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Accuracy of a new rapid diagnostic test for urinary antigen detection and assessment of drug treatment in opisthorchiasis

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Infectious diseases of Poverty 2023年第6期12卷 79-90页

作者： Chanika Worasith Jiraporn Sithithaworn Phattharaphon Wongphutorn Chutima Homwong Kanoknan Khongsukwiwat Anchalee Techasen Kulthida Y.Kopolrat Watcharin Loilome Nisana Namwat Bandit Thinkamrop Chaiwat Tawarungruang Attapol Titapun Thewarach Laha Ross H.Andrews simon d.taylor‑robinson Paiboon Sithithaworn department of Adult Nursing Faculty of NursingKhon Kaen UniversityKhon KaenThailand Cholangiocarcinoma Research Institute Khon Kaen UniversityKhon KaenThailand Faculty of Associated Medical Sciences Khon Kaen UniversityKhon KaenThailand Biomedical Science Program Graduate SchoolKhon Kaen UniversityKhon KaenThailand Faculty of Public Health Kasetsart University Chalermphrakiat Sakon Nakhon Province CampusSakon NakhonThailand department of Systems Biosciences and Computational Medicine Faculty of MedicineKhon Kaen UniversityKhon KaenThailand Khon Kaen University Phenome Centre Khon Kaen UniversityKhon KaenThailand department of Epidemiology and Biostatistics Faculty of Public HealthKhon Kaen UniversityKhon KaenThailand department of Surgery Faculty of MedicineKhon Kaen UniversityKhon KaenThailand depart‑ment of Parasitology Faculty of MedicineKhon Kaen UniversityKhon KaenThailand Faculty of Medicine St Mary’s CampusImperial College LondonLondonUK division of digestive Health Department of Surgery and Can‑cerImperial College LondonLondonUK

Background Screening for opisthorchiasis,a parasitic worm infection affecting many millions of people in Southeast Asia,has traditionally relied on faecal egg examination such as the formalin-ethyl acetate concentration technique(FECT)and Kato-Katz *** the urinary enzyme-linked immunosorbent assay(ELISA)has been used more recently,we developed a urinary antigen-based rapid diagnostic test(RdT)to simplify diagnosis and as a point-of-care testing(POCT)and field applications for surveillance and control of *** A urinaryOpisthorchis viverrini(OV)-RdT was developed using immunochromatographic methodology with a specific monoclonal antibody against *** diagnostic performance of the urinary OV-RdT was compared to that of quantitative faecal FECT and urinary antigen ELISA(n=493).Cross-reactivities of urinary OV-RdT with other helminthiases coexisted *** were determined(n=96).A field trial in the application of urinary OV-RdT was compared with urinary antigen ELISA at baseline screening and assessment of drug treatment outcomes in opisthorchiasis(n=1629).The McNemar chi-square,Kruskal-Wallis and Cohen’s kappa coefficient(κ-value)tests were used for statistical *** Urinary OV-RdT had sensitivity of 94.2%and specificity of 93.2%,compared to faecal *** OV-RdT had high diagnostic agreement(Kappa=0.842-0.874,Pd quantitative correlation with urinary antigen ELISA(Kruskal-Wallis tests=316.2,Pd faecal FECT(Kruskal-Wallis tests=362.3,PdT,ELISA and FECT were 48.9%,52.5%and 49.3%,***-reactions of urinary OV-RdT with other helminthiases were few(2%).Field trials of urinary OV-RdT yielded comparable prevalence *** between urinary OV-RdT(53.2%)and urinary antigen ELISA(54.0%).OV screening showed high diagnostic agreement(kappa>0.8,PdT and urinary antigen *** cure rates of opisthorchiasis at 1 month post-praziq

关键词： Liver fluke Opisthorchis viverrini Urinary antigen detection Urinary Opisthorchis viverrini rapid diagnosis test Enzyme-linked immunosorbent assay Quantitative formalin-ethyl acetate concentration technique

Hepatic steatosis and fibrosis: Non-invasive assessment

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World Journal of Gastroenterology 2016年第45期22卷 9880-9897页

作者： Rustam N Karanjia Mary ME Crossey I Jane Cox Haddy KS Fye Ramou Njie Robert d Goldin simon d taylor-robinson Liver Unit Division of Digestive Health Department of Surgery and Cancer Imperial College London St Mary’s Campus London W2 1NY United Kingdom Institute of Hepatology London Foundation for Liver Research 111 Coldharbour Lane London SE5 9NT United Kingdom Faculty of Life Sciences and Medicine King’s College London London SE5 9NT United Kingdom MRC Gambia Atlantic Road Fajara The Gambia

Chronic liver disease is a major cause of morbidity and mortality worldwide and usually develops over many years, as a result of chronic inflammation and scarring, resulting in end-stage liver disease and its complications. The progression of disease is characterised by ongoing inflammation and consequent fibrosis, although hepatic steatosis is increasingly being recognised as an important pathological feature of disease, rather than being simply an innocent bystander. However, the current gold standard method of quantifying and staging liver disease, histological analysis by liver biopsy, has several limitations and can have associated morbidity and even mortality. Therefore, there is a clear need for safe and noninvasive assessment modalities to determine hepatic steatosis, inflammation and fibrosis. This review covers key mechanisms and the importance of fibrosis and steatosis in the progression of liver disease. We address non-invasive imaging and blood biomarker assessments that can be used as an alternative to information gained on liver biopsy.

关键词：肝的脂肪变性纤维变性非侵略的评价血 biomarker 超声

Non-invasive splenic parameters of portal hypertension:Assessment and utility

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World Journal of Hepatology 2020年第11期12卷 1055-1066页

作者： Ayesha Karim Ahmad Sebastiana Atzori James Maurice simon d taylor-robinson Adrian KP Lim Liver Unit Department of DigestionMetabolism&ReproductionFaculty of MedicineImperial College LondonLondon W21NYUnited Kingdom Liver Unit Department of DigestionMetabolism&ReproductionImperial College LondonLondon W21NYUnited Kingdom Liver Unit and Imaging Department of DigestionMetabolism&ReproductionImperial College LondonLondon W21NYUnited Kingdom

BACKGROUNd Portal hypertension is a major complication of cirrhosis that is associated with significant morbidity and *** present gold-standard method to risk stratify and observe cirrhosis patients with portal hypertension is hepatic venous pressure gradient measurement or ***,these methods are invasive,carry a risk of complications and are associated with significant patient ***,non-invasive splenic parameters are of clinical interest as potential useful markers in determining the presence of portal ***,diagnostic accuracy and reproducibility remains *** To assess the diagnostic accuracy of spleen stiffness,area and diameter in predicting the presence of portal *** Of 50 patients with varying liver disease pathologies were prospectively recruited from the ***’s Hospital Liver Unit in London;25 with evidence of portal hypertension and 25 with no evidence of portal *** stiffness,spleen stiffness,spleen diameter and spleen area were measured using the Philips Affiniti 70 elastography point quantification point shear wave elastography *** aspartate aminotransferase-to-platelet-ratio-index(APRI)score was also *** measures,univariate and multivariate logistic regression were used to evaluate demographic,clinical and elastography *** correlation coefficient was used to determine the reproducibility of splenic area and *** On univariate and individual performance,platelet count[area under the receiver operating characteristic(AUROC)0.846,P valued APRI score(AUROC 0.827,P valuedentifying the presence of portal *** multivariate logistic regression models constructed,the combination of spleen area greater than 57.90 cm2 and platelet count less than 126×10^9 had 63.2%sensitivity and 100%specificity

关键词： Portal hypertension Esophageal varices Point shear wave elastography Spleen stiffness Spleen area Non-invasive

Imaging of liver cancer

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World Journal of Gastroenterology 2009年第11期15卷 1289-1300页

作者： Ben Ariff Claire R Lloyd Sameer Khan Mohamed Shariff Andrew V Thillainayagam devinder S Bansi Shahid A Khan simon d taylor-robinson Adrian KP Lim department of Imaging Imperial College Healthcare NHS Trust Charing Cross Hospital Campus Fulham Palace Road London W6 8RF United Kingdom department of Hepatology and Gastroenterology Division of Medicine Imperial College London St Mary's Hospital Campus South Wharf Road London W2 1NY United Kingdom

Improvements in imaging technology allow exploitation of the dual blood supply of the liver to aid in the identif ication and characterisation of both malignant and benign liver lesions. Imaging techniques available include contrast enhanced ultrasound, computed tomography and magnetic resonance imaging. This review discusses the application of several imaging techniques in the diagnosis and staging of both hepatocellular carcinoma and cholangiocarcinoma and outlines certain characteristics of benign liver lesions. The advantages of each imaging technique are highlighted, while underscoring the potential pitfalls and limitations of each imaging modality.

关键词：成像技术肝癌计算机断层扫描恶性肝肿瘤磁共振成像血液供应成像方式超声波

Hepatocellular carcinoma: Epidemiology, risk factors and pathogenesis

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World Journal of Gastroenterology 2008年第27期14卷 4300-4308页

作者： Asmaa Ibrahim Gomaa Shahid A Khan Mireille B Toledano Imam Waked simon d taylor- robinson department of Hepatology and Gastroenterology Imperial College London St Mary’s Hospital Campus department of Epidemiology and Public Health Imperial College London St Mary’s Hospital Campus National Liver Institute Menoufiya University

Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Given that the burden of chronic liver disease is expected to rise owing to increasing rates of alcoholism, hepatitis B and C prevalence and obesity-related fatty liver disease, it is expected that the incidence of HCC will also increase in the foreseeable future. This article summarizes the international epidemiology, the risk factors and the pathogenesis of HCC, including the roles of viral hepatitis, toxins, such as alcohol and aflatoxin, and insulin resistance.

关键词：肝细胞癌流行病学致病因子病因学发病机理

Non-invasive means of measuring hepatic fat content

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World Journal of Gastroenterology 2008年第22期14卷 3476-3483页

作者： Sanjeev R Mehta E Louise Thomas Jimmy d Bell desmond G Johnston simon d taylor-robinson division of Medicine Imperial College London St Mary's Campus Praed Street London W2 1NY United Kingdom Imaging Sciences depart-ment Division of Clinical Sciences Imperial College London Hammersmith Campus Du Cane Road London W12 OHS United Kingdom

Hepatic steatosis affects 20% to 30% of the general adult population in the western world. Currently, the technique of choice for determining hepatic fat deposition and the stage of fibrosis is liver biopsy. However, it is an invasive procedure and its use is limited, particularly in children. It may also be subject to sampling error. Non-invasive techniques such as ultrasound, computerised tomography (CT), magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H MRS) can detect hepatic steatosis, but currently cannot distinguish between simple steatosis and steatohepatitis, or stage the degree of fibrosis accurately. Ultrasound is widely used to detect hepatic steatosis, but its sensitivity is reduced in the morbidly obese and also in those with small amounts of fatty infiltration. It has been used to grade hepatic fat content, but this is subjective. CT can detect hepatic steatosis, but exposes subjects to ionising radiation, thus limiting its use in longitudinal studies and in children. Recently, magnetic resonance (MR) techniques using chemical shift imaging have provided a quantitative assessment of the degree of hepatic fatty infiltration, which correlates well with liver biopsy results in the same patients. Similarly, in vivo 1H MRS is a fast, safe, non-invasive method forthe quantification of intrahepatocellular lipid (IHCL) levels. Both techniques will be useful tools in future longitudinal clinical studies, either in examining the natural history of conditions causing hepatic steatosis (e.g. non-alcoholic fatty liver disease), or in testing new treatments for these conditions.

关键词：脂肪纤维异常肥胖脂肪肝胰岛素耐药性超声检查

Use of second generation contrast-enhanced ultrasound in the assessment of focal liver lesions

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World Journal of Gastroenterology 2007年第45期13卷 5963-5970页

作者： Stanislas HX Morin Adrian KP Lim eremy FL Cobbold simon d taylor-robinson Sciences Hammersmith Hospital Campus Faculty of Medicine Imperial College London London United Kingdom Liver Unit St Mary's Hospital Campus Faculty of Medicine Imperial College London London United Kingdom Liver Unit St Mary’s Hospital Campus Faculty of Medicine Imperial College London London United Kingdom

Ultrasound (US) is often the first imaging modality employed in patients with suspected focal liver lesions. The role of US in the characterisation of focal liver lesions has been transformed with the introduction of specific contrast media and the development of specialized imaging techniques. Ultrasound now can fully characterise the enhancement pattern of hepatic lesions, similar to that achieved with contrast enhanced multiphasic computed tomography (CT) and magnetic resonance imaging (MRI). US contrast agents are safe, well-tolerated and have very few contraindications. Furthermore, real-time evaluation of the vascularity of focal liver lesions has become possible with the use of the newer microbubble contrast agents. This article reviews the enhancement pattern of the most frequent liver lesions seen, using the second generation US contrast media. The common pitfalls for each type of lesion are discussed. The recent developments in US contrast media and specific imaging techniques have been a major advance and this technique, in view of the intrinsic advantages of US, will undoubtedly gain popularity in the years to come.

关键词：超声波检查肝损伤实验研究临床表现

Current and future applications of in vitro magnetic resonance spectroscopy in hepatobiliary disease

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World Journal of Gastroenterology 2006年第30期12卷 4773-4783页

作者： I Jane Cox Amar Sharif Jeremy FL Cobbold Howard C Thomas simon d taylor-robinson Imaging Sciences department Division of Clinical Sciences Imperial College London Hammersmith Hospital Campus Du Cane Road London W12 OHS United Kingdom department of Medicine Division of Medi-cine Imperial College London St Mary's Campus London W2 United Kingdom

原子磁性的回声光谱学允许细胞的生物化学和新陈代谢的学习，在整个身体在活体内并且在更高的磁场力量在试管内。因为这种技术非侵略、非选择，磁性的回声光谱学方法论广泛地在生物化学和药被使用了。房间，身体液体和纸巾的在试管内磁... 详细信息

原子磁性的回声光谱学允许细胞的生物化学和新陈代谢的学习，在整个身体在活体内并且在更高的磁场力量在试管内。因为这种技术非侵略、非选择，磁性的回声光谱学方法论广泛地在生物化学和药被使用了。房间，身体液体和纸巾的在试管内磁性的回声光谱学研究在医药生物化学被使用了调查 pathophysiological 过程，更最近，这种技术被医生使用了决定疾病畸形在活体内。这个加亮的话题说明在试管内的潜力在学习肝胆管系统的磁性的回声光谱学。在恶意、非恶意的肝疾病和胆汁作文的学习的磁性的回声光谱学学习的在试管内质子和磷的角色被讨论，特别地与关联词在活体内的参考整个身体的磁性的回声光谱学应用。在摘要，磁性的回声光谱学技术能在到内在的 pathophysiological 过程的疾病严厉和指针上提供非侵略的生物化学的信息。磁性的回声光谱学为疾病简历标记，以及估计的治疗学的反应作为一个屏蔽工具保持潜在的诺言。

关键词：肝胆疾病磁共振成像代谢障碍治疗

Effect of nutritional counselling on hepatic,muscle and adipose tissue fat content and distribution in non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2006年第36期12卷 5813-5819页

作者： E Louise Thomas Audrey E Brynes Gavin Hamilton Nayna Patel Adam Spong Robert d Goldin Gary Frost Jimmy d Bell simon d taylor-robinson The Robert Steiner MR Unit MRC Clinical Sciences Centre department of Nutrition and dietetics The Robert Steiner MR Unit MRC Clinical Sciences Centre Faculty of Medicine Imperial College London Hammersmith Hospital Du Cane Rd London W12 0HS United Kingdom and Histopathology Department Faculty of Medicine Imperial College London St Mary's Hospital Praed Street London W2 1NY United Kingdom Faculty of Medicine Faculty of Medicine Imperial College London St Mary's Hospital Praed Street London W2 1NY United Kingdom

AIM: To assess the effectiveness of the current UK clinical practice in reducing hepatic fat (IHCL). METHOdS: Whole body MRI and 1H MRS were obtained, before and after 6 mo nutritional counselling, from liver, soleus and tibialis muscles in 10 subjects with non-alcoholic fatty liver disease (NAFLd). RESULTS: A 500 Kcal-restricted diet resulted in an average weight loss of 4% (-3.4 kg,) accompanied by significant reductions in most adipose tissue (AT) depots, including subcutaneous (-9.9%), abdominal subcutaneous (-10.2%) and intra-abdominal-AT (-11.4%). Intramyocellular lipids (IMCL) were significantly reduced in the tibialis muscle (-28.2%). decreases in both IHCL (-39.9%) and soleus IMCL (-12.2%) content were also observed, although these were not significant. Several individuals showed dramatic decreases in IHCL, while others paradoxically showed increases in IHCL content. Changes in body composition were accompanied by improvements in certain liver function tests: serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Significant correlations were found between decreases in IHCL and reductions in both intra-abdominal and abdominal subcutaneous AT. Improvements in liver function tests were associated with reductions in intra-abdominal AT, but not with changes in IHCL. CONCLUSION: This study shows that even a very modest reduction in body weight achieved through lifestyle modification can result in changes in body fat depots and improvements in LFTs.

关键词：营养咨询肝疾病肌肉疾病脂肪分布