BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD)is a leading cause of chronic liver disease with a significant risk of developing hepatocellular carcinoma(HCC).Recent clinical evidence indica...BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD)is a leading cause of chronic liver disease with a significant risk of developing hepatocellular carcinoma(HCC).Recent clinical evidence indicates the potential benefits of statins in cancer chemoprevention and therapeutics.However,it is still unclear if these drugs can lower the specific risk of HCC among patients with MASLD.AIM To investigate the impact of statin use on the risk of HCC development in patients with MASLD.METHODS A systematic review and meta-analysis of all the studies was performed that measured the effect of statin use on HCC occurrence in patients with MASLD.The difference in HCC risk between statin users and non-users was calculated among MASLD patients.We also evaluated the risk difference between lipophilic versus hydrophilic statins and the effect of cumulative dose on HCC risk reduction.RESULTS A total of four studies consisting of 291684 patients were included.MASLD patients on statin therapy had a 60%lower pooled risk of developing HCC compared to the non-statin group[relative risk(RR)=0.40,95%CI:0.31-0.53,I2=16.5%].Patients taking lipophilic statins had a reduced risk of HCC(RR=0.42,95%CI:0.28-0.64),whereas those on hydrophilic statins had not shown the risk reduction(RR=0.57,95%CI:0.27-1.20).The higher(>600)cumulative defined daily doses(cDDD)had a 70%reduced risk of HCC(RR=0.30,95%CI:0.21-0.43).There was a 29%(RR=0.71,95%CI:0.55-0.91)and 43%(RR=0.57,95%CI:0.40-0.82)decreased risk in patients receiving 300-599 cDDD and 30-299 cDDD,respectively.CONCLUSION Statin use lowers the risk of HCC in patients with MASLD.The higher cDDD and lipophilicity of statins correlate with the HCC risk reduction.展开更多
The application of artificial intelligence(AI)using deep learning and machine learning approaches in modern medicine is rapidly expanding.Within the field of Gastroenterology,AI is being evaluated across a breadth of ...The application of artificial intelligence(AI)using deep learning and machine learning approaches in modern medicine is rapidly expanding.Within the field of Gastroenterology,AI is being evaluated across a breadth of clinical and diagnostic applications including identification of pathology,differentiation of disease processes,and even automated procedure report generation.Many pancreatic pathologies can have overlapping features creating a diagnostic dilemma that provides a window for AI-assisted improvement in current evaluation and diagnosis,particularly using endoscopic ultrasound.This topic highlight will review the basics of AI,history of AI in gastrointestinal endoscopy,and prospects for AI in the evaluation of autoimmune pancreatitis,pancreatic ductal adenocarcinoma,chronic pancreatitis and intraductal papillary mucinous neoplasm.展开更多
文摘BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD)is a leading cause of chronic liver disease with a significant risk of developing hepatocellular carcinoma(HCC).Recent clinical evidence indicates the potential benefits of statins in cancer chemoprevention and therapeutics.However,it is still unclear if these drugs can lower the specific risk of HCC among patients with MASLD.AIM To investigate the impact of statin use on the risk of HCC development in patients with MASLD.METHODS A systematic review and meta-analysis of all the studies was performed that measured the effect of statin use on HCC occurrence in patients with MASLD.The difference in HCC risk between statin users and non-users was calculated among MASLD patients.We also evaluated the risk difference between lipophilic versus hydrophilic statins and the effect of cumulative dose on HCC risk reduction.RESULTS A total of four studies consisting of 291684 patients were included.MASLD patients on statin therapy had a 60%lower pooled risk of developing HCC compared to the non-statin group[relative risk(RR)=0.40,95%CI:0.31-0.53,I2=16.5%].Patients taking lipophilic statins had a reduced risk of HCC(RR=0.42,95%CI:0.28-0.64),whereas those on hydrophilic statins had not shown the risk reduction(RR=0.57,95%CI:0.27-1.20).The higher(>600)cumulative defined daily doses(cDDD)had a 70%reduced risk of HCC(RR=0.30,95%CI:0.21-0.43).There was a 29%(RR=0.71,95%CI:0.55-0.91)and 43%(RR=0.57,95%CI:0.40-0.82)decreased risk in patients receiving 300-599 cDDD and 30-299 cDDD,respectively.CONCLUSION Statin use lowers the risk of HCC in patients with MASLD.The higher cDDD and lipophilicity of statins correlate with the HCC risk reduction.
文摘The application of artificial intelligence(AI)using deep learning and machine learning approaches in modern medicine is rapidly expanding.Within the field of Gastroenterology,AI is being evaluated across a breadth of clinical and diagnostic applications including identification of pathology,differentiation of disease processes,and even automated procedure report generation.Many pancreatic pathologies can have overlapping features creating a diagnostic dilemma that provides a window for AI-assisted improvement in current evaluation and diagnosis,particularly using endoscopic ultrasound.This topic highlight will review the basics of AI,history of AI in gastrointestinal endoscopy,and prospects for AI in the evaluation of autoimmune pancreatitis,pancreatic ductal adenocarcinoma,chronic pancreatitis and intraductal papillary mucinous neoplasm.
