Studies that compare tumor genotype with phenotype have provided the basis of a new histological/molecular classification of hepatocellular adenomas. Based on two molecular criteria (presence of a TCF1/HNF1α or β-ca...Studies that compare tumor genotype with phenotype have provided the basis of a new histological/molecular classification of hepatocellular adenomas. Based on two molecular criteria (presence of a TCF1/HNF1α or β-catenin mutation), and an additional histological criterion (presence or absence of an inflammatory infiltrate), subgroups of hepatocellular adenoma can be defined and distinguished from focal nodular hyperplasia. Analysis of 96 hepatocellular adenomas performed by a French collaborative network showed that they can be divided into four broad subgroups: the fi rst one is defi ned by the presence of mutations in TCF1 gene inactivating the hepatocyte nuclear factor 1 (HNF1α); the second by the presence of β-catenin activating mutations; the category without mutations of HNF1α or β-catenin is further divided into 2 subgroups depending on the presence or absence of in? ammation. Therefore, the approach to the diagnosis of problematic benign hepatocytic nodules may be entering a new era directed by new molecular information. It is hoped that immunohistological tools will improve significantly diagnosis of liver biopsy in our ability to distinguish hepatocellular adenoma from focal nodular hyperplasia (FNH), and to delineate clinically meaningful entities within each group to define the best clinical management. The optimal care of patients with a liver nodule will benefit from the recent knowledge coming from molecular biology and the combined expertise of hepatologists, pathologists, radiologists, and surgeons.展开更多
Background and aims: Recent studies have suggested that bacterial coinfection with Helicobacter species in patients already infected with hepatitis C virus ( HCV) could be involved in the development of cirrhosis and ...Background and aims: Recent studies have suggested that bacterial coinfection with Helicobacter species in patients already infected with hepatitis C virus ( HCV) could be involved in the development of cirrhosis and hepatocellular carcin oma (HCC). A retrospective cross sectional study was performed in order to explo re the association between Helicobacter species and HCV associated liver disease s. Methods: The presence of Helicobacter species was tested by polymerase chain reaction on liver samples from four groups of patients. Resutls: Helicobacter 16 S rDNA was found in only 4.2% of liver samples from control patients (n = 24) and in 3.5% of liver samples from patients with non- cirrhotic chronic hepatit is C (n = 29) while it was found in 68.0% of liver samples from patients with HCV positive cirrhosis without HCC (n = 25) as well as in 61.3% of cirrhotic l iver samples from patients with HCV positive cirrhosis and HCC (n = 31). In addi tion, when the HCC tumour tissue was tested (n = 21), 90.5% of samples were po sitive. DNA from Helicobacter pylori- and Helicobacter pullorum- like organis ms was found. Conclusions: There is an association between the presence of Helic obacter species DNA in the liver and hepatitis C cirrhosis, with or without HCC. Indeed, the presence of these bacteria could be the result of structural change s in the liver. Alternatively, Helicobacter species could be a co- risk factor in HCV chronic liver diseases. This result warrants prospective studies to deter mine the possible causal role of these bacteria in the progression of chronic he patitis C.展开更多
Objective: To compare the current non-invasive tests for Helicobacter pylori infection in children and adolescents.Study design: This multicenter, multinational study investigated the sensitivity, specificity, and pos...Objective: To compare the current non-invasive tests for Helicobacter pylori infection in children and adolescents.Study design: This multicenter, multinational study investigated the sensitivity, specificity, and positive and negative predictive values of four non-invasive tests: urea breath test (UBT), stool antigen test, and antibody detection in serum and urine, in comparison with biopsy-based tests.Results: Of 503 patients included pre-treatment, 473 fulfilled the definition of H pylori status and among those 316 had results available for the four non-invasive tests (including 133 H pylori-positive patients).The specificity was excellent for all tests.The UBT had the best sensitivity in all age groups, followed by serology, stool test, and antibody detection in urine.A trend for better sensitivity with an increase in age was observed except for the stool test.The receiver operating characteristics (ROC) curves showed that sensitivity of serology, stool test, and urinelisa could be improved by changing the cutoff value.An inadequate storage of the specimens may explain the poor results of the stool test.Conclusion: The UBT appears to be an excellent test for diagnosis of H pylori infection for children and adolescents.展开更多
文摘Studies that compare tumor genotype with phenotype have provided the basis of a new histological/molecular classification of hepatocellular adenomas. Based on two molecular criteria (presence of a TCF1/HNF1α or β-catenin mutation), and an additional histological criterion (presence or absence of an inflammatory infiltrate), subgroups of hepatocellular adenoma can be defined and distinguished from focal nodular hyperplasia. Analysis of 96 hepatocellular adenomas performed by a French collaborative network showed that they can be divided into four broad subgroups: the fi rst one is defi ned by the presence of mutations in TCF1 gene inactivating the hepatocyte nuclear factor 1 (HNF1α); the second by the presence of β-catenin activating mutations; the category without mutations of HNF1α or β-catenin is further divided into 2 subgroups depending on the presence or absence of in? ammation. Therefore, the approach to the diagnosis of problematic benign hepatocytic nodules may be entering a new era directed by new molecular information. It is hoped that immunohistological tools will improve significantly diagnosis of liver biopsy in our ability to distinguish hepatocellular adenoma from focal nodular hyperplasia (FNH), and to delineate clinically meaningful entities within each group to define the best clinical management. The optimal care of patients with a liver nodule will benefit from the recent knowledge coming from molecular biology and the combined expertise of hepatologists, pathologists, radiologists, and surgeons.
文摘Background and aims: Recent studies have suggested that bacterial coinfection with Helicobacter species in patients already infected with hepatitis C virus ( HCV) could be involved in the development of cirrhosis and hepatocellular carcin oma (HCC). A retrospective cross sectional study was performed in order to explo re the association between Helicobacter species and HCV associated liver disease s. Methods: The presence of Helicobacter species was tested by polymerase chain reaction on liver samples from four groups of patients. Resutls: Helicobacter 16 S rDNA was found in only 4.2% of liver samples from control patients (n = 24) and in 3.5% of liver samples from patients with non- cirrhotic chronic hepatit is C (n = 29) while it was found in 68.0% of liver samples from patients with HCV positive cirrhosis without HCC (n = 25) as well as in 61.3% of cirrhotic l iver samples from patients with HCV positive cirrhosis and HCC (n = 31). In addi tion, when the HCC tumour tissue was tested (n = 21), 90.5% of samples were po sitive. DNA from Helicobacter pylori- and Helicobacter pullorum- like organis ms was found. Conclusions: There is an association between the presence of Helic obacter species DNA in the liver and hepatitis C cirrhosis, with or without HCC. Indeed, the presence of these bacteria could be the result of structural change s in the liver. Alternatively, Helicobacter species could be a co- risk factor in HCV chronic liver diseases. This result warrants prospective studies to deter mine the possible causal role of these bacteria in the progression of chronic he patitis C.
文摘Objective: To compare the current non-invasive tests for Helicobacter pylori infection in children and adolescents.Study design: This multicenter, multinational study investigated the sensitivity, specificity, and positive and negative predictive values of four non-invasive tests: urea breath test (UBT), stool antigen test, and antibody detection in serum and urine, in comparison with biopsy-based tests.Results: Of 503 patients included pre-treatment, 473 fulfilled the definition of H pylori status and among those 316 had results available for the four non-invasive tests (including 133 H pylori-positive patients).The specificity was excellent for all tests.The UBT had the best sensitivity in all age groups, followed by serology, stool test, and antibody detection in urine.A trend for better sensitivity with an increase in age was observed except for the stool test.The receiver operating characteristics (ROC) curves showed that sensitivity of serology, stool test, and urinelisa could be improved by changing the cutoff value.An inadequate storage of the specimens may explain the poor results of the stool test.Conclusion: The UBT appears to be an excellent test for diagnosis of H pylori infection for children and adolescents.
