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Biomarkers in autoimmune pancreatitis and immunoglobulin G4-related disease

World Journal of gastroenterology 2021年第19期27卷 2257-2269页

作者： Akane Hara Tomohiro Watanabe Kosuke Minaga Tomoe Yoshikawa Ken Kamata Masatoshi Kudo department of gastroenterology and hepatology Kindai University Faculty of MedicineOsaka-Sayama 589-8511Japan

Solitary organ autoimmune disorders,formerly known as autoimmune pancreatitis(AIP),autoimmune sialadenitis,and autoimmune sclerosing cholangitis,are now considered organ-specific manifestations of systemic immunoglobulin G4-related disease(IgG4-RD).AIP and IgG4-RD are characterized by elevated serum concentration of IgG4 antibody(Ab),accumulation of IgG4-expressing plasmacytes in the affected organs,and involvement of multiple *** is well established that enhanced IgG4 Ab responses are a hallmark of AIP and IgG4-RD for diagnosis and monitoring disease ***,a significant fraction of patients with AIP and IgG4-RD who develop chronic fibroinflammatory responses have normal serum concentrations of this IgG *** addition,disease flare-up is sometimes seen even in the presence of normalized serum concentrations of IgG4 Ab after successful induction of remission by ***,it is necessary to identify new biomarkers based on the understanding of the pathophysiology of AIP and ***,we found that activation of plasmacytoid dendritic cells producing both interferon-α(IFN-α)and interleukin-33(IL-33)mediate murine AIP and human *** importantly,we provided evidence that serum concentrations of IFN-αand IL-33 could be useful biomarkers for the diagnosis and monitoring of AIP and IgG4-RD activity after induction of remission in these autoimmune *** this Frontier article,we have summarized and discussed biomarkers of AIP and IgG4-RD,including Igs,autoAbs,and cytokines to provide useful information not only for clinicians but also for researchers.

关键词： Biomarker Autoimmune pancreatitis Immunoglobulin G4-related disease Plasmacytoid dendritic cells Cytokine Chemokine

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Hepatocellular carcinoma in Egypt: A single center study over a decade

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World Journal of gastroenterology 2005年第33期11卷 5193-5198页

作者： Adbel-Rahman El-Zayadi Hanaa M Badran Eman MF Barakat Mohy El-Deen Attia Sherine Shawky Mostafa K Mohamed Osaima Selim Ahmed Saeid department of Tropical medicine Ain Shams university Cairo Egypt department of hepatology National Liver Institute MenoufeyaEgypt department of Tropical medicine Ain Shams university Cairo Egypt department of hepatology and gastroenterology Theodor Bilharz Research Institute Cairo Egypt The Social Research Center The American university in cairo Egypt department of Community medicine Ain Shams university CairoEgypt department of Clinical Pathology Ain Shams university CairoEgypt cairo Liver Center Giza Egypt

AIM： To identify the trend, possible risk factors and any pattern change of hepatocellular carcinoma （HCC） in Egypt over a decade. METHODS： All HCC patients attending cairo Liver Center between January 1993 and December 2002, were enrolled in the study. Diagnosis of HCC was based on histopathological examination and/or detection of hepatic focal lesions by two imaging techniques plus α-fetoprotein level above 200 ng/mL. The duration of the study was divided into two periods of 5 years each; period Ⅰ （1993-1997） and period Ⅱ （1998-2002）. Trend, demographic features of patients （age, gender, and residence）, risk factors （HBsAg, HCV-Ab, schistosomiasis and others） and pattern of the focal lesions were compared between the two periods. Logistic regression model was fitted to calculate the adjusted odds ratios for the potential risk factors. The population attributable risk percentage was calculated to estimate the proportion of HCC attributed to hepatitis B and C viral infections. RESULTS： Over a decade, 1 328 HCC patients out of 22 450 chronic liver disease （CLD） patients were diagnosed with an overall proportion of 5.9%. The annual proportion of HCC showed a significant rising trend from 4.0% in 1993 to 7.2% in 2002 （P = 0.000）. A significant increase in male proportion from 82.5% to 87.6% （P = 0.009）; M/F from 5：1 to 7：1 and a slight increase of the predominant age group （40-59 years） from 62.6% to 66.8% （P = 0.387）in periods Ⅰ and Ⅱ respectively, reflecting a shift to younger age group. In the bivariate analysis, HCC was significantly higher in rural residents, patients with history of schistosomiasis and/or blood transfusion. Yet, after adjustment, these variables did not have a significant risk for development of HCC. There was a significant decline of HBsAg from 38.6% to 20.5% （P = 0.000）, and a slight increase of HCV-Ab from 85.6% to 87.9% in periods I and II respectively. HBV conferred a higher risk to develop HCC more than HCV in period Ⅰ （OR 1.9 vsl.6） and pe

关键词： Hepatocellular carcinoma HCC prevalence HCCrisk factors Pattern of HCC HCV and HCC HBV and HCC

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Endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis: Long-term outcomes after removal of a self-expandable metal stent

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World Journal of gastroenterology 2017年第4期23卷 661-667页

作者： Ken Kamata Mamoru Takenaka Masayuki Kitano Shunsuke Omoto Takeshi Miyata Kosuke Minaga Kentaro Yamao Hajime Imai Toshiharu Sakurai Tomohiro Watanabe Naoshi Nishida Masatoshi Kudo department of gastroenterology and hepatology Kindai University Faculty of MedicineOsaka-Sayama 589-8511Japan

AIM To assess the long-term outcomes of this procedure after removal of self-expandable metal stent(SEMS). The efficacy and safety of endoscopic ultrasoundguided gallbladder drainage(EUS-GBD) with SEMS were also *** Between January 2010 and April 2015, 12 patients with acute calculous cholecystitis, who were deemed unsuitable for cholecystectomy, underwent EUSGBD with a SEMS. EUS-GBD was performed under the guidance of EUS and fluoroscopy, by puncturing the gallbladder with a needle, inserting a guidewire, dilating the puncture hole, and placing a SEMS. TheSEMS was removed and/or replaced with a 7-Fr plastic pigtail stent after cholecystitis improved. The technical and clinical success rates, adverse event rate, and recurrence rate were all *** The rates of technical success, clinical success, and adverse events were 100%, 100%, and 0%, respectively. After cholecystitis improved, the SEMS was removed without replacement in eight patients, whereas it was replaced with a 7-Fr pigtail stent in four patients. Recurrence was seen in one patient(8.3%) who did not receive a replacement pigtail stent. The median follow-up period after EUS-GBD was 304 d(78-1492).CONCLUSION EUS-GBD with a SEMS is a possible alternative treatment for acute cholecystitis. Long-term outcomes after removal of the SEMS were excellent. Removal of the SEMS at 4-wk after SEMS placement and improvement of symptoms might avoid migration of the stent and recurrence of cholecystitis due to food impaction.

关键词： Endoscopic ultrasound-guided gallbladder drainage Cholecystitis Endoscopic ultrasound-guided biliary drainage

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Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy

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World Journal of gastroenterology 2017年第2期23卷 328-335页

作者： Yoriaki Komeda Hiroshi Kashida Toshiharu Sakurai George Tribonias Kazuki Okamoto Masashi Kono Mitsunari Yamada Teppei Adachi Hiromasa Mine Tomoyuki Nagai Yutaka Asakuma Satoru Hagiwara Shigenaga Matsui Tomohiro Watanabe Masayuki Kitano Takaaki Chikugo Yasutaka Chiba Masatoshi Kudo department of gastroenterology and hepatology Kindai University Faculty of Medicine department of Pathology Kindai University Faculty of Medicine Clinical Research Center Kindai University Hospital

AIMTo compare the efficacy and safety of cold snare polypectomy (CSP) and hot forceps biopsy (HFB) for diminutive colorectal *** prospective, randomized single-center clinical trial included consecutive patients ≥ 20 years of age with diminutive colorectal polyps 3-5 mm from December 2014 to October 2015. The primary outcome measures were en-bloc resection (endoscopic evaluation) and complete resection rates (pathological evaluation). The secondary outcome measures were the immediate bleeding or immediate perforation rate after polypectomy, delayed bleeding or delayed perforation rate after polypectomy, use of clipping for bleeding or perforation, and polyp retrieval rate. Prophylactic clipping after polyp removal wasn’t routinely *** hundred eight patients were randomized into the CSP (102), HFB (106) and 283 polyps were evaluated (CSP: 148, HFB: 135). The en-bloc resection rate was significantly higher with CSP than with HFB [99.3% (147/148) vs 80.0% (108/135), P < 0.0001]. The complete resection rate was significantly higher with CSP than with HFB [80.4% (119/148) vs 47.4% (64/135), P < 0.0001]. The immediate bleeding rate was similar between the groups [8.6% (13/148) vs 8.1% (11/135), P = 1.000], and endoscopic hemostasis with hemoclips was successful in all cases. No cases of perforation or delayed bleeding occurred. The rate of severe tissue injury to the pathological specimen was higher HFB than CSP [52.6% (71/135) vs 1.3% (2/148), P < 0.0001]. Polyp retrieval failure was encountered CSP (7), HFB (2).CONCLUSIONCSP is more effective than HFB for resecting diminutive polyps. Further long-term follow-up study is required.

关键词： Cold snare polypectomy Colonoscopy Polypectomy Colorectal diminutive polyps Hot forceps biopsy

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Noninvasive assessment of hepatic fibrosis in Egyptian patients with chronic hepatitis C virus infection

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World Journal of gastroenterology 2012年第23期18卷 2988-2994页

作者： Shawky Abdelhamid Fouad Serag Esmat Dalia Omran Laila Rashid Mohamed H Kobaisi department of Internal medicine Faculty of Medicine Cairo University Cairo 11562 Egypt department of Tropical medicine Faculty of Medicine Cairo University Cairo 11562 Egypt department of Biochemistry Faculty of Medicine Cairo University Cairo 11562 Egypt department of Pathology National Institute of Nephrology Cairo 35789 Egypt

AIM: To evaluate the accuracy of specific biochemical markers for the assessment of hepatic fibrosis in patients with chronic hepatitis C virus (HCV) infection. METHODS: One hundred and fifty-four patients with chronic HCV infection were included in this study; 124 patients were non-cirrhotic, and 30 were cirrhotic. The following measurements were obtained in all patients: serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, total bilirubin, prothrombin time and concentration, complete blood count, hepatitis B surface antigen (HBsAg), HCVAb, HCV-RNA by quantitative polymerase chain reaction, abdominal ultrasound and ultrasonic-guided liver biopsy. The following ratios, scores and indices were calculated and compared with the results of the histopathological examination: AST/ALT ratio (AAR), age platelet index (API), AST to platelet ratio index (APRI), cirrhosis discriminating score (CDS), Pohl score, G teborg university Cirrhosis Index (GUCI). RESULTS: AAR, APRI, API and GUCI demonstrated good diagnostic accuracy of liver cirrhosis (80.5%, 79.2%, 76.6% and 80.5%, respectively); P values were: 0.05). In addition, we found significant correlations for the AAR, APRI, API, GUCI and Pohl score between the non-cirrhotic (F0, F1, F2, F3) and cirrhotic (F4) groups (P values: 0.05). CONCLUSION: The use of AAR, APRI, API, GUCI and Pohl score measurements may decrease the need

关键词： Age platelet index Aspartate aminotrans-ferase platelet ratio index Aspartate aminotransferase-to-alanine aminotransferase ratio Cirrhosis discrimi-nating score Fibrosis evaluation G^teborg universityCirrhosis Index Hepatitis C virus infection Liver fibro-sis Pohl score

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Promising anticancer therapy: combination of immune checkpoint inhibitors and molecular-targeted agents

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Hepatobiliary Surgery and Nutrition 2020年第6期9卷 777-779页

作者： Toshiharu Sakurai Naoshi Nishida Masatoshi Kudo department of gastroenterology and hepatology Kindai University Faculty of MedicineOsakaJapan

Hepatocellular carcinoma(HCC)is the fourth leading cause of cancer death worldwide,and prognosis remains unsatisfactory when the disease is diagnosed at an advanced *** resistance is one of the main obstacles to the treatment of advanced *** studies have proposed that the activation of escape pathways from RAF/MEK/ERK/STAT3 might result in sorafenib resistance(1-3).Leung et *** that HCC cells with higher SHP2 expression was associated with a lower sensitivity towards sorafenib treatment(4).Consistently,SHP2 inhibitor SHP099 abrogated sorafenib resistance in cancer cells by blocking RAS/MEK/ERK and AKT signaling pathways(4).Unlike other tyrosine phosphatases,SHP2 functions as a positive regulator of proliferative signals.

关键词： STAT3 death treatment

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Durvalumab plus tremelimumab in unresectable hepatocellular carcinoma

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Hepatobiliary Surgery and Nutrition 2022年第4期11卷 592-596页

作者： Masatoshi Kudo department of gastroenterology and hepatology Kindai University Faculty of MedicineOsakaJapan

Introduction The results of the Phase 3 HIMALAYA trial were presented at ASCO-GI 2022(1).Durvalumab+tremelimumab(Durva/Treme)has also been approved for the treatment of urothelial cancer and non-small cell lung *** hepatocellular carcinoma(HCC),nivolumab+ipilimumab has received accelerated approval from the FDA as second line therapy after sorafenib with Phase 1/2 study results,and a Phase 3 trial is currently ***/Treme is the first anti-PD-L1+anti-CTLA-4 combination immunotherapy to be successfully tested in Phase 3.

关键词： hepatocellular lung carcinoma

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Hepatic allograft rejection after liver transplantation: Clinicopathological debates

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iLIVER 2023年第2期2卷 116-121页

作者： Nourhan Badwei Tropical medicine Gastroenterology and HepatologyHepatoma GroupFaculty of MedicineAin Shams UniversityCairo 11588Egypt

Liver transplantation(LT)represents a life-saving surgical procedure and is considered the current standard of care for the majority of patients having end-stage liver *** known,significant progress in organ preservation techniques,perioperative care,and strict immunosuppression protocols are associated with favorable patient/graft survival ***,proper evaluation of liver allograft-related complications among survivors has paid great attention,particularly the rejection sequel after *** is a seriously underestimated cause of allograft injury,which pushes researchers for understanding the exact pathogenesis of different types and proper time diagnosis for better management of such ***,it still represents a challenge because of the complexities related to diagnosis and ***,increasing clinical awareness with earlier diagnosis of post-LT rejection is essential through stimulating further ***,our review will focus on the clinicopathological debates regarding liver allograft loss after transplantation.

关键词： Liver transplantation Graft rejection Diagnostic debates

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Clinical implications of the dual blockade of the PD-1/PD-L1 and vascular endothelial growth factor axes in the treatment of hepatocellular carcinoma

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Hepatobiliary Surgery and Nutrition 2020年第5期9卷 640-643页

作者： Naoshi Nishida department of gastroenterology and hepatology Kindai University Faculty of MedicineOsakaJapan

Currently,liver cancer is the fourth most common cause of cancer mortality *** overwhelming majority of liver cancers are hepatocellular carcinomas(HCC),developing on the background of chronic liver diseases,including chronic hepatitis B,chronic hepatitis C,and non-alcoholic steatohepatitis(1).Despite the recent progress in the treatment of HCC,it remains largely refractory,with a high recurrence rate even after therapeutic intervention(2).Numerous agents,including tyrosine-kinase inhibitors(TKIs),antibodies blocking the vascular endothelial growth factor(VEGF)/VEGF receptor(VEGFR)axis,and immune checkpoint inhibitors,are now available for the treatment of advanced stage HCC(3).However,their antitumor responses are still unsatisfactory.

关键词： hepatocellular mortality treatment

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A new era of systemic therapy for intermediate and advanced stage hepatocellular carcinoma

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Hepatobiliary Surgery and Nutrition 2020年第4期9卷 530-533页

作者： Masatoshi Kudo department of gastroenterology and hepatology Kindai University Faculty of MedicineOsakaJapan

Until recently,transarterial chemoembolization(TACE)was the only standard treatment for intermediate-stage hepatocellular carcinoma(HCC)according to the worldwide guidelines for the diagnosis and treatment of HCC(1,2).However,TACE is not always effective in providing a survival benefit because of the extreme heterogeneity of intermediate-stage HCC regarding tumor size and number,and liver function(Child-Pugh A5-B9).

关键词： diagnosis arterial treatment

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