical charts of 480 patients with ALD or NAFLD (2004-2011) managed at a tertiary center were retrospectively *** was diagnosed based on exclusion of other causes of liver disease and alcohol use of 40 g/d in women or >60 g/d in men for >***:Of 480 patients (307 NAFLD),200 diabetics differed from nondiabetics for:age (52±11 vs.49±11 years;p=0.004);male gender (48% vs.57%;p=0.03);metabolic syndrome (49% vs.30%;p=0.0002);NAFLD (80% vs.56%;p<0.0001);cirrhosis (70% vs.59%;p=0.005);and hepatocellular carcinoma (HCC;8% vs.3%;p=0.009).Over a 3 year median follow-up period,diabetics relative to nondiabetics had a higher probability to develop cirrhosis (60% vs.41%;p=0.022) and HCC (27% vs.10%;p=0.045).There was a trend for increased development of hepatic encephalopathy in diabetics compared to nondiabetics (55% vs.39%;p=0.053),and there was no difference between the two groups in survival or other liver disease ***:DM increased risk for cirrhosis and HCC among patients with ALD and *** studies with longer follow-up periods are needed to examine the impact of DM on survival and the role of aggressive HCC screening in diabetic cirrhotics.

关键词： Diabetes mellitus Steatohepatitis Nonalcoholic steatohepatitis Alcoholic cirrhosis

Effect of Hepatitis C Treatment on Renal Function in Liver Transplant Patients

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Journal of Clinical and Translational Hepatology 2018年第4期6卷 391-395页

作者： mohamed shoreibah John Romano Ornar T.Sims Yuqi Guo DeAnn Jones Krishna Venkata Vishnu Kommineni Jordan Orr Paul Fitzmorris Omar I.Massoud Division of Gastroenterology&Hepatology School of MedicineUniversity of Alabama at BirminghamBirminghamALUSA Department of Internal Medicine School of MedicineUniversity of Alabama at BirminghamBirminghamALUSA Department of Social Work College of Arts and SciencesUniversity of Alabama at BirminghamBirminghamALUSA Department of Health Behavior School of Public HealthUniversity of Alabama at BirminghamBirminghamALUSA Center for AIDS Research School of MedicineUniversity of Alabama at BirminghamBirminghamALUSA School of Social Work University of AlabamaTuscaloosaALUSA Department of Pharmacology University of Alabama at BirminghamBirminghamALUSA Division of Gastroenterology and Hepatology Department of MedicineVanderbilt UniversityNashvilleTNUSA

Background andAims:Hepatitis C Virus(HCV)is uniformly recurrent after liver transplant(LT)and recurrence is associated with an increased risk of *** medications increase the risk of chronic kidney disease,and the presence of chronic kidney disease presents a challenge for HCV treatment in LT *** aim of this study was to assess changes in glomerular filtration rates(GFRs)of LT recipients receiving HCV ***:This is a retrospective study of LT patients who received HCV treatment between 2015 and 2016(n=60).The outcomes of interest were differences in serum creatinine levels and in GFR,measured at treatment initiation and at 24 weeks after *** average age of the patients was 59 years-old,and 17%were cirrhotic and 67%were *** patients received sofosbuvir/ledipasvir without ***:All patients achieved sustained virologic response at 12 weeks after treatment(SVR12).At baseline,55%of patients had GFR60 mL/min per 1.73 *** those patients,GFR did not change in 81%,and 19%had worsened *** the entire cohort,65%of patients had improved or stable GFR and 35%had worsened *** average change in serum creatinine between baseline and 24 weeks was 0.10(p=0.18).Conclusions:This study showed improved or unchanged GFR in 65%and worsened GFR in 35%of LT recipients who achieved *** of GFR was more frequently encountered in those with impaired renal function at *** should be used when treating HCV in LT recipients,especially those with baseline status of renal impairment.

关键词： Hepatitis C Renal function Direct-acting antivirals Liver transplant Treatment

Case series on multimodal endoscopic therapy for gastric antral vascular ectasia, a tertiary center experience

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World Journal of Gastrointestinal Endoscopy 2018年第1期10卷 30-36页

作者： Tasnia Matin Mohammed Naseemuddin mohamed shoreibah Peng Li Kondal Kyanam Kabir Baig Charles Mel Wilcox Shajan Peter Internal Medicine UAB Hospital Division of Gastroenterology University of Alabama School of Medicine Department of Gastroenterology Emory Division of Gastroenterology Uni-versity of Alabama at Birmingham School of Public Health University of Alabama at Birmingham

AIM To study and describe patients who underwent treatment for gastric antral vascular ectasia(GAVE) with different endoscopic treatment *** We reviewed patients with GAVE who underwent treatment at University of Alabama at Birmingham between March 1, 2012 and December 31, 2016. Included patients had an endoscopic diagnosis of GAVE with associated upper gastrointestinal bleeding or iron deficiency *** Seven out of 15 patients had classic watermelon description for GAVE, 1/15 with diffuse/honeycomb pattern and 6/15 with nodular GAVE per EGD description. Seven out of 15 patients required multimodal treatment. Four out of six of patients with endoscopically nodular GAVE required multimodal therapy. Overall, mean pre-and post-treatment hemoglobin(Hb) values were 8.2 ± 0.8 g/dL and 9.7 ± 1.6 g/dL, respectively(P ≤ 0.05). Mean number of packed red blood cells transfusions before and after treatment was 3.8 ± 4.3 and 1.2 ± 1.7(P ≤ 0.05), *** Patients with nodular variant GAVE required multimodal approach more frequently than non-nodular variants. Patients responded well to multimodal therapy and saw decrease in transfusion rates and increase in Hb concentrations. Our findings suggest a multimodal approach may be beneficial in nodular variant GAVE.

关键词： Gastric antral vascular ectasia Upper GI bleed Radiofrequency ablation Endoscopic band ligation Argon plasma coagulation