Current Issue : October-December Volume : 2026 Issue Number : 4 Articles : 5 Articles
IgG4-related disease is a rare, immune-mediated, multisystem fibroinflammatory condition. It is characterized by elevated serum IgG4 concentrations and tissue infiltration of IgG4-positive plasma cells with distinctive histopathological features, including storiform fibrosis and obliterative phlebitis. Gastroenterological involvement is diverse and represents a critical diagnostic consideration, encompassing the pancreas, bile ducts, liver, esophagus, stomach, and intestine. In this review, we summarize the current understanding of genetic susceptibility and environmental risk factors underlying this disease, and systematically describe the clinical presentations, histopathological characteristics, imaging findings, and serological profiles of each major gastroenterological manifestation. We further review evidencebased treatment regimens ranging from glucocorticoids and conventional immunosuppressants to emerging biologic therapies, discuss organ-specific therapeutic responses, and identify predictors of disease relapse along with long-term surveillance strategies. From a gastroenterologist’s perspective, this review aims to provide a practical and integrated framework to facilitate early recognition, accurate differentiation from mimicking conditions such as pancreaticobiliary malignancies, and optimized long-term management of this complex yet treatable disease....
Objectives: Artificial intelligence (AI)- assisted endoscopy has been developed for the early detection of upper gastrointestinal cancer; however, its clinical effectiveness remains insufficiently evaluated. This study assessed its effectiveness in a health screening facility. Methods: This retrospective cohort study compared AI- assisted and non- AI- assisted upper gastrointestinal endoscopy at Omiya City Clinic, Japan (April 2021–March 2024). Participants who underwent endoscopy between April 2021 and March 2023 were classified as the non- AI group, while those examined between April 2023 and March 2024 comprised the AI group. The AI- assisted system was introduced in April 2023. The primary outcome was cancer detection rate (CDR), with secondary outcomes including biopsy rate and positive predictive value (PPV). Propensity score matching (PSM) was performed for age, sex, alcohol consumption, smoking, Helicobacter pylori infection history, endoscopist experience, and prior- year endoscopy to minimize bias. Results: In total, 17,662 were included in the AI group and 32,318 in the non- AI group. PSM created 17,662 matched pairs. In the AI group, the CDR for gastric cancer (GC) was significantly higher compared to the non- AI group (0.10% vs. 0.03%, p < 0.05). The biopsy rate was slightly higher in the AI group, with no significant difference, whereas the PPV of biopsy for gastric cancer and esophageal cancer was significantly increased (4.84% vs. 2.16%, p < 0.05). Conclusions: In a clinical screening setting, AI- assisted endoscopy significantly improved the CDR of GC and enhanced the PPV of biopsies. These findings highlight AI- assisted endoscopy as a valuable tool for early GC diagnosis in screening environments....
Functional intestinal disorders are common; however, current imaging modalities are limited. Contrast-enhanced Multispectral optoacoustic tomography (CE-MSOT) represents a novel, noninvasive, and radiation-free imaging technique that enables assessment of gastrointestinal transit time through the use of orally administered contrast agents. This could aid in symptom evaluation and diagnostic clarification in bowel disorders. A clinical pilot-study was conducted (Registry: ClinicalTrials.gov, TRN: NCT06617364, Registration date: 24 September 2024) involving 10 pediatric patients presenting with gastrointestinal complaints undergoing a lactose hydrogen breath test. CEMSOTwas performed following the oral administration of Indocyanine Green (ICG) as a contrast agent. In the terminal ileum and sigmoid colon multispectral optoacoustic tomography (MSOT) signals were spectrally unmixed to isolate ICG-specific signals. The appearance of ICG in these segments was used to estimate gastrointestinal transit time. ICG signals were detected in the terminal ileum as early as 13 min after oral administration (median: 80 min), and in the sigmoid colon as early as 41 min (median: 125 min)....
Gastric cancer is one of the most common malignant tumors of the digestive tract, with a low rate of early detection and an unsatisfactory overall prognosis in advanced stages. Oxaliplatin-based regimens are widely used in the treatment of advanced gastric cancer; however, acquired resistance limits sustained therapeutic benefit and adversely affects recurrence and survival outcomes. Ferroptosis, a form of regulated cell death (RCD) characterized by iron-dependent lipid peroxidation, is jointly regulated by the System Xc−-GSH-GPX4 axis, the FSP1-CoQ10 pathway, and signaling pathways such as p53, and is also influenced by exosomal signaling and metabolic reprogramming within the tumor microenvironment (TME). Current studies indicate that the development of oxaliplatin resistance in gastric cancer is often accompanied by activation of antioxidant systems, elevation of the lipid peroxidation threshold, and suppression of ferroptosis. Induction of ferroptosis through natural compounds or combination strategies has been shown, under certain conditions, to enhance the cytotoxicity of oxaliplatin and partially reverse resistant phenotypes. This review focuses on the molecular mechanisms underlying ferroptosis, summarizes the characteristics of aberrant ferroptosis regulation in gastric cancer, outlines the major pathways through which ferroptosis participates in oxaliplatin resistance, discusses strategies for reversing resistance by inducing ferroptosis, and explores the potential of ferroptosis-related molecules as predictive biomarkers and targets for clinical translation....
Background/Objectives: Transabdominal ultrasonography (TUS) is widely used for the detection of gallbladder lesions (GBLs), but differentiating malignant lesions from nonmalignant lesions remains challenging. Microvascular flow imaging (MVFI), including superb microvascular imaging, detective flow imaging, and B-flow, enables visualization of low-flow vessels without contrast agents. This study aimed to characterize MVFI vascular features of GBLs and evaluate their reproducibility. Methods: We retrospectively analyzed 42 patients with GBLs who underwent TUS between March 2022 and December 2025. Two blinded readers independently assessed B-mode and MVFI findings. The evaluated MVFI findings included vascular flow detection, number of basal vessels, vessel shape, vessel thickness, and vessel irregularity. Interobserver agreement was assessed using Cohen’s kappa coefficient, and imaging findings were compared between invasive malignant and non-malignant lesions. Results: Of the 42 lesions, 10 were invasive malignant and 32 were non-malignant. Vascular signals were detected in all invasive malignant lesions and in 21 of 32 non-malignant lesions. Multiple basal vessels and vessel dilation were more frequently observed in invasive malignant lesions. Interobserver agreement was excellent for the number of basal vessels (κ = 0.91) and good for vessel thickness (κ = 0.72), indicating that these findings were more reproducible than other MVFI features. Conclusions: MVFI enables visualization of intralesional vascular features in GBLs. Multiple basal vessels and vessel dilation were associated with invasive malignancy and showed favorable reproducibility. These findings may serve as candidate imaging markers for future prospective validation....
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