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Screening and follow-up of chronic liver diseases with understanding their etiology in clinics and hospitals.

ABSTRACT: Background and Aim:Considering the increasing prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH), the development of an effective screening and follow-up system that enables the recognition of etiological changes by primary physicians in clinics and specialists in hospitals is required. Methods:Chronic hepatitis B (HBV) and C (HCV), NASH, and alcoholic steatohepatitis (ASH) patients who were assayed for Mac-2-binding protein glycosylation isomer (M2BPGi) (n =?272) and underwent magnetic resonance elastography (MRE) (n =?119) were enrolled. Patients who underwent MRE were also tested by ultrasound elastography (USE) (n =?80) and for M2BPGi (n =?97), autotaxin (ATX) (n =?62), and platelet count (n =?119), and their fibrosis-4 (FIB-4) index was calculated (n =?119). Results:FIB-4 index >2, excluding HBV-infected patients, M2BPGi >0.5, ATX >0.5, and platelet count <20?×?104/?L were the benchmark indices, and we took into consideration other risk factors, such as diabetes mellitus and age, to recommend further examinations, such as USE, based on the local situation to avoid overlooking hepatocellular carcinoma (HCC) in the clinic. During specialty care in the hospital, MRE exhibited high diagnostic ability for fibrosis stages >F3 or F4; it could efficiently predict collateral circulation with high sensitivity, which can replace USE. We also identified etiological features and found that collateral circulation in NASH/ASH patients tended to exceed high-risk levels; moreover, these patients exhibited more variation in HCC-associated liver stiffness than the HBV and HCV patients. Conclusions:Using appropriate markers and tools, we can establish a stepwise, practical, noninvasive, and etiology-based screening and follow-up system in primary and specialty care.

SUBMITTER: Ogawa M

PROVIDER: S-EPMC7578295 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Screening and follow-up of chronic liver diseases with understanding their etiology in clinics and hospitals.

Ogawa Masahiro M Tsuchiya Atsunori A Watanabe Takayuki T Setsu Toru T Kimura Naruhiro N Matsuda Masato M Hoshiyama Yoshiki Y Saito Hiroaki H Kanazawa Tsutomu T Shiotani Motoi M Sato Tatsuhiko T Yagi Takuya T Igarashi Koji K Yoshimura Norihiko N Takamura Masaaki M Aoyama Hidefumi H Terai Shuji S

JGH open : an open access journal of gastroenterology and hepatology 20200824 5

<h4>Background and aim</h4>Considering the increasing prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH), the development of an effective screening and follow-up system that enables the recognition of etiological changes by primary physicians in clinics and specialists in hospitals is required.<h4>Methods</h4>Chronic hepatitis B (HBV) and C (HCV), NASH, and alcoholic steatohepatitis (ASH) patients who were assayed for Mac-2-binding protein glycosylation isom ...[more]

PMID: 33102751

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Project description:BackgroundHigh-resolution genomic microarrays enable simultaneous detection of copy-number aberrations such as the known recurrent aberrations in chronic lymphocytic leukemia [del(11q), del(13q), del(17p) and trisomy 12], and copy-number neutral loss of heterozygosity. Moreover, comparison of genomic profiles from sequential patients' samples allows detection of clonal evolution.Design and methodsWe screened samples from 369 patients with newly diagnosed chronic lymphocytic leukemia from a population-based cohort using 250K single nucleotide polymorphism-arrays. Clonal evolution was evaluated in 59 follow-up samples obtained after 5-9 years.ResultsAt diagnosis, copy-number aberrations were identified in 90% of patients; 70% carried known recurrent alterations, including del(13q) (55%), trisomy 12 (10.5%), del(11q) (10%), and del(17p) (4%). Additional recurrent aberrations were detected on chromosomes 2 (1.9%), 4 (1.4%), 8 (1.6%) and 14 (1.6%). Thirteen patients (3.5%) displayed recurrent copy-number neutral loss of heterozygosity on 13q, of whom 11 had concurrent homozygous del(13q). Genomic complexity and large 13q deletions correlated with inferior outcome, while the former was linked to poor-prognostic aberrations. In the follow-up study, clonal evolution developed in 8/24 (33%) patients with unmutated IGHV, and in 4/25 (16%) IGHV-mutated and treated patients. In contrast, untreated patients with mutated IGHV (n=10) did not acquire additional aberrations. The most common secondary event, del(13q), was detected in 6/12 (50%) of all patients with acquired alterations. Interestingly, aberrations on, for example, chromosome 6q, 8p, 9p and 10q developed exclusively in patients with unmutated IGHV.ConclusionsWhole-genome screening revealed a high frequency of genomic aberrations in newly diagnosed chronic lymphocytic leukemia. Clonal evolution was associated with other markers of aggressive disease and commonly included the known recurrent aberrations.

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Screening and follow-up of chronic liver diseases with understanding their etiology in clinics and hospitals.

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Screening and follow-up of chronic liver diseases with understanding their etiology in clinics and hospitals.

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