Two hundred forty-six patients with valid LSM acquisitions and satisfactory liver biopsy specimens were included in the analysis. Patients who failed LSM acquisitions had higher BMI (35.6 ± 6.3 versus 28.0 ± 4.5 kg/m2, P < 0.001) and waist circumference (114 ± 14 versus 94 ± 12 cm, P < 0.001). Valid LSM acquisitions were obtained in 62 of 63 (98.4%) patients with BMI less than 25 kg/m2, 114 of 117 (97.4%) patients with BMI 25 to 30 kg/m2, and 70 of 94 (74.5%) patients with BMI of 30 kg/m2 or higher.

The rate of successful acquisitions Alpelisib at the same BMI was similar in whites and Chinese. Thirty-one (12.6%) and 25 (10.2%) patients had advanced fibrosis and cirrhosis, respectively (Table 1). The LSMs of patients with F0, F1, F2, F3, and F4 disease were 5.7 ± 1.8, 6.8 ± 2.4, 7.8 ± 2.4, 11.8 ± 5.2, and 25.1 ± 17.1 kPa, respectively (P < 0.0001 by analysis of variance). Patients with F3 and F4 disease had significantly higher LSM than those with less fibrosis

(Fig. 1). Overall, the accuracy of transient elastography to detect F2 or higher, F3 or higher, and F4 disease was good, with areas under the receiver operating curve (AUROCs) of 0.84, 0.93, and 0.95, respectively (Table 2). The corresponding AUROCs were 0.87, 0.94, and check details 0.94, respectively, in the French cohort, and 0.84, 0.92, and 0.97, respectively, in the Chinese cohort. The best LSM cutoff for F2 or greater disease was 7.0 kPa (Table 2). The negative predictive value to exclude F2 or greater disease was 84% (95% confidence interval [CI], 78%–90%). Cutoff values of 5.8 kPa and 9.0 kPa had greater than 90% sensitivity and specificity to rule out and rule in F2 disease, respectively. The best cutoff for F3 or greater disease Thiamet G was 8.7 kPa (Table 2). The negative predictive value to exclude F3 or greater disease was 95% (95% CI, 91%–98%). Cutoff values of 7.9 and 9.6 kPa had greater than

90% sensitivity and specificity to rule out and rule in F3 disease, respectively. The best cutoff for F4 disease was 10.3 kPa (Table 2). The negative predictive value to exclude cirrhosis was 99% (95% CI, 98%–100%). The same cutoff value also had greater than 90% sensitivity to rule out cirrhosis. A cutoff value of 11.5 kPa had greater than 90% specificity to detect cirrhosis. Steatosis grade (P = 0.31), NAFLD activity score (P = 0.31), serum ALT (P = 0.39), and BMI (P = 0.29) did not influence LSM after adjusting for fibrosis stage (Fig. 2). Similarly, whites and Chinese had similar LSMs at the same fibrosis stage (P = 0.22). Discordance of at least two stages between transient elastography and histology was observed in 33 (13.4%) patients according to the cutoffs derived in this study. Transient elastography predicted a higher fibrosis stage in 30 cases and a lower fibrosis stage in three cases. Using cutoffs reported by Yoneda et al.,20 discordance was also observed in 33 (13.4%) patients.

015), and ezrin (P = 0.092) positivity and loss of E-cadherin expression (P = 0.006), compared to CD133-negative HCCs. Ezrin expression was more common in EpCAM-positive HCCs, compared to EpCAM-negative HCCs (P = 0.007), and snail was more frequently expressed in c-kit-positive HCCs, compared to c-kit-negative HCCs (P = 0.031). A univariable survival analysis,

according to the expression status of the four stemness-related markers, demonstrated that K19 expression in HCC was associated with a poor overall (P = 0.018) and disease-free survival (P = 0.007) (Supporting Table 3). CD133-expressing HCCs showed decreased overall survival (P = 0.057), compared to CD133-negative HCCs, although this website marginally significant. EpCAM or c-kit expression status was not related to HCC prognosis in this study. In addition, expression of three or more stemness-related proteins in HCC was characterized by a decreased overall survival (P = 0.086); however, selleck disease-free

survival was not affected by this variable. Because the majority (n = 101) of cohort 1 HCCs were HBV-related, survival analysis was repeated separately for 101 HBV-related HCCs and 36 HBV-unrelated HCCs (11 HCV-related, 6 alcohol-related, and 19 of uncertain etiology) to see whether K19 would be still prognostically significant in non-B-viral HCCs. Disease-free survival was still significantly decreased in K19-positive, HBV-unrelated HCCs, compared to K19-negative cases (P = 0.005) (Supporting Fig. 3). Overall survival, however, was not significantly different Cepharanthine between the two groups. As for the HBV-related HCCs, decreased overall survival (P = 0.002) and disease-free survival (P = 0.121) were noted in the K19-positive groups. Because K19 appeared to be the stemness-related marker that was most significantly associated with clinicopathologic

features of tumor aggressiveness, the next cohort was divided into two groups, according to K19 protein expression status. Immunohistochemical stain for K19 protein was done using whole sections of representative paraffin blocks from each case, and K19 positivity was found in 68 (28.7%) cases. The pattern of K19 immunoreactivity was focal and heterogeneous. The smaller tumor cells at the periphery of the tumor-cell nests, or intermingled with the hepatocyte-like cells within the tumor-cell nests, expressed K19 in 16 cases, whereas the majority of the K19-expressing tumor cells were hepatocyte-like cells (n = 52). HCCs were grouped according to K19 protein-expression status, and clinicopathological features were compared between the two groups (Table 2). The K19-positive group was composed of higher proportions of younger (P = 0.004) and female (P < 0.001) patients, compared to the K19-negative group. K19-positive HCCs were more frequently associated with high AFP levels (>1,000 IU/mL), compared to K19-negative HCCs (P < 0.001). On pathologic examination, K19-positive HCCs showed more frequent microvascular invasion (P = 0.017) and fibrous stroma (P = 0.

RNA was extracted and quantitative RT-PCR of discriminative cell markers (e.g. APOB, CD163, CD31, VCL) was performed. The functional activity of LSECs, KCs and HSCs was determined by uptake of acetylated low-density lipoprotein (AcLDL) and 1 latex beads or vitamin A storage, respectively. Results: Liver cell preparation resulted in following cell yields per 30-100g liver: 4.2×10^8±8.1×10^7 SEM PHHs, 4.2×10^7±6.7×10^6 SEM KCs, 7.5×10^6±1.6×10^6 SEM LSECs, 1.1×10^7±5.7×10^6 SEM HSCs. Different cell populations showed appropriate cell morphologies, indicating their identity ICG-001 concentration (bright-light microscopy). Immunofluorescence staining of albumin, CD146, CD68 and a-SMA

allowed semi-quantitative descriptions of cell purities, resulting in 90-97%. These findings were confirmed by gene expression profile of discriminative markers. Functional activity of PHHs could be documented by high abundance of albumin. Cultured KCs retained their physiological function; they efficiently phagocytized 1 latex beads in a time dependent manner. In comparison, LSECs rapidly took up AcLDL within 1h, demonstrating their functional activity in vitro. Dependent on their activation status, cultured HSCs stored different amounts of vitamin A, shown by autoflu-orescence of retinyl ester. Conclusions: Primary human hepato-cytes and non-parenchymal liver cells were isolated in high cell yield and purity. Cells showed defined cell morphologies and expression of discriminative cell markers on

RNA and protein level. Furthermore, cells were physiologically check details active in vitro. The presented method is a valuable tool with

high potential to investigate the contribution of liver cells to various liver diseases. Disclosures: The following people have nothing to disclose: Melanie Lutterbeck, Catherine I. Real, Kathrin Skibbe, Joerg Timm, Andreas Paul, Guido Gerken, Joerg F. Schlaak, Ruth Broering [Purpose] Betaine-homocysteine S-methyltransferase (BHMT) and cystathionine γ-lyase (CTH) are enzymes responsible for homocysteine Chlormezanone metabolism in the liver. Homocysteine is remeth-ylated to methionine by BHMT with the aid of betaine, or is converted to cystathionine by cystathionine β-synthase. Cysta-thionine is transsulfurated to cysteine by CTH. Nuclear receptor small heterodimer partner (SHP, NR0B2) is a pleiotropic transcriptional repressor involved in regulating various metabolic pathways in the liver. This study identified SHP as a novel modulator of homocysteine metabolism via crosstalk with FOXA1. [Methods] Gene expression levels were determined by Western blot and qPCR, as well as by next-generation RNA sequencing. Luciferase assays were performed with reporter plasmids driven by mouse Bhmt or Cth promoters. Metabolites in the liver and serum were analyzed by gas chromatogra-phymass spectrometer (GC-MS). [Results] The expression of Bhmt and Cth exhibited circadian oscillation, which was significantly increased in the liver of Shp−/− mice as compared to the wild-type (WT) mice.

Histocytes and phagocytes were found in one patient. But detection of bacteria, virus and other pathogens were negative. In recent years, SFTSV (severe fever with thrombocytopenia syndrome virus)

infection was selleck kinase inhibitor reported in several provinces in China. It could cause multiple organ dysfunction. Change of WBC, PLT and serum enzymes were remarkably in these patients. The cases we reported here had the similar clinical features and laboratory findings with SFTS, and the clinical course of these cases consisted with virus infection. Unfortunately, neither SFTSV nor other pathogens have been detected in these cases so far. We supposed that SFTSV is not unique virus, it might be some other unknown virus or pathogens that could cause these

symptoms. More cases should be observed and further study should be done to confirm our hypothesis. Disclosures: The following people have nothing to disclose: Jie Cai, Xiling Guo, Yin Chen, Yiyue Ge, Lunbiao Cui, Yali Weng “
“The rapid emergence of nonalcoholic fatty liver disease (NAFLD) as a cause of both liver-related morbidity and mortality and cardiometabolic risk has led to the search for effective lifestyle strategies to reduce liver fat. Lifestyle intervention comprising dietary VX-770 mouse restriction in conjunction with increased physical activity has shown clear hepatic benefits when weight loss approximating 3%-10% of body weight is achieved. Yet, the poor sustainability of weight loss challenges the current therapeutic focus on body weight and highlights the need for alternative strategies for NAFLD management.

Epidemiologic data show an independent relationship between liver fat, physical activity, and fitness, Sodium butyrate and a growing body of longitudinal research demonstrates that increased physical activity participation per se significantly reduces hepatic steatosis and serum aminotransferases in individuals with NAFLD, independent of weight loss. Mechanistic insights to explain this interaction are outlined, and recommendations for the implementation of lifestyle intervention involving physical activity are discussed. In light of the often poor sustainability of weight loss strategies, and the viability of physical activity therapy, clinicians should assess physical fitness and physical activity habits, educate patients on the benefits of fitness outside of weight loss, and focus on behavior change which promotes physical activity adoption. (HEPATOLOGY 2010) Nonalcoholic fatty liver disease (NAFLD) affects ∼30% of adults and a majority of obese individuals.1 In addition to increasing morbidity and mortality from liver disease and cancer, excess liver fat is an independent risk factor for cardiovascular disease, insulin resistance, prediabetes and type 2 diabetes.1 Thus, strategies to modulate the burden of NAFLD are likely to have benefits beyond attenuating liver disease to the broader realm of obesity-related cardiometabolic risk reduction.

All feature a chromanol ring, with a group that can donate an atom to reduce free radicals LDK378 manufacturer and a side chain that allows for penetration into biological membranes. There are substantial differences in the biological properties of these compounds. The natural form of vitamin E (rrr α-tocopherol) has been shown to improve the histological features of NASH in a large, prospective, controlled

trial.30 These data are corroborated by several smaller studies. It is, however, important to note that vitamin E is not a panacea and only improves histological features in 43% of subjects.30 There is considerable controversy over whether vitamin E produces a small but significant increase in all-cause mortality when taken as a health supplement.33-36 Therefore, there is room for additional therapies for NASH. In this issue of HEPATOLOGY, Zein et al.37 provide evidence of improvement of NASH following pentoxifylline administration. The rationale for the use of pentoxifylline is based on its reported ability to inhibit the synthesis/release of tumor necrosis factor-α (TNF-α) and its ability to inhibit TNF- and eicosanoid-induced

inflammatory responses.38 TNF-α is a proinflammatory, proapoptotic cytokine that is activated as part of the innate immune system and has been implicated as a key player in the development of hepatic steatosis and steatohepatitis. The development of hepatic steatosis has also been shown to increase the susceptibility of hepatocytes to TNF-mediated apoptosis.39 Prior small trials have also shown the promise of efficacy of pentoxifylline NVP-AUY922 clinical trial for treatment of NASH.40, 41 The data from Zein et al.37 further corroborate these early data. The ideal treatment for NASH should be one that decreases overall mortality, including liver-related and cardiovascular Alectinib deaths, while

remaining safe, widely available, and relatively inexpensive. Demonstration of an improvement of all-cause mortality would require a very large study followed over an extended period of time. These considerations make it impractical to use this as a primary endpoint in clinical trials, and instead has led to the use of surrogate endpoints to determine the efficacy of a drug for NASH. Because liver-related mortality is associated mainly with cirrhosis, prevention of cirrhosis or reversal of the disease associated with cirrhosis, i.e., steatohepatitis, is often considered acceptable as an endpoint for NASH. Because steatohepatitis may disappear with disease progression, it is further imperative to combine this endpoint with “at least no worsening of fibrosis” to make it clinically relevant.42 In the study by Zein et al., the primary endpoint was a decrease in the NAFLD activity score (NAS) of 2 or greater. This score was developed as a relatively quantifiable way to evaluate the impact of drug treatment on the severity of key histological features of NASH.

94, 95% Cl: 1.7727.03, p=0.005] or not was only associated with bleeding after prophylactic EVL. Conclusions: No administration of PPI was significantly associated with increased risk of bleeding after prophylactic EVL. Especially, PPI medication was the only predictor factor in the case of no gastric varix. We suggest PPI therapy should be routinely performed in patients receiving EVL to reduce the risk of post EVL bleeding. Disclosures: Hyung Joon Yim – Grant/Research Support: GSK Korea, Handok Pharm, Gilead

Korea; Speaking and Teaching: BMS Korea The following people have nothing to disclose: Seong Hee Kang, Seung Young Kim, Hae Rim Kim, Eileen L. Yoon, Hyun Jung Lee, Sang Jun Suh, Sung Woo Jung, Ja Seol Koo, Ji Hoon Kim, Yeon Seok Seo, Rok Son Choung, Jong Eun Yeon, Kwan Soo Byun, Soon Ho Um, Sang Woo Lee, Jai Hyun Choi, Ho Sang Ryu Background and Aims Transjugular intrahepatic portosystemic Enzalutamide supplier shunt (TIPS) is a common and effective treatment of refractory ascites or refractory variceal bleeding in patients with portal hypertension and cirrhosis. It is unclear whether TIPS has any long-term effects on patient survival in patients with cirrhosis. We aimed to determine whether TIPS is associated with survival in patients with cirrhosis. Methods We created a cohort of adult patients with cirrhosis without previous liver transplantation who were listed for liver transplantation in the United States between 2002-2011

(n=80,519) and followed from the time of listing until the time of death on the waiting list, buy PI3K Inhibitor Library transplantation, or drop-out from the waiting list. Patients Dichloromethane dehalogenase were censored if they were still on the waiting list at the time of last follow-up. We used Cox proportional hazards analysis and competing risks analysis to compare patients who had TIPS at the time of listing

(n=6115) to those who did not (n=74,044) with regards to death on the waiting list, transplantation and drop-out from the waiting list, after adjusting for important baseline characteristics (MELD score, underlying liver disease, presence of hepatocellular carcinoma, age, gender, race/ethnicity, diabetes, body mass index, serum albumin, ascites, encephalopathy, portal vein thrombosis, and ABO blood group) Results Among 80, 519 patients listed for liver transplantation, 10, 920 (14%) died on the waiting list, 40,180 (50%) underwent transplantation, 11,288 (14%) dropped out, and 17,771 (22%) were still on the waiting list during a mean follow-up of 1.2 years. Compared to patients who did not have a TIPS, those with a TIPS had lower risk of death on the waiting list (adjusted hazard ratio [AHR] 0.83 95% Cl 0.78-0.90). They also had a lower likelihood of transplantation (AHR 0.87 [0.83-0.90]) and dropout from the waiting list (AHR 0.92 [0.86-0.99]) suggesting that the lower risk of death could not be explained by higher rate of removal of relatively sick patients from the waiting list due to transplantation or drop-out.

94, 95% Cl: 1.7727.03, p=0.005] or not was only associated with bleeding after prophylactic EVL. Conclusions: No administration of PPI was significantly associated with increased risk of bleeding after prophylactic EVL. Especially, PPI medication was the only predictor factor in the case of no gastric varix. We suggest PPI therapy should be routinely performed in patients receiving EVL to reduce the risk of post EVL bleeding. Disclosures: Hyung Joon Yim – Grant/Research Support: GSK Korea, Handok Pharm, Gilead

Korea; Speaking and Teaching: BMS Korea The following people have nothing to disclose: Seong Hee Kang, Seung Young Kim, Hae Rim Kim, Eileen L. Yoon, Hyun Jung Lee, Sang Jun Suh, Sung Woo Jung, Ja Seol Koo, Ji Hoon Kim, Yeon Seok Seo, Rok Son Choung, Jong Eun Yeon, Kwan Soo Byun, Soon Ho Um, Sang Woo Lee, Jai Hyun Choi, Ho Sang Ryu Background and Aims Transjugular intrahepatic portosystemic ABT 737 shunt (TIPS) is a common and effective treatment of refractory ascites or refractory variceal bleeding in patients with portal hypertension and cirrhosis. It is unclear whether TIPS has any long-term effects on patient survival in patients with cirrhosis. We aimed to determine whether TIPS is associated with survival in patients with cirrhosis. Methods We created a cohort of adult patients with cirrhosis without previous liver transplantation who were listed for liver transplantation in the United States between 2002-2011

(n=80,519) and followed from the time of listing until the time of death on the waiting list, CX-5461 cell line transplantation, or drop-out from the waiting list. Patients Phospholipase D1 were censored if they were still on the waiting list at the time of last follow-up. We used Cox proportional hazards analysis and competing risks analysis to compare patients who had TIPS at the time of listing

(n=6115) to those who did not (n=74,044) with regards to death on the waiting list, transplantation and drop-out from the waiting list, after adjusting for important baseline characteristics (MELD score, underlying liver disease, presence of hepatocellular carcinoma, age, gender, race/ethnicity, diabetes, body mass index, serum albumin, ascites, encephalopathy, portal vein thrombosis, and ABO blood group) Results Among 80, 519 patients listed for liver transplantation, 10, 920 (14%) died on the waiting list, 40,180 (50%) underwent transplantation, 11,288 (14%) dropped out, and 17,771 (22%) were still on the waiting list during a mean follow-up of 1.2 years. Compared to patients who did not have a TIPS, those with a TIPS had lower risk of death on the waiting list (adjusted hazard ratio [AHR] 0.83 95% Cl 0.78-0.90). They also had a lower likelihood of transplantation (AHR 0.87 [0.83-0.90]) and dropout from the waiting list (AHR 0.92 [0.86-0.99]) suggesting that the lower risk of death could not be explained by higher rate of removal of relatively sick patients from the waiting list due to transplantation or drop-out.

Hispanic race and amount of healthcare resource utilization may have a role in explaining this variation.

Table 1. Regional data regarding THC, length of stay and number of procedures for inpatients with AH (n=11,304) *denotes significantly greater result relative to other regions (p<0.05) Disclosures: Ashwini Lakshmanan - Advisory Committees or Review Panels: Salix Pharmaceuticals Vinay Sundaram - Advisory Committees or Review Panels: Salix, Gilead, Jansen; Speaking and Teaching: Salix The following people have nothing to disclose: Folasade P. May, Vineet Syan BACKGROUND AND AIM: New interferon-free regimens for treatment of CHC have high efficacy and favorable safety profile. Our aim was to EPZ015666 clinical trial assess PROs in CHC with different stages of hepatic fibrosis treated with SOF+LDV regimens. METHODS: PRO questionnaires [Chronic Liver Disease Questionnaire-HCV (CLDQ-HCV), Short Form-36 (SF-36), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and Work Productivity and Activity Index: Specific Health Problem (WPAI:SHP)] were administered at baseline, during, and post-treatment to genotype 1 CH-C subjects

treated with SOF+LDV+RBV or SOF+LDV for 8, 12 and 24 weeks (ION-1, 2 and 3 clinical trials). METAVIR fibrosis stage was determined from pretreatment liver biopsies. RESULTS: 1,005 subjects who had undergone liver biopsies were included (94 – stage 0 fibrosis, 311 – stage 1, 301 – stage 2, 197 – BGJ398 stage 3, and 102 – stage 4). Patients with earlier stages of fibrosis were younger (p=0.0043) with lower BMI (p=0.0015) and lower ALT (p<0.0001). At baseline, patients with more advanced fibrosis had greater PRO impairments; this difference was most prominent for PROs related to physical functioning Adenosine including the physical component of SF-36, physical and emotional well-being and fatigue scale of FACIT-F, activity impairment of WPAI:SHP (up to 12.6% less impairment in stage 0 vs. stage 4, p<0.0001). In multivariate analysis, the stage of fibrosis was independently associated with impairment of PROs (CLDQ-HCV, physical component of SF-36, total FACIT-F and activity impairment

of WPAI scores: beta up to -2.4% per each additional stage, p<0.05). During and post-treatment, these PROs remained lower in patients with advanced fibrosis. Nevertheless, significant improvements (p<0.05) in most PROs were observed at SVR-12, regardless of fibrosis stage (by 2.4%-10.3% from baseline; all p>0.05 across fibrosis stages). In particular, patients with stages 0-2 (early fibrosis) had similar PRO improvements as compared to those with advanced fibrosis [e.g., improvement in vitality of SF-36 from baseline: +7.94% in stages 0-2 (p<0.0001), +8.08% in stages 3-4 (p<0.0001), (p>0.05 between fibrosis groups)]. In multivariate analysis, improvement of PROs after SVR-12 was not related to the stage of fibrosis (all p>0.05).

1 Yet, many patients develop postoperative complications because the remnant livers or grafts are too small or of poor quality to sustain sufficient

organ function. This somewhat new and poorly defined phenomenon has been termed “small-for-size syndrome” http://www.selleckchem.com/Caspase.html (SFSS) to describe this scenario. The concept is, in fact, not a new one, because as early as the 1970s, Thomas E. Starzl described the complicated postoperative course of a young woman subjected to an almost 90% hepatectomy and who was subsequently characterized by prolonged hyperbilirubinemia, encephalopathy, and coagulopathy.2 In an unconventional way for a review, we will start with three case reports to illustrate the scope and clinical relevance of SFSS after liver surgery and transplantation. CALI, chemotherapy-associated liver injury; LDK378 CT, computed tomography; DOI, 2,5-dimethoxy-4-iodoamphetamine; EHPBA, European Hepato-Pancreatico-Biliary Association; GRWR, graft-to-recipient weight ratio; HCC, hepatocellular carcinoma; IHPBA, International Hepato-Pancreatico-Biliary Association; IL-6, interleukin-6; LDLT, living donor liver transplantation; MELD, Model for End-Stage Liver Disease; OLT, orthotopic liver transplantation; PTX, pentoxifylline; RLBW, remnant liver to body weight; SFSS, small-for-size syndrome; TNF, tumor necrosis factor.

Case 1: A 47-year-old healthy man, whose wife was listed for OLT due to a symptomatic nonresectable hemangioendothelioma of the liver, offered to be considered for living donor liver transplantation (LDLT). Following the standard work-up for this procedure, he underwent a right hemi-hepatectomy including the middle hepatic vein to serve as allograft for his wife. The

remnant left hemi-liver was estimated by computed tomographic (CT) volumetry to weigh 450 g, i.e., around 32% of the whole liver. The ratio of the remnant liver weight to body weight (RLBW) was 0.65%. The Pazopanib molecular weight donor had a difficult postoperative course developing mild encephalopathy and hyperbilirubinemia lasting 20 days peaking at 178 μmol/L (10.4 mg/dL) by day five, and severe coagulopathy (prothrombin time <30%) that normalized by day 7. The donor eventually recovered fully, and was discharged in good general condition 22 days after surgery. Case 2: A 42-year-old male was listed for OLT because of Child B cirrhosis (Model for End-Stage Liver Disease [MELD] score: 21) and a small (3 cm) hepatocellular carcinoma (HCC) related to hepatitis B virus infection. He received the right hemi-liver containing the middle hepatic vein from his wife (graft weighing 620 g), who had an uneventful postoperative course. The ratio of graft size in grams to her husband’s body weight (80 kg) (graft-to-recipient weight ratio [GRWR]) was 0.7%. The postoperative period was complicated by encephalopathy, hyperbilirubinemia (up to 262 μmol/L, 15.

However, there are few data on clinical characteristics and treatment of patients with GCP in unoperated stomachs. Methods: The records of 15 patients with histologically confirmed GCP, who had no history of gastric surgery and all received endoscopic submucosal dissection (ESD) after endoscopic ultrasonography

(EUS) at Nanjing Drum Tower Hospital from June 2010 to December 2012, were retrieved and retrospectively analyzed. Wnt inhibitor Results: GCP was more common in men (M: F 12:3), with the median age of 58 years (range 24–72 years). The most common sites were the cardia (60%), followed by the gastric antrum (26.7%), the gastric body (6.7%), and the gastric fundu (6.4%). The average lesion diameter was 2.7 cm (range 0.6–5.8 cm). Gastroscopic examinations indicated that 10 were classified as the protruded type, and 5 were the flat type with the mucosal erosion. In terms of EUS appearance, Night (60%) exhibited cystic-solid masses accompanied by the thickened mucosa and muscularis mucosae, and the remaining

6 were anechoic (4, 26.7%) or hypoechoic (2, 13.3%) lesions with regular borders originating from submucosal layer. Histologically, all resected specimens were characterized by herniation of surface epithelium and cystic glands in the submucosa and muscularis mucosae. Among them, eight displayed severe chronic atrophic gastritis, and 6 coexisted with intraepithelial neoplasia restricted to the surface epithelium. The en bloc resection rate in the 9 patient with GCP was 100%. No serious complications occurred. No recurrence was observed during C59 wnt the follow-up period (median time, 14 months; range, 1–25 months). Conclusion: The characteristic EUS features of GCP are potentially useful for differentiating GCP from other mesenchymal tumors in the stomach. ESD is a relatively effective and safe modality in patients with GCP.

Key Word(s): 1. GCP; 2. ESD; Presenting Author: Dichloromethane dehalogenase YONGHWAN KWON Additional Authors: SEONG-WOO JEON Corresponding Author: YONGHWAN KWON Affiliations: Kyungpook national university hospital Objective: To evaluate the endoscopic, histological features and long term follow up recurrence of early gastric cancer (EGC) in patients with histopathological discrepancies between forcep biopsy and negative findings at endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR). Methods: Between January 2007 and December 2010, 1038 consecutive patients with EGC underwent 493 ESD cases and 545 EMR cases, we’ve researched these patients’ data retrospectively and included patients who were reported pathological no residual tumor found after endoscopic resection. Before endoscopic resection, these enrolled patients had confirmed EGC on the endoscopic forceps biopsy. The patients’ demographic, clinical characteristics and follow up recurrence were evaluated. Results: Finally, 19 patients (1.