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Association between autoimmune gastritis and gastric polyps:Clinical characteristics and risk factors

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 73-87页

作者： Jing-Zheng Jin Xiao Liang Shu-Peng Liu Rui-Lan Wang Qing-Wei Zhang Yu-Feng Shen Xiao-Bo Li Division of gastroenterology and Hepatology Renji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China Division of gastroenterology and Hepatology Shanghai Institute of Digestive DiseasesShanghai 200001China Division of gastroenterology and Hepatology Renji Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai 200127China Division of gastroenterology and Hepatology Sichuan Armed Police Corps HospitalLeshan 610041Sichuan ProvinceChina Division of gastroenterology and Hepatology NHC Key Laboratory of Digestive DiseasesRenji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China department of gastroenterology Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine Shanghai Institute of Digestive DiseasesShanghai 200127China

BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well *** To explore the clinical characteristics and risk factors of AIG with GPs in *** This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July *** collected clinical,biochemical,serological,and demographic data were of each *** regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG *** operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with *** Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective *** PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with *** gastrin-17 levels may also play a role in this *** findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.

关键词： Autoimmune gastritis Gastric polyps Neuroendocrine tumor Risk factors Nomogram

Exploring the performance of large language models on hepatitis B infection-related questions:A comparative study

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World Journal of gastroenterology 2025年第3期31卷 103-112页

作者： Yu Li Chen-Kai Huang Yi Hu Xiao-Dong Zhou Cong He Jia-Wei Zhong department of gastroenterology Jiangxi Provincial Key Laboratory of Digestive DiseasesJiangxi Clinical Research Center for GastroenterologyDigestive Disease HospitalThe First Affiliated HospitalJiangxi Medical CollegeNanchang UniversityNanchang 330006Jiangxi ProvinceChina HuanKui Academy Nanchang UniversityNanchang 330006Jiangxi ProvinceChina

BACKGROUND Patients with hepatitis B virus(HBV)infection require chronic and personalized care to improve *** language models(LLMs)can potentially provide medical information for *** To examine the performance of three LLMs,ChatGPT-3.5,ChatGPT-4.0,and Google Gemini,in answering HBV-related *** LLMs’responses to HBV-related questions were independently graded by two medical professionals using a four-point accuracy scale,and disagreements were resolved by a third *** question was run three times using three *** was assessed via the Gunning Fog index and Flesch-Kincaid grade *** Overall,all three LLM chatbots achieved high average accuracy scores for subjective questions(ChatGPT-3.5:3.50;ChatGPT-4.0:3.69;Google Gemini:3.53,out of a maximum score of 4).With respect to objective questions,ChatGPT-4.0 achieved an 80.8%accuracy rate,compared with 62.9%for ChatGPT-3.5 and 73.1%for Google *** the six domains,ChatGPT-4.0 performed better in terms of diagnosis,whereas Google Gemini demonstrated excellent clinical ***,in the readability analysis,the mean Gunning Fog index and Flesch-Kincaid grade level scores of the three LLM chatbots were significantly higher than the standard level eight,far exceeding the reading level of the normal *** Our results highlight the potential of LLMs,especially ChatGPT-4.0,for delivering responses to HBV-related *** may be an adjunctive informational tool for patients and physicians to improve ***,current LLMs should not replace personalized treatment recommendations from physicians in the management of HBV infection.

关键词： ChatGPT-3.5 ChatGPT-4.0 Google Gemini Hepatitis B infection Accuracy

WNT/β-catenin-M2 macrophage interplay as a target for therapy against hepatocellular carcinoma:Role of Calculus bovis

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World Journal of gastroenterology 2025年第3期31卷 130-133页

作者： Tryfonas Mpektsis Anastasios Manolakis Andreas Kapsoritakis department of gastroenterology University Hospital of LarisaLarisa 41100Greece

liver cancer,and in particular hepatocellular carcinoma(HCC)is a disease of rising prevalence and *** date,definitive treatment options include either surgical excision or ablation of the affected *** increasing research on several pathways that could be involved in the progression of HCC,new elements within these pathways emerge as potential targets for novel *** WNT/β-catenin pathway favors the presence of M2 tumor-associated macrophages which in turn promote tumor growth and *** inhibition of this pathway is considered a good candidate for such targeted therapeutic ***,as Huang et al show in their recently published article,Calculus bovis which is used in traditional Chinese medicine can exert an inhibitory effect on theβ-catenin pathway and become a potential candidate for targeted pharmacotherapy against liver cancer.

关键词： Hepatocellular carcinoma Calculus bovis WNT/β-catenin pathway Tumorassociated macrophages

Can Emax and platelet count truly differentiate between benign and malignant liver lesions?

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World Journal of gastroenterology 2025年第3期31卷 120-122页

作者： Manjeet Kumar Goyal Omesh Goyal department of gastroenterology and Human Nutrition Unit All India Institute of Medical SciencesNew Delhi 110029DelhiIndia department of gastroenterology Dayanand Medical College and HospitalLudhiana 141001PunjabIndia

This letter critically evaluates Jiang et al's article on the differentiation of benign and malignant liver lesions using Emax and platelet *** notable findings,significant methodological and interpretative limitations are *** study lacks detailed assay conditions for Emax measurement,employs inadequate statistical methods without robust multivariate analysis,and does not provide clinically relevant threshold *** nomogram's reliance on Emax as a major diagnostic contributor is questionable due to attenuation in hepatocellular carcinoma patients with ***,the study's limitations,such as selection bias and confounding factors,are not adequately *** research should adopt more rigorous methodologies,including prospective studies with larger cohorts and standardized protocols for biomarker measurement,to enhance validity and clinical applicability.

关键词： Emax Platelet count Benign liver lesions Malignant liver lesions Hepatocellular carcinoma Cirrhosis Diagnostic biomarkers Shear wave elastography Methodological limitations Clinical utility

Redefining endoluminal biliary drainage:Challenges and innovations in endosonography-guided techniques

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World Journal of gastroenterology 2025年第1期31卷 146-151页

作者： Marcel Razpotnik department of gastroenterology and Hepatology Campus Virchow/Campus MitteCharitéBerlinBerlin 10117Germany

Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary ***,its use in complex biliary obstructions is *** the past decades,therapeutic endosonography(EUS)and emerging technologies such as lumen-apposing metal stents have enabled endoscopic treatment of conditions previously requiring nonendoscopic or surgical *** show that EUS-guided choledochoduodenostomy is a reliable alternative to endoscopic retrograde cholangiopancreatography in the treatment of distal malignant biliary obstructions and can be considered a primary drainage modality in centers with adequate *** malignant hilar biliary obstructions,draining at least 50%of viable liver tissue often requires combining different *** treatment strategy in these patients should be individualized,depending on the Bismuth classification,patient physical status,and intended systemic *** to the lack of evidence,general recommendations cannot be made for EUS-guided hepaticoduodenostomy or combined procedures with transhepatic bridging *** novel techniques should be limited to selected palliative cases where conventional methods have failed and conducted within clinical trials to generate evidence before broader application.

关键词： Endoscopic biliary drainage Interventional endosonography Lumen-apposing metal stent Malignant hilar biliary obstruction Malignant distal biliary obstruction

Vedolizumab serum trough concentrations with and without thiopurines in ulcerative colitis: The prospective VIEWS pharmacokinetics study

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World Journal of gastroenterology 2025年第2期31卷 102-112页

作者： Thanaboon Chaemsupaphan Aviv Pudipeddi Hui-Yu Lin Sudarshan Paramsothy Viraj C Kariyawasam Melissa Kermeen Rupert W Leong department of gastroenterology and liver Services Concord Repatriation General HospitalSydney 2139New South WalesAustralia Faculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand Faculty of Medicine and Health University of SydneySydney 2139New South WalesAustralia department of gastroenterology Tan Tock Seng HospitalSingapore 308433Singapore Faculty of Medicine and Health Sciences Macquarie UniversitySydney 2139New South WalesAustralia department of gastroenterology and Hepatology Blacktown HospitalSydney 2148New South WalesAustralia Blacktown Clinical School Western Sydney UniversitySydney 2148New South WalesAustralia

BACKGROUND Ulcerative colitis(UC)is a chronic inflammatory condition requiring continuous treatment and *** is limited pharmacokinetic data on vedolizumab during maintenance therapy and the effect of thiopurines on vedolizumab trough concentrations is *** To investigate the exposure-response relationship of vedolizumab and the impact of thiopurine withdrawal in UC patients who have achieved sustained clinical and endoscopic remission during maintenance *** This is a post-hoc analysis of prospective randomized clinical trial(VIEWS)involving UC patients across 8 centers in Australia from 2018 to *** in clinical and endoscopic remission were randomized to continue or withdraw thiopurine while receiving *** evaluated vedolizumab serum trough concentrations,presence of anti-vedolizumab antibodies,and clinical outcomes over 48 weeks to assess exposure-response asso-ciation and impact of thiopurine *** There were 62 UC participants with mean age of 43.4 years and 42%were *** participants received vedolizumab as maintenance therapy with 67.7%withdrew *** serum trough concentrations remained stable over 48 weeks regardless of thiopurine use,with no anti-vedolizumab antibodies ***-tients with clinical remission had higher trough concentrations at week *** quartile analysis,a threshold of>11.3μg/mL was associated with sustained clinical remission,showing a sensitivity of 82.4%,specificity of 60.0%,and an area of receiver operating characteristic of 0.71(95%CI:0.49-0.93).Patients discontinuing thiopurine required higher vedolizumab concentrations for achieving *** A positive exposure-response relationship between vedolizumab trough concentrations and UC outcomes suggests that monitoring drug levels may be *** thiopurine did not influence vedolizumab levels,its with-drawal may necessitate higher vedolizumab trough concentrations to maintain remi

关键词： Pharmacokinetic Vedolizumab Thiopurine Ulcerative colitis Trough concentration Antibody Inflammatory bowel diseases

Gastric polyps are not created equal: Know your enemy

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World Journal of gastroenterology 2025年第2期31卷 144-146页

作者： Fady Daniel department of gastroenterology and Hepatology American University of Beirut Medical CenterBeirut 11072020Lebanon

Gastric polyps are commonly detected during upper gastrointestinal *** are most often benign and rarely become ***,adequate knowledge,diagnostic modalities,and management strategies should be the endoscopist’s readily available“weapons”to defeat the potentially malignant“enemies”.This article sheds light on the valuable effort by Costa et al to generate a new classification system of gastric polyps as“good”,“bad”,and“ugly”.This comprehensive overview provides clinicians with a simplified decision-making process.

关键词： Gastric polyps Polypoid subepithelial lesions Early gastric cancer Endoscopic ultrasonography Electronic chromoendoscopy

Prognostic model for esophagogastric variceal rebleeding after endoscopic treatment in liver cirrhosis: A Chinese multicenter study

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World Journal of gastroenterology 2025年第2期31卷 85-101页

作者： Jun-Yi Zhan Jie Chen Jin-Zhong Yu Fei-Peng Xu Fei-Fei Xing De-Xin Wang Ming-Yan Yang Feng Xing Jian Wang Yong-Ping Mu Cell Biology Laboratory Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Institute of liver diseases Shanghai Academy of Chinese MedicineShanghai 201203China Clinical Key Laboratory of Traditional Chinese Medicine of Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Key Laboratory of liver and Kidney Disease of the Ministry of Education Shanghai University of Traditional Chinese MedicineShanghai 201203China department of gastroenterology and Hepatology Zhongshan Hospital Affiliated to Fudan UniversityShanghai 200032China Shanghai Institute of liver Disease Fudan UniversityShanghai 200032China Evidence-Based Medicine Center Fudan UniversityShanghai 200032China department of Gastrointestinal Endoscopy Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China department of Hepatology Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China

BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and *** its clinical importance,recognized prognostic models that can effectively predict esophagogastric variceal rebleeding in patients with liver cirrhosis are *** To construct and externally validate a reliable prognostic model for predicting the occurrence of esophagogastric variceal *** This study included 477 EGVB patients across 2 cohorts:The derivation cohort(n=322)and the validation cohort(n=155).The primary outcome was rebleeding events within 1 *** least absolute shrinkage and selection operator was applied for predictor selection,and multivariate Cox regression analysis was used to construct the prognostic *** validation was performed with bootstrap *** assessed the discrimination,calibration and accuracy of the model,and performed patient risk *** Six predictors,including albumin and aspartate aminotransferase concentrations,white blood cell count,and the presence of ascites,portal vein thrombosis,and bleeding signs,were selected for the rebleeding event prediction following endoscopic treatment(REPET)*** predicting rebleeding within 1 year,the REPET model ex-hibited a concordance index of 0.775 and a Brier score of 0.143 in the derivation cohort,alongside 0.862 and 0.127 in the validation ***,the REPET model revealed a significant difference in rebleeding rates(P<0.01)between low-risk patients and intermediate-to high-risk patients in both *** We constructed and validated a new prognostic model for variceal rebleeding with excellent predictive per-formance,which will improve the clinical management of rebleeding in EGVB patients.

关键词： Esophagogastric variceal bleeding Variceal rebleeding liver cirrhosis Prognostic model Risk stratification Secondary prophylaxis

Computed tomography enterography-based radiomics for assessing mucosal healing in patients with small bowel Crohn's disease

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World Journal of gastroenterology 2025年第3期31卷 62-72页

作者： Hao Ding Yuan-Yuan Fang Wen-Jie Fan Chen-Yu Zhang Shao-Fei Wang Jing Hu Wei Han Qiao Mei department of gastroenterology The First Affiliated Hospital of Anhui Medical UniversityHefei 230022Anhui ProvinceChina department of Radiation Oncology The First Affiliated Hospital of Anhui Medical UniversityHefei 230022Anhui ProvinceChina department of gastroenterology Suzhou First People's HospitalSuzhou 234099Anhui ProvinceChina

BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD ***,it poses a significant challenge due to its limited accessibility through conventional endoscopic *** To establish a noninvasive radiomic model based on computed tomography enterography(CTE)for MH assessment in SBCD *** Seventy-three patients diagnosed with SBCD were included and divided into a training cohort(n=55)and a test cohort(n=18).Radiomic features were obtained from CTE images to establish a radiomic *** demographics were analysed to establish a clinical model.A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic *** diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),*** Of the 73 patients enrolled,25 patients achieved *** radiomic-clinical nomogram had an area under the ROC curve of 0.961(95%confidence interval:0.886-1.000)in the training cohort and 0.958(0.877-1.000)in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone,as demonstrated by *** These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.

关键词： Crohn’s disease Computed tomography enterography Mucosal healing Nomogram Radiomics