World J Hepatol [JOURNAL]
Sun
200 papers
Early screening for liver cancer must be performed.
Liu ZH, Wang WJ, Dang SS
World J Hepatol · 2025 Nov · PMID 41368114 · Full text
Hepatocellular carcinoma (HCC) is imposing a growing global health burden, with China accounting for nearly half of incident cases and mortality worldwide. Early screening is critical to improving survival in high-burden...
Hepatocellular carcinoma (HCC) is imposing a growing global health burden, with China accounting for nearly half of incident cases and mortality worldwide. Early screening is critical to improving survival in high-burden regions. However, the global standardized screening rate for high-risk populations is less than 24%, and HCC screening currently faces severe challenges. We synthesize recent advances in HCC screening, including optimized serum biomarkers, evolving imaging techniques, and validated models. Emerging liquid biopsy technologies and artificial intelligence further demonstrate considerable promise for enhancing noninvasive detection efficacy. Multifaceted collaboration among policymakers, healthcare systems, and communities is essential to implement effective screening programs and ultimately improve survival outcomes.
Liver as a metabolic sensor in gestational diabetes: Implications for offspring's liver and diabetes risk.
Abdalla MMI, Ismail-Khan M
World J Hepatol · 2025 Nov · PMID 41368113 · Full text
Gestational diabetes mellitus (GDM) is increasingly recognized not only for its immediate obstetric complications but also for its long-term metabolic consequences in both mothers and their offspring. Traditionally, rese...
Gestational diabetes mellitus (GDM) is increasingly recognized not only for its immediate obstetric complications but also for its long-term metabolic consequences in both mothers and their offspring. Traditionally, research has emphasized the roles of pancreatic β-cell dysfunction and placental dysregulation in GDM. However, emerging evidence highlights the maternal liver as a central metabolic hub during pregnancy coordinating glucose, lipid, and hormonal adaptations essential for fetal development. This review synthesizes current findings on how GDM disrupts the maternal liver's adaptive roles, transforming it from a metabolic coordinator into a source of maladaptive endocrine, inflammatory, and nutrient signals. It outlines key mechanistic pathways through which maternal hepatic dysfunction may increase offspring susceptibility to non-alcoholic fatty liver disease and type 2 diabetes mellitus. These include hepatokine dysregulation, altered lipid metabolism, impaired insulin signaling, inflammatory and oxidative stress pathways, and epigenetic and transcriptomic reprogramming. In addition, it explores novel axes such as the gut-liver-placenta interplay, bile acid signaling disruptions, endoplasmic reticulum stress responses, and extracellular vesicle-mediated communication. By reframing the maternal liver's role in GDM pathophysiology, this review identifies critical windows for early clinical intervention and highlights the potential for liver-focused strategies to prevent the intergenerational transmission of metabolic disease.
Molecular biomarkers of sintilimab plus lenvatinib in hepatitis-B-virus-associated hepatocellular carcinoma.
Wang LJ, Cui Y, Huang LF … +7 more , Zhang JQ, Zhao TT, Wang HW, Liu M, Jin KM, Wang K, Xing BC
World J Hepatol · 2025 Nov · PMID 41368112 · Full text
BACKGROUND: The combination of immune checkpoint inhibitors and antiangiogenic drugs has shown promising efficacy in advanced hepatocellular carcinoma (HCC). However, tumor regression and progression-free survival (PFS)...
BACKGROUND: The combination of immune checkpoint inhibitors and antiangiogenic drugs has shown promising efficacy in advanced hepatocellular carcinoma (HCC). However, tumor regression and progression-free survival (PFS) vary considerably among patients receiving this therapy. AIM: To identify predictive biomarkers in HCC patients treated with sintilimab (programmed cell death protein-1 inhibitor) plus lenvatinib (tyrosine kinase inhibitor). METHODS: In this single-center study in China, patients with unresectable HCC received sintilimab every 21 days and daily oral lenvatinib. Treatment response was assessed by modified response evaluation criteria in solid tumors. Tumor biopsies underwent RNA sequencing, immune microenvironment profiling, and whole-exome sequencing. Differentially expressed genes (DEGs) and immune cell subsets between response groups were identified, followed by survival analyses. All potential predictors of PFS, together with clinical variables, were included in Cox regression to identify independent prognostic factors. RESULTS: Between August 2019 and November 2021, 33 patients with hepatitis-B-virus-related HCC were enrolled; by January 2024, 13 had undergone potentially curative surgery or ablation. RNA sequencing identified 94 DEGs between responders ( = 22) and non-responders ( = 11) using Fisher's exact test or Wilcoxon rank-sum test (all < 0.05). High long intergenic non-protein coding RNA 01554 () and whirlin expression were associated with longer PFS in Kaplan-Meier analysis ( < 0.05). DEG-immune cell analysis showed positive correlations with pro-B and plasma cells in responders, and negative correlations with CD4+ central memory T (Tcm), T helper 1, and natural killer T cells in non-responders; none significantly predicted PFS, although CD4+ Tcm cells approached significance ( < 0.10). Whole-exome sequencing revealed Fanconi anemia complementation group D2 mutations enriched in non-responders ( < 0.05), while cut-like homeobox 1 mutations predicted poorer PFS ( = 0.011). Cox regression identified solitary tumor [ = 0.02, hazard ratio (HR) = 0.31], high ( = 0.01, HR = 0.16), and elevated CD4+ Tcm cells ( = 0.05, HR = 0.29) as independent predictors of prolonged PFS. CONCLUSION: Sintilimab plus lenvatinib showed heterogeneous efficacy in HCC. High expression, elevated CD4+ Tcm cells, and solitary tumors may serve as predictive biomarkers for prolonged disease control.
Laparoscopic open surgery for complex hepatolithiasis: A retrospective comparative study.
Lin DX, Zhuo XB, Chang GJ … +5 more , Lei WD, Huang J, Zhang Y, Qiu ZJ, Zhang SY
World J Hepatol · 2025 Nov · PMID 41368111 · Full text
BACKGROUND: Laparoscopic surgery is increasingly used for complex hepatolithiasis; however, data on laparoscopic open surgery remain limited. This study was undertaken to test the hypothesis that laparoscopic surgery of...
BACKGROUND: Laparoscopic surgery is increasingly used for complex hepatolithiasis; however, data on laparoscopic open surgery remain limited. This study was undertaken to test the hypothesis that laparoscopic surgery offers comparable safety and efficacy to open surgery, with added benefits in recovery outcomes. AIM: To compare clinical outcomes between laparoscopic and open approaches in complex hepatolithiasis. METHODS: This retrospective cohort study was conducted at Ningde Municipal Hospital, a tertiary care center, and included 80 patients with complex hepatolithiasis treated between January 2020 and August 2024. Patients were non-randomly allocated to laparoscopic ( = 40) or open surgery ( = 40) groups based on the treatment period. Clinical, intraoperative, and postoperative data were analyzed using appropriate parametric or non-parametric tests; categorical data were analyzed using or Fisher's exact test. RESULTS: Laparoscopic surgery was associated with a longer median operative time (250.0 minutes 207.0 minutes, = 0.003) but shorter postoperative hospital stay (9.0 days 14.0 days, < 0.001) compared to open surgery. Wound infection rates were significantly less frequent in the laparoscopic group (5.0% 22.5%, = 0.023). Stone clearance rates and overall complications were comparable. One case of perioperative mortality occurred in the open surgery cohort. CONCLUSION: Laparoscopic surgery is a feasible and safe alternative to open surgery for complex hepatolithiasis, offering faster recovery and reduced wound-related complications.
Epidemiology and clinical features of alcoholic liver disease in Hainan Province, China.
Zhang DY, Li D, Huang SM … +3 more , Chen C, Zeng F, Bai FH
World J Hepatol · 2025 Nov · PMID 41368110 · Full text
BACKGROUND: Alcohol can cause alcoholic fatty liver, alcoholic steatohepatitis, alcoholic liver cirrhosis (ALC), and hepatocellular carcinoma. China has become the second-largest country in the world in terms of alcohol...
BACKGROUND: Alcohol can cause alcoholic fatty liver, alcoholic steatohepatitis, alcoholic liver cirrhosis (ALC), and hepatocellular carcinoma. China has become the second-largest country in the world in terms of alcohol consumption, lacking national epidemiological data on alcoholic liver disease (ALD). AIM: To understand the incidence and characteristics of ALD in Hainan Province of China. METHODS: From October 2022 to April 2023, a stratified proportional multi-stage whole population sampling method was adopted to select permanent residents of Haikou, Sanya, Qionghai, Dongfang, and Wuzhishan in Hainan Province to carry out questionnaire surveys, blood tests, and ultrasound examinations of the liver. RESULTS: A total of 2704 valid questionnaires were obtained from residents aged 15-93 years old. The rates of drinking, hazardous drinking, and harmful drinking were 31.73%, 14.53%, and 5.03%, respectively. The above rates were higher for males than for females, increasing with income, and the rates for ethnic minorities, such as Li, were higher than for Han Chinese ( < 0.05). Drinking rates increased with literacy ( < 0.05). Drinking rate and hazardous drinking rate decreased with age, were higher for residents of agricultural households than non-agricultural households, and higher for married than unmarried individuals ( < 0.05). The total number of patients with ALD was 142, with a detection rate of 5.25%. ALD detection rate was higher for males than females, decreased with age, and higher with income ( < 0.05). Patients with ALD included 48 (33.8%) cases of mild ALD, 64 (45.1%) cases of alcoholic fatty liver, 18 (12.7%) cases of alcoholic steatohepatitis, and 12 (8.5%) cases of ALC. The proportion of those who consumed more than 80 g of alcohol per day increased as they progressed from mild ALD to ALC stage. Diabetes mellitus and hyperlipidemia were easily combined in some cases, accounting for 25 (17.6%) and 80 (56.3%), respectively. The average daily alcohol consumption of ALD patients of Li ethnicity ≥ 80 g was significantly more than that of Han ethnicity ( = 5.652, = 0.02), and was predominantly among those who drank large amounts of alcohol intermittently ( = 89.093, < 0.001). CONCLUSION: The rates of drinking, hazardous drinking, harmful drinking, and detection of ALD in Hainan Province need to be paid attention to by advocating a healthy lifestyle, such as abstinence and limiting alcohol consumption.
Autoimmune-like hepatitis induced by drugs: Still many unanswered questions.
Bessone F, Bjornsson ES
World J Hepatol · 2025 Nov · PMID 41368109 · Full text
Drug-induced autoimmune-like hepatitis (DI-ALH) is an increasingly recognized phenotype within the spectrum of drug-induced liver injury. Several drugs, including nitrofurantoin, minocycline, hydralazine, methyldopa and...
Drug-induced autoimmune-like hepatitis (DI-ALH) is an increasingly recognized phenotype within the spectrum of drug-induced liver injury. Several drugs, including nitrofurantoin, minocycline, hydralazine, methyldopa and infliximab, have a well-documented capacity to induce DI-ALH. Distinguishing DI-ALH from classic autoimmune hepatitis (AIH) can be challenging due to overlapping clinical, biochemical, and serological features. Accurate distinction from classic AIH is crucial, as management and prognosis differ. While some DI-ALH cases resolve spontaneously after drug withdrawal, others show persistent or worsening liver injury. Histological studies have shown that fibrosis and cirrhosis are more prevalent in classic AH. Unfortunately, there are no pathognomic clinical, biochemical or immunological features that reliably distinguish DI-ALH from classic AIH. However, most patients with DI-ALH do not relapse after corticosteroid withdrawal, in contrast to the high relapse rate observed in classic AIH. Most patients respond well to corticosteroids, and once liver tests normalize, biochemical parameters should be monitored, and long-term immunosuppression should not be indicated. However, DI-ALH is not exempt from risk of relapse, underscoring the need for long-term follow-up. Most patients with DI-ALH have a favorable prognosis; however, although rare, cases of cirrhosis and, in exceptional instances, acute liver failure have been reported. International collaborative studies are needed to further characterize DI-ALH. In this review, we update current controversies, present emerging concepts, and outline future challenges in the diagnosis and management of this complex condition learned so far.
Genetic predeterminants and recent advancements in steatotic liver disease: A roadmap toward precision hepatology.
Kumar G, Shah YR, Shahzad A … +9 more , Jameel K, Guevara-Lazo D, Khan NA, Dahiya DS, Gangwani MK, Ravichandran R, Patel R, Hayat U, Thandassery RB
World J Hepatol · 2025 Nov · PMID 41368108 · Full text
Steatotic liver disease (SLD) encompasses a group of disorders characterized by the excessive accumulation of fat in the liver. It is classified into four categories based on clinical manifestations: Metabolic dysfunctio...
Steatotic liver disease (SLD) encompasses a group of disorders characterized by the excessive accumulation of fat in the liver. It is classified into four categories based on clinical manifestations: Metabolic dysfunction-associated SLD (MASLD), metabolic-alcohol-associated liver disease (ALD), ALD, and cryptogenic SLD. In the United States, its prevalence stands at 34.2%, making it the most common cause of cirrhosis and hepatocellular carcinoma (HCC). In addition to factors related to endocrine, nutrition, and medications, several genetic markers have been implicated in the disease's pathogenesis. Notable genes include , , , and . These genetic polymorphisms can significantly impact prognosis and disease outcomes. For example, is the most frequently associated gene with MASLD, increasing the risk of HCC by 12-fold and liver-related mortality by 18-fold. Furthermore, certain genetic markers are more prevalent in specific ethnic groups; for instance, is common among Hispanics, while is linked to higher fat content in African Americans. With a better understanding of the genetic factors involved in the pathogenesis of SLD, significant advancements have been made in diagnostics and therapeutics. This review explores the role of genetic factors in the disease's development, discusses current advancements in non-invasive diagnostic modalities, and examines therapeutic improvements based on these genetic insights to achieve better outcomes.
Direct-acting antiviral therapy reduces variceal rebleeding and improves liver function in hepatitis C virus-related cirrhosis: A multicenter retrospective cohort study.
Abdel Hafez RS, Semeya AA, Elgamal R … +1 more , Othman AA
World J Hepatol · 2025 Nov · PMID 41368107 · Full text
BACKGROUND: Hepatitis C virus (HCV) infection remains a major public health issue in Egypt, with a high prevalence of genotype 4. Direct-acting antivirals (DAAs) achieve > 95% sustained virologic response (SVR), but thei...
BACKGROUND: Hepatitis C virus (HCV) infection remains a major public health issue in Egypt, with a high prevalence of genotype 4. Direct-acting antivirals (DAAs) achieve > 95% sustained virologic response (SVR), but their impact on variceal rebleeding in genotype 4 cirrhotic patients is underexplored. This study evaluated the association between DAA therapy and variceal rebleeding in Egyptian patients with HCV-related cirrhosis. AIM: To evaluate the association between DAA therapy and variceal rebleeding in Egyptian patients with HCV-related cirrhosis. METHODS: A multicenter retrospective cohort study included HCV genotype 4 cirrhotic patients from five Egyptian centers with a first variceal bleeding episode. Patients were divided into DAA-treated (Group A) and non-treated (Group B) groups and followed for 5 years. Propensity score matching (PSM), Cox regression, and competing risk analysis were adjusted for confounders. RESULTS: DAA treatment significantly reduced variceal rebleeding (HR 2.57; 95%CI: 1.39-4.72; = 0.002), ascites development over 5 years (6.8% 27.1%, = 0.006), and hepatic dysfunction progression. During treatment, it improved liver function [lower model for end-stage liver disease (MELD), stable Child-Pugh class] and reduced complications. All Group A patients achieved SVR by PCR, while Group B remained HCV-positive, likely contributing to the observed reductions in rebleeding and hepatic decompensation. These benefits persisted over 5 years, with longer survival without rebleeding (4.5 years 3.2 years), lower MELD (7 12, < 0.001), and reduced hepatic decompensation (Child-Pugh progression: 5.1% 35.6%, < 0.001). At 5 years, the DAA group had better liver function (higher albumin, lower international normalized ratio, improved platelets), while the non-DAA group worsened. PSM confirmed these findings (HR: 0.45, 95%CI: 0.27-0.75, = 0.002), and competing risk analysis showed sustained protection (sub-distribution HR: 0.44, 95%CI: 0.26-0.74, = 0.002). Endoscopy revealed variceal regression with DAA but progression in the non-DAA group. DAA therapy significantly reduced variceal rebleeding, hepatic decompensation, and mortality (8.5% 20.3%, = 0.045), with survival benefits linked to SVR. Additionally, it was associated with improved survival, with a lower 5-year mortality rate in the DAA group (8.5% 20.3%, = 0.045). The protective effect of DAA therapy remained consistent across multivariable Cox regression, time-dependent modeling, and competing risk analyses. CONCLUSION: DAA treatment in HCV-related cirrhosis significantly reduces variceal rebleeding, ascites development, and hepatic dysfunction progression. The 5-year follow-up data demonstrate sustained improvements in liver function and hematologic parameters, underscoring the long-term benefits of DAA therapy.
Tumor necrosis factor alpha-induced protein 3: Biomarker discovery and therapeutic advancement in primary biliary cholangitis.
Koriem KMM
World J Hepatol · 2025 Nov · PMID 41358062 · Full text
In this article, the author comment on the article by Zang . Tumor necrosis factor alpha-induced protein 3 (TNFAIP3) was examined in this study as a novel biomarker to predict the efficiency of ursodeoxycholic acid (UDCA...
In this article, the author comment on the article by Zang . Tumor necrosis factor alpha-induced protein 3 (TNFAIP3) was examined in this study as a novel biomarker to predict the efficiency of ursodeoxycholic acid (UDCA) and thereby improved primary biliary cholangitis (PBC) treatment. Differentially expressed genes in PBC patients and healthy controls (HCs) were detected using microarray expression analysis. PBC patients and HCs were examined for predictive performance and associations between important genes and clinicopathological features using immunohistochemistry, logistic regression, and receiver operating characteristic curve methods. Thirteen genes linked to the development of PBC were detected by the bioinformatic research. TNFAIP3 was chosen for additional examination from these 13 genes. TNFAIP3 was shown to be more expressed in PBCs patients than in HCs using immunohistochemical method. TNFAIP3 and fatigue have a significant impact on UDCA in PBC patients in multivariate cox regression analysis. Additionally, there was a correlation between TNFAIP3 expression and splenomegaly, alkaline phosphatase, albumin, total bilirubin, and age. In conclusion, TNFAIP3 and fatigue have significant impact on UDCA in PBC. These findings provide a new view on PBC pathophysiology and suggest that TNFAIP3 may be a suitable biomarker or therapeutic target for the disease.
Association between metabolic dysfunction-associated steatotic liver disease, vitamin D3, and diabetic gastric motility disorders in type 2 diabetes mellitus.
Cui X, Liang Z
World J Hepatol · 2025 Nov · PMID 41358061 · Full text
This letter comments on a study linking metabolic dysfunction-associated steatotic liver disease (MASLD), vitamin D3, and severe gastric autonomic neuropathy (diabetic gastric motility disorders) in type 2 diabetes melli...
This letter comments on a study linking metabolic dysfunction-associated steatotic liver disease (MASLD), vitamin D3, and severe gastric autonomic neuropathy (diabetic gastric motility disorders) in type 2 diabetes mellitus (T2DM). We question the necessity of excluding patients with severe cataract (unable to complete fundus exams), as the focus on T2DM-MASLD correlation may render other T2DM complications less relevant. We emphasize vitamin D3's multifaceted relevance: It associates with T2DM (high-dose supplementation reduces onset risk), MASLD (serum levels predict risk), smooth muscle function, immunity, and T2DM-related fractures advanced glycation end products. We propose correlating MASLD severity with vitamin D3 levels and diabetic gastric motility disorders in validation analyses (, correlation, area under the curve) to refine factor analysis. Additionally, based on the authors' note of vitamin D3-tryptophan metabolism links, we call for deeper integration of metabolic pathways to clarify vitamin D3's role in smooth muscle electrophysiology, leveraging the team's prior research insights.
Impact of alcohol-associated and metabolic dysfunction-associated steatotic liver diseases upon hepatic disorder and carcinogenesis in the current era.
Hori T
World J Hepatol · 2025 Nov · PMID 41358060 · Full text
In this editorial, author specifically focuses upon metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver diseases (ALD) in the current era. This editorial article is inspired by t...
In this editorial, author specifically focuses upon metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver diseases (ALD) in the current era. This editorial article is inspired by the observational study by Harris in the recent issue. Alcohol and metabolic dysfunction cause steatotic changes in the hepatic parenchyma. The ALD and MASLD are major cause of chronic liver disease. Liver cirrhosis (LC) is a result of chronic liver inflammation with many causes (, viral hepatitis, drug, alcohol and metabolic disorder). Metabolic dysfunction-associated steatohepatitis and alcohol-associated hepatitis can lead to liver fibrosis and LC. LC leads to hepatic dysfunction and can progress to eventual liver failure and death. Though chronic viral hepatitis is considered a main cause of LC for a long time, other etiologies (, ALD, MASLD) has significantly increased in the current era. From the viewpoint of carcinogenesis, LC frequently causes hepatocellular carcinoma (HCC), and HCC is the most common type of primary liver cancer worldwide. As regards major causes of HCC, chronic viral hepatitis is gradually outweighed by ALD and MASLD. Note that patients coexisting with ALD and metabolic dysfunction-associated steatohepatitis show higher occurrence of HCC. Impact of ALD and MASLD upon the development of chronic liver disease, liver fibrosis, LC, and HCC is drastically increased in the current era. Establishments of diagnostic and therapeutic strategies to overcome these hepatic disorders are still required.
Essential phospholipids and enzyme-based staging in nonalcoholic fatty liver disease: A call to action.
Madian A
World J Hepatol · 2025 Nov · PMID 41358059 · Full text
Nonalcoholic fatty liver disease, recently termed metabolic dysfunction-associated steatotic liver disease, affects 25% of adults globally, with a prevalence reaching 93% in obese individuals. The MANPOWER study, a anal...
Nonalcoholic fatty liver disease, recently termed metabolic dysfunction-associated steatotic liver disease, affects 25% of adults globally, with a prevalence reaching 93% in obese individuals. The MANPOWER study, a analysis of 2843 Russian patients with newly diagnosed nonalcoholic fatty liver disease, evaluated Essentiale Forte N [essential phospholipids (EPLs)] therapy and a liver enzyme-based staging algorithm. Using generalized linear regression and McNemar tests, EPLs reduced liver enzyme levels (alanine aminotransferase: -20.4 U/L, aspartate aminotransferase: -16.9 U/L, gamma-glutamyl transferase: -17.1 U/L at 24 weeks, < 0.001) and improved ultrasonography findings (76.8% reduction in hyperechogenicity, < 0.001). A logistic regression algorithm using alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels achieved 72.3% accuracy, 75.6% sensitivity, 71.0% specificity, and an area under the receiver operating characteristic curve of 0.74 (95% confidence interval: 0.71-0.77) for identifying nonalcoholic steatohepatitis. These findings advocate EPLs as a safe, effective therapy and propose a scalable diagnostic tool, urging validation to reduce the reliance on biopsy.
Metabolic associated steatotic liver disease in Qatar: Analysis of dietary patterns and nutrient intake.
Alalwani J, Derbala M, Tayyem R … +1 more , Bassil M
World J Hepatol · 2025 Nov · PMID 41358058 · Full text
BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common and increasingly prevalent condition in the Middle East, but its determinants in the region are underexplored. Diet and lifestyle a...
BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common and increasingly prevalent condition in the Middle East, but its determinants in the region are underexplored. Diet and lifestyle are known to significantly influence MASLD progression. AIM: To assess energy and nutrient intake among MASLD patients living in Qatar and evaluate their dietary patterns. METHODS: Using a cross-sectional design, 94 Arab patients with MASLD, aged ≥ 18 years, living in Qatar were studied. MASLD was diagnosed using ultrasonography, fibro scan, or elastography. Sociodemographic information was collected using a self-administered questionnaire. Dietary intake was assessed through three 24-hour recalls and a qualitative food frequency questionnaire. Energy, macro-, and micronutrient intake were analyzed using Elizabeth Stewart Hands and Associates Food Processor Nutrition Analysis software. Statistical analyses, including factor loadings were performed using STATA 18. RESULTS: Compared to recommended dietary allowance, MASLD patients had high intakes of fat, saturated fat, and cholesterol. They also showed reduced intakes of vitamin K in men, and vitamins E and A (retinol), calcium and magnesium in both genders, while selenium and sodium intakes were higher than recommendations. Three dietary patterns were identified: The 'Traditional Qatari food' pattern, the 'Prudent' pattern, and the 'Fast-food' pattern. However, no significant associations were found between these dietary patterns and body mass index or low-density lipoprotein, using adjusted regression models. CONCLUSION: Findings warrant replication in longitudinal studies and call for dietary interventions to reduce energy density and enhance overall diet quality, including micronutrient intake, for MASLD prevention and management in the region.
Explainable artificial intelligence and ensemble learning for hepatocellular carcinoma classification: State of the art, performance, and clinical implications.
Akbulut S, Colak C
World J Hepatol · 2025 Nov · PMID 41358057 · Full text
Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality globally, necessitating advanced diagnostic tools to improve early detection and personalized targeted therapy. This review synthesizes e...
Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality globally, necessitating advanced diagnostic tools to improve early detection and personalized targeted therapy. This review synthesizes evidence on explainable ensemble learning approaches for HCC classification, emphasizing their integration with clinical workflows and multi-omics data. A systematic analysis [including datasets such as The Cancer Genome Atlas, Gene Expression Omnibus, and the Surveillance, Epidemiology, and End Results (SEER) datasets] revealed that explainable ensemble learning models achieve high diagnostic accuracy by combining clinical features, serum biomarkers such as alpha-fetoprotein, imaging features such as computed tomography and magnetic resonance imaging, and genomic data. For instance, SHapley Additive exPlanations (SHAP)-based random forests trained on NCBI GSE14520 microarray data ( = 445) achieved 96.53% accuracy, while stacking ensembles applied to the SEER program data ( = 1897) demonstrated an area under the receiver operating characteristic curve of 0.779 for mortality prediction. Despite promising results, challenges persist, including the computational costs of SHAP and local interpretable model-agnostic explanations analyses (, TreeSHAP requiring distributed computing for metabolomics datasets) and dataset biases (, SEER's Western population dominance limiting generalizability). Future research must address inter-cohort heterogeneity, standardize explainability metrics, and prioritize lightweight surrogate models for resource-limited settings. This review presents the potential of explainable ensemble learning frameworks to bridge the gap between predictive accuracy and clinical interpretability, though rigorous validation in independent, multi-center cohorts is critical for real-world deployment.
Mechanistic interplay between aflatoxin B1 and tissue inhibitor of metalloproteinase-3 in hepatocellular carcinoma.
Luo Y, Wang LJ, Wang CL
World J Hepatol · 2025 Oct · PMID 41179738 · Full text
Hepatocellular carcinoma (HCC) is a major global health challenge, particularly in regions with high aflatoxin B1 (AFB1) exposure. This editorial explores the mechanistic interplay between AFB1 and tissue inhibitor of me...
Hepatocellular carcinoma (HCC) is a major global health challenge, particularly in regions with high aflatoxin B1 (AFB1) exposure. This editorial explores the mechanistic interplay between AFB1 and tissue inhibitor of metalloproteinase-3 (TIMP-3) in AFB1-related HCC. TIMP-3, frequently downregulated in HCC due to promoter methylation, is linked to increased tumor aggressiveness and poor prognosis. We propose that AFB1 induces epigenetic silencing of TIMP-3, potentially DNA adducts and oxidative stress, exacerbating AFB1-related HCC progression. This AFB1-TIMP-3 axis highlights TIMP-3's potential as a prognostic biomarker and therapeutic target. Future research should focus on elucidating these molecular pathways and integrating TIMP-3 into clinical practice for early detection and targeted therapies in AFB1-prevalent regions.
Clinical characteristics and genetic causes of unexplained pediatric liver disease.
Chen Y, Wang ZY, Chen BQ … +6 more , Qi YJ, Liu HY, Shi WX, Guo L, Liu Z, Sun LF
World J Hepatol · 2025 Oct · PMID 41179737 · Full text
BACKGROUND: In recent years, the number of pediatric patients with unexplained liver disease has been increasing. Whole-exome sequencing (WES) technology has played a significant role in the diagnosis; however, related s...
BACKGROUND: In recent years, the number of pediatric patients with unexplained liver disease has been increasing. Whole-exome sequencing (WES) technology has played a significant role in the diagnosis; however, related studies remain limited. AIM: To investigate the clinical characteristics and genetic causes of unexplained pediatric liver disease to improve the diagnosis and treatment of this disease. METHODS: Eighty children with unexplained liver disease were divided into two groups: The liver enzyme elevation group (Group A) and the cholestasis group (Group B). Children with both elevated liver enzymes and cholestasis were assigned to Group B. The clinical characteristics of the patients were retrospectively summarized, and WES was performed in the patients and their parents. RESULTS: Genetic results were obtained in 46 patients (46/80, 57.5%), including 38 in Group A (38/65, 58.5%) and 8 in Group B (8/15, 53.3%). A total of 53 pathogenic or likely pathogenic variants were identified in 42 patients (42/80, 52.5%), including 40 previously reported variants and 13 novel variants. Seven variants of uncertain significance were identified in 7 patients (7/80, 8.8%), of which 4 were novel variants. A total of 19 gene mutations were identified: 2 cases of , 15 cases of , 1 case of , 4 cases of , 1 case of , 1 case of , 5 cases of , 2 cases of , 2 cases of PYGL, 1 case of , 1 case of , 1 case of , 1 case of GLB1, and 1 case of in Group A; and 1 case of , 3 cases of , 1 case of , 1 case of , 1 case of , and 1 case of in Group B. CONCLUSION: WES significantly improved the etiological diagnosis of unexplained pediatric liver disease, helping guide individualized treatment and improve prognosis.
Ginger mitigates acrylamide-induced hepatotoxicity through antioxidant and anti-inflammatory mechanisms in rats.
Nour El Deen AE, Rashed F, Osman A … +9 more , Khalil Farag O, Abdel Ghany AF, Elsayed AM, Mansour SMA, Mohammed MAA, Taha RS, Basha SAZ, Mohamed MMY, Taha A
World J Hepatol · 2025 Oct · PMID 41179736 · Full text
BACKGROUND: Acrylamide (ACR), a toxic compound commonly found in heat-processed foods, poses a serious risk to liver health due to its oxidative and inflammatory effects. AIM: To evaluate the hepatoprotective potential o...
BACKGROUND: Acrylamide (ACR), a toxic compound commonly found in heat-processed foods, poses a serious risk to liver health due to its oxidative and inflammatory effects. AIM: To evaluate the hepatoprotective potential of ginger extract in mitigating ACR-induced liver toxicity in a rat model. METHODS: Male Sprague-Dawley rats were randomly assigned into control, ACR-treated, and ACR + ginger-treated groups. Liver function enzymes [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP)], oxidative stress biomarkers [malondialdehyde (MDA), glutathione (GSH), catalase (CAT), superoxide dismutase (SOD)], and histopathological assessments were performed. In addition, gene expression analyses of key antioxidant and inflammatory markers were conducted using quantitative polymerase chain reaction. RESULTS: ACR administration significantly increased serum levels of ALT, AST, ALP, and MDA, while reducing levels of GSH, CAT, and SOD. Histological analysis revealed hepatic degeneration and inflammation. Co-administration of ginger extract significantly reversed these effects, restoring antioxidant enzyme levels, reducing oxidative stress, and improving liver histoarchitecture. CONCLUSION: Ginger extract exhibited strong hepatoprotective effects against ACR-induced toxicity through antioxidant and anti-inflammatory mechanisms. These findings support the potential role of ginger as a natural dietary intervention for mitigating liver damage caused by environmental toxins. Further clinical studies are recommended to confirm its efficacy in human populations.
Novel educational video module about alcohol use disorder increases treatment rates and decreases return to alcohol use.
Twohig P, Slocum ZP, Willet A … +8 more , Schissel M, Balasanova AA, Scholten K, Warner J, Sempokuya T, Khoury N, Ashford A, Peeraphatdit TB
World J Hepatol · 2025 Oct · PMID 41179735 · Full text
BACKGROUND: Patients and providers are often unaware of available treatment options for alcohol use disorder (AUD) and how to pursue them. AIM: To improve AUD treatment rates using an educational video module (EVM). METH...
BACKGROUND: Patients and providers are often unaware of available treatment options for alcohol use disorder (AUD) and how to pursue them. AIM: To improve AUD treatment rates using an educational video module (EVM). METHODS: Prospective single-center cohort study evaluating the impact of a novel interactive patient EVM in promoting AUD treatment among hospitalized patients with alcohol-associated liver disease. Treatment was defined as receiving medication or participating in psychosocial treatment within 30 days of discharge. Primary outcome was change in treatment rates after viewing the EVM compared to a retrospective control cohort. Secondary outcomes were predictors of receiving treatment, EVM feedback, 30-day hospital readmission, outpatient follow-up, return to alcohol use, and mortality. RESULTS: Forty-two patients were included. Mean age was 45 years, 50% were female, and mean model for end-stage liver disease score 15.5. After viewing the EVM, treatment rates increased for pharmacologic (50% 22%, = 0.0008) and psychosocial treatment (73.8% 44%, = 0.01). Return to alcohol use was significantly lower (7.9% 35.6%, = 0.003). All 100% of patients would recommend the EVM. CONCLUSION: EVM allows hospitalized patients to receive standardized education about AUD treatment. This may address patient and provider knowledge gaps and reduce the growing burden of alcohol-associated liver disease. Future studies should evaluate EVM in larger patient populations using a multi-center study design.
Current clinical research status and future treatment directions for liver cirrhosis combined with portal vein thrombosis.
He WL, Yan S, Lu JJ … +2 more , Chen L, Wu JZ
World J Hepatol · 2025 Oct · PMID 41179734 · Full text
Portal vein thrombosis (PVT) is one of the most common serious complications in patients with liver cirrhosis. The occurrence of PVT not only aggravates the condition of liver cirrhosis but can also cause several serious...
Portal vein thrombosis (PVT) is one of the most common serious complications in patients with liver cirrhosis. The occurrence of PVT not only aggravates the condition of liver cirrhosis but can also cause several serious complications, such as portal hypertension, esophagogastric variceal bleeding, and refractory ascites. All these factors have a serious impact on patients' quality of life and prognosis. This article evaluates the current evidence on the management of PVT in cirrhosis and explores the role of direct oral anticoagulants, but data on individualized anticoagulation strategies are limited and lacking for the treatment of PVT in cirrhosis, and it is hoped that it will inform a broad range of clinicians on the treatment of cirrhosis combined with PVT.
Clinicopathological insights and management of liver metastases: Current advances and future perspectives.
Ebrahim NAA, Farghaly TA, El-Sherif AA … +7 more , Fahmy AM, Othman MO, Tahoun NS, Korany OM, Arafat A, Oreaba R, Soliman SMA
World J Hepatol · 2025 Oct · PMID 41179733 · Full text
Liver metastases are a leading contributor to cancer-related illness and death, occurring far more frequently than primary liver tumors. Their management remains highly challenging due to the complexity of disease behavi...
Liver metastases are a leading contributor to cancer-related illness and death, occurring far more frequently than primary liver tumors. Their management remains highly challenging due to the complexity of disease behavior and the need for an individualized, multidisciplinary approach. Effective care increasingly relies on integrating sophisticated diagnostic techniques, advanced systemic and locoregional therapies, and molecularly tailored treatment strategies. This review provides an in-depth analysis of the current clinicopathological perspectives on liver metastases. It explores their epidemiology, mechanisms of spread, histological growth patterns, diagnostic imaging advancements, molecular characteristics, and therapeutic interventions. Additionally, it examines the broader implications for patient quality of life (QoL), healthcare costs, and the particular difficulties associated with managing liver metastases in pediatric patients and individuals with rare malignancies. The article outlines the diverse histopathological features and tumor-liver interface growth patterns, emphasizing their prognostic and therapeutic significance. It evaluates contemporary imaging modalities-including magnetic resonance imaging and computed tomography (CT) with hepatocyte-specific agents, positron emission tomography/CT, and contrast-enhanced ultrasound-and highlights the emerging importance of liquid biopsy and molecular profiling in shaping treatment decisions. The review discusses available treatment options such as chemotherapy, targeted agents, immunotherapies, surgical resection, liver transplantation, and various locoregional therapies. Furthermore, it addresses evolving fields like prognostic scoring systems, radiomics, artificial intelligence (AI) applications, and patient-derived organoid and xenograft models. A summary of current clinical trials and translational research initiatives reflects the fast-paced evolution of this field. The management of liver metastases is rapidly advancing, driven by precision oncology principles and collaborative, multidisciplinary care. The integration of molecular diagnostics, novel therapeutic approaches, and cutting-edge technologies-including AI and organoid-based personalized drug testing-is poised to enhance treatment selection, improve clinical outcomes, and support better QoL. These innovations hold the potential to transform the outlook for patients with liver metastases, moving toward more durable disease control in appropriately selected cases.
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