Abstract:
BACKGROUND:Early differentiation of malignant from benign bile duct obstruction is of utmost importance. AIM:To identify biochemical and clinical predictors for malignancy in patients with bile duct obstruction, and establish a predictive model by combining pre-treatment patient characteristics. A web-based application was developed for easy assessment of malignant bile duct probability (www.pmal-score.org). METHODS:One thousand hundred and thirty-five patients [median age 66 (52-75) years, 53% male] with bile duct obstruction of various aetiologies were retrospectively evaluated at our tertiary referral centre. Multivariate logistic regression analysis identified factors as independently significant for malignant bile duct obstruction. A predictive risk score was established using ROC analysis and applied to an external validation cohort of 101 patients. RESULTS:Three hundred and ninety-four patients had malignant bile duct obstruction proven by surgery, while in 741 patients benign obstruction was observed. Multivariate analysis identified various clinical factors to be predictive for malignancy. On the basis of eight predictors, a risk score for malignancy was developed [X = 0.025 * [age] + 1.239 * [1 if weight loss, otherwise 0] - 0.235 * [1 if pain, otherwise 0] + 0.649 * [1 if diabetes, otherwise 0] + 0.896 * [1 if jaundice, otherwise 0] + 0.109 * [bilirubin] + 0.0007 * [γ-GT] + 0.0003 * [AP] - 4.374]: A significant correlation between the predicted malignancy and the actual malignancy was found by ROC (AUC: 0.862; 95% CI 0.838-0.886, P < 0.0001). CONCLUSIONS:This predictive risk score estimates the risk of malignancy in patients with bile duct obstruction, and it seems to be very accurate. A better prediction enables both earlier diagnosis of malignant obstructive disease and improved management of patients with bile duct obstruction, which may result in reduced morbidity and mortality.
journal_name
Aliment Pharmacol Therjournal_title
Alimentary pharmacology & therapeuticsauthors
Meister T,Uphoff MA,Heinecke A,Domagk D,Kunsch S,Lindhorst A,Ellenrieder V,Heinzow HSdoi
10.1111/apt.13152subject
Has Abstractpub_date
2015-05-01 00:00:00pages
877-87issue
9eissn
0269-2813issn
1365-2036journal_volume
41pub_type
杂志文章abstract:BACKGROUND:Tegaserod, a 5-hydroxytryptamine-4 receptor agonist, enhances gastric emptying, but its effects on proximal stomach function have not been studied. AIM:To study the effect of tegaserod on gastric compliance, accommodation and perception of distension in humans. METHODS:Nineteen healthy volunteers (10 femal...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.2003.01775.x
更新日期:2003-11-15 00:00:00
abstract:BACKGROUND:One-week low-dose proton pump inhibitor-based triple therapies have usually proved to be effective treatments for Helicobacter pylori infection. AIM:To investigate the eradication efficacy, safety profile and patient compliance of two triple therapies containing a standard dose of rabeprazole and a new fluo...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1046/j.1365-2036.2000.00846.x
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Gastroprotective strategies are recommended for nonsteroidal anti-inflammatory drug (NSAID) users at risk of upper gastrointestinal (UGI) complications. AIM:To compare the use of gastroprotective strategies in NSAID users in three countries, and the subsequent impact of rofecoxib withdrawal. METHODS:We con...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.12028
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Guidelines recommend withholding sofosbuvir (SOF) in patients with an estimated glomerular filtration rate (eGFR) of less than 30 mL/min. AIM:To assess the risk of acute kidney injury (AKI) in patients with no renal contraindications for SOF-based treatment. METHODS:This multicenter retrospective observati...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1111/apt.14117
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Randomized, placebo controlled trials are used to assess the efficacy of therapies for Crohn's disease. The placebo response and remission rates vary among studies. AIM:To analyse how the placebo response and remission rates in Crohn's trials have changed over time in the era of parenteral biologic therapie...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2009.04125.x
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Helicobacter pylori infection elicits persistent neutrophil infiltration in gastric mucosa. The expression of cyclooxygenase (COX)-2 and inhibition of apoptosis in the neutrophils could contribute to the pathogenesis of H. pylori infection. Rebamipide, a mucosal protective and ulcer-healing drug, has been kn...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.18.s1.1.x
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:Gastric cancer can be divided into cardia and noncardia gastric adenocarcinoma (NCGA). Non cardia gastric cancer is a disease that has declined in global incidence but has remained as an extremely lethal cancer. AIM:To review recent advances in epidemiology and strategies in prevention of non cardia gastric...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/apt.12814
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Data on whether long-acting somatostatin analogue octreotide causes or prevents pancreatic injury following endoscopic retrograde cholangiopancreatography (ERCP) are controversial. AIM:This multicentre, prospective trial studied the effect of octreotide on pancreatic injury in a large unselected group of pa...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1365-2036.1998.00414.x
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Gastro-oesophageal reflux disease (GERD) is an important problem in systemic sclerosis due to impaired salivation and oesophageal function. AIM:To determine the efficacy of adding ranitidine at bedtime to control nocturnal acid breakthrough (NAB) and GERD in patients with systemic sclerosis already prescrib...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2036.2007.03469.x
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Gastro-oesophageal reflux disease (GERD) and irritable bowel syndrome may occur more often than expected by chance, but little community data exists and risk factors are unknown. AIM:To determine prevalence and risk factors for overlap of GERD and irritable bowel disease. METHODS:Population-based, cross-se...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2036.2007.03366.x
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:The incidence of 'true' re-infection with Helicobacter pylori after successful eradication remains uncertain. AIM:To determine the worldwide rates, risk factors and clinical implications of 'true' re-infection of Helicobacter pylori. 'True' re-infection of H. pylori is defined as the situation where tests f...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2008.03873.x
更新日期:2009-01-01 00:00:00
abstract::The success of a clinical trial is judged by achieving statistical and clinical significance on the primary endpoint. This is particularly relevant in those trials that are initiated to achieve regulatory approval of a new therapeutic agent. Selection of an endpoint for which statistical significance will be too diffi...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2036.2006.02839.x
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:The long-term time trends of multiple gastrointestinal diseases are characterised by a striking rise and fall. These temporal changes provide important clues about disease aetiology. AIM:To highlight the importance of Helicobacter pylori infection in shaping the temporal trends of many common gastrointestin...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 历史文章,杂志文章,评审
doi:10.1111/apt.12380
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Interferon therapy has been shown to induce lipid abnormalities. AIM:We assessed the effects of interferon-beta on the lipoprotein profile and post-heparin lipase activities in 26 normolipaemic patients with chronic hepatitis C. METHODS:Interferon-beta was administered subcutaneously at doses of 6 x 106 U ...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1046/j.1365-2036.2000.00792.x
更新日期:2000-07-01 00:00:00
abstract:BACKGROUND:Ustekinumab is a monoclonal antibody targeting interleukins-12 and -23, with efficacy in Crohn's disease (CD) demonstrated in clinical trials. AIM:To assess the real-world clinical, endoscopic and radiographic response and remission outcomes achieved with ustekinumab in medically-refractory CD. METHODS:A r...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,多中心研究
doi:10.1111/apt.14016
更新日期:2017-05-01 00:00:00
abstract::Methotrexate has a place in the treatment of an increasing number of diseases. Its emerging role in the treatment of primary biliary cirrhosis and inflammatory bowel disease still requires further evaluation. Its toxicity profile is wide and is affected by a variety of factors. Hepatotoxicity from long-term use in pat...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2036.1996.70244000.x
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:The hepatitis C virus (HCV) care cascade has changed dramatically following the introduction of direct-acting anti-virals (DAAs). Up-to-date estimates of the cascade are needed to monitor progress, identify key gaps and inform policy. AIM:To estimate the current and future HCV care cascade in the United Sta...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.15291
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:The Th2 allergic pathway in eosinophilic oesophagitis (EoE) responds to food antigen exposure. AIM:To compare the presence and temporal pattern of food antigen penetration in oesophageal mucosa in active and inactive EoE and controls METHODS: Thirty-two patients with EoE (20 active) and 10 controls were ask...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.16180
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:CXC chemokines such as interleukin (IL)-8 are neutrophil chemoattractants, the levels of which increase in Helicobacter pylori-infected gastric mucosa. Many investigators have focused on the chemotactic aspects of IL-8: however, CXC chemokines are also reported to have angiogenic activity and to serve as rem...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.2000.014s1094.x
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Helicobacter-negative gastritis has been increasingly reported. Molecular techniques as the polymerase chain reaction (PCR) may detect bacterial DNA in histologically negative gastritis. AIM:To evaluate of Helicobacter PCR in gastric biopsies for the daily diagnostics of Helicobacter-negative gastritis. ME...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.13564
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:H2-receptor antagonists are becoming widely available as over-the-counter medications for the treatment of heartburn and excess gastric acidity. AIM:To determine the effects of single low doses of ranitidine on intragastric acidity. METHODS:Intragastric pH was measured for 9 h after lunch in five studies i...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.1998.00307.x
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:The treatment of HBeAg-negative chronic hepatitis B (CHB) is considered to be open-ended, with no guidelines for treatment cessation. AIM:To evaluate biochemical and virological relapse requiring retreatment in noncirrhotic HBeAg-negative CHB in patients who stopped treatment following a period of prolonged...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.12908
更新日期:2014-10-01 00:00:00
abstract::Secretin-producing enteroendocrine cells arise from a multipotential endocrine progenitor in the crypts of the small intestine. As these cells migrate up the crypt-villus axis, they produce secretin and stop dividing as they terminally differentiate and die. Transcription of the secretin gene is controlled by a comple...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2036.2000.014s1170.x
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Proton pump inhibitors are effective for the healing of oesophagitis. Standard doses of omeprazole, lansoprazole or pantoprazole are sufficient for healing in mild to moderate cases of oesophagitis. AIM:To compare the efficacy of double the standard doses of omeprazole, lansoprazole or pantoprazole for main...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.1998.00278.x
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Different authors have postulated both toxic and protective effects for nitric oxide (NO) in the pathophysiology of active inflammation. AIM:To examine the role of NO, especially that produced by the inducible form of nitric oxide synthase (iNOS), by investigating the effects of NOS inhibitors and NO donors...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.2000.014s1026.x
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:The role of 5-hydroxytryptamine in the control of gastric fundus tone in humans is still unknown. Selective 5-hydroxytryptamine re-uptake inhibitors act both centrally and peripherally to enhance the availability of physiologically released 5-hydroxytryptamine. AIM:To study the influence of a selective 5-hy...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2036.2003.01469.x
更新日期:2003-02-15 00:00:00
abstract:BACKGROUND:Transjugular intrahepatic portosystemic stent shunts (TIPSS) have been used successfully to reduce portal pressure in the context of variceal haemorrhage. Recent interest has focused on the possible use of TIPSS to manage refractory ascites. AIM:To study the effect of TIPSS insertion in 18 patients with ref...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1046/j.1365-2036.1996.60202000.x
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Two variants in the organic cation transporter gene cluster have been recently reported to confer susceptibility to Crohn's disease (CD). AIM:To investigate these variants in CD and ulcerative colitis (UC), and their interaction with CARD15 gene and correlation to clinical subphenotypes. METHODS:Case-contr...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/j.1365-2036.2006.02780.x
更新日期:2006-02-15 00:00:00
abstract:BACKGROUND:Psychiatric co-morbidity, in particular major depression and anxiety, is common in patients with Crohn's disease (CD) and ulcerative colitis (UC). Prior studies examining this may be confounded by the co-existence of functional bowel symptoms. Limited data exist examining an association between depression or...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 杂志文章
doi:10.1111/apt.12195
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Antibiotic resistance has increasingly been recognized as the major cause of treatment failure for Helicobacter pylori infection. New therapies for patients with metronidazole- or clarithromycin-resistant H. pylori are needed. AIM:To investigate the role of nitrofurantoin quadruple therapy for the treatment...
journal_title:Alimentary pharmacology & therapeutics
pub_type: 临床试验,杂志文章
doi:10.1046/j.1365-2036.2001.00945.x
更新日期:2001-04-01 00:00:00