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Carcinogenesis is one of the major complications for patients with inflammatory bowel disease (IBD) and causes poor prognosis. We aimed to describe cancer incidence in the Chinese IBD cohort compared to general population‐based cancer registration data and further explore associated risk factors for cancer occurrence in IBD patients. IBD inpatients from January 1998 to January 2018 in Peking Union Medical College Hospital (PUMCH) were included in our study. Patients were followed‐up from the date of IBD diagnosis until either the date of first cancer diagnosis or January 2019. Standardized incidence ratios (SIRs) of overall cancer and site‐specific cancers were calculated. A total of 869 Ulcerative Colitis (UC) and 516 Crohn's disease (CD) patients were finally included with median follow‐up time of 7 and 5 years, respectively. Fifty‐three cases developed malignancies. After standardization by age and gender, SIR of total cancer occurrence in IBD patients was 1.77 (95% CI, 1.33‐2.32). As for UC, digestive cancers (SIR 3.75; 95% CI, 2.29‐5.80), thyroid cancer (SIR 10.34; 95% CI, 4.72‐19.64) and hematological malignancies (SIR 6.25; 95% CI, 1.68‐16.00) had the highest incidence, which were prominent in young and middle‐aged patients. Use of steroids, immunosuppressants or infliximab did not present higher risk of malignancies in UC patients. There was no significant difference in cancer risk between CD patients and general population. In conclusion, the increased risks of multiple cancers are particularly prominent in Chinese UC patients and these findings can provide more targeted guidance for cancer monitoring in Chinese IBD patients. [ABSTRACT FROM AUTHOR]

Background and Aim: Behcet's disease is a systemic vasculitis that can involve gastrointestinal tract. This is a systematic review and meta‐analysis evaluating the efficacy and safety of anti‐tumor necrosis factor (TNF) agents in treating patients with intestinal Behcet's disease. Methods: We conducted searches on PubMed, Embase, and Cochrane. Data from eligible studies were used to calculate the pooled estimate of proportions of clinical remission, mucosal healing at Months 3, 6, 12, and 24 as well as the pooled incidence of adverse drug reactions. And subgroup analysis based on the specific type of anti‐TNF agents was performed. Results: Of the 828 studies initially identified, 13 were included finally, all of which were single‐arm cohort studies. The pooled proportions of clinical remission at Months 3, 6, 12, and 24 were 0.61 (95%CI 0.48–0.78), 0.51 (95%CI 0.40–0.66), 0.57 (95%CI 0.48–0.67), and 0.38 (95%CI 0.16–0.88), respectively. The pooled proportions of mucosal healing at Months 3, 6, 12, and 24 were 0.66 (95%CI 0.50–0.86), 0.82 (95%CI 0.48–0.98), 0.65 (95%CI 0.51–0.81), and 0.69 (95%CI 0.39–1.00), respectively. The pooled estimate of proportion of overall adverse drug reactions for infliximab was 0.22 (95%CI 0.07–0.69). Conclusions: Anti‐TNF agents, including infliximab and adalimumab, were an efficient therapy for intestinal Behcet's disease. The safety of anti‐TNF agents used in the treatment of intestinal Behcet's disease was acceptable. [ABSTRACT FROM AUTHOR]

Background & Aims: The evaluation of the stage of liver fibrosis is essential in patients with chronic liver disease. However, due to the low quality of ultrasound images, the non‐invasive diagnosis of liver fibrosis based on ultrasound images is still an outstanding question. This study aimed to investigate the diagnostic accuracy of a deep learning‐based method in ultrasound images for liver fibrosis staging in multicentre patients. Methods: In this study, we proposed a novel deep learning‐based approach, named multi‐scale texture network (MSTNet), to assess liver fibrosis, which extracted multi‐scale texture features from constructed image pyramid patches. Its diagnostic accuracy was investigated by comparing it with APRI, FIB‐4, Forns and sonographers. Data of 508 patients who underwent liver biopsy were included from 4 hospitals. The area‐under‐the ROC curve (AUC) was determined by receiver operating characteristics (ROC) curves for significant fibrosis (≥F2) and cirrhosis (F4). Results: The AUCs (95% confidence interval) of MSTNet were 0.92 (0.87‐0.96) for ≥F2 and 0.89 (0.83‐0.95) for F4 on the validation group, which significantly outperformed APRI, FIB‐4 and Forns. The sensitivity and specificity of MSTNet (85.1% (74.5%‐92.0%) and 87.6% (78.0%‐93.6%)) were better than those of three sonographers in assessing ≥F2. Conclusions: The proposed MSTNet is a promising ultrasound image‐based method for the non‐invasive grading of liver fibrosis in patients with chronic HBV infection. [ABSTRACT FROM AUTHOR]

Whether patients with myelodysplastic syndrome (MDS) undergoing allogeneic hematopoietic stem cell transplantation (allo‐HSCT) benefit from pretransplant cytoreductive therapy remains controversial. Our study compared the outcomes of upfront transplantation with those of pretransplant cytoreductive therapy in the patients who received transplantation and those who dropped out due to cytoreductive therapy‐related adverse effects. Patients with MDS‐EB‐1 or MDS‐EB‐2 were enrolled and divided into three groups based on therapy pretransplantation: upfront transplantation (upfront, n = 54), induction chemotherapy (CT, n = 66) and hypomethylating agents (HMA, n = 37) alone. One hundred fifty‐seven patients were enrolled and 124 received allo‐HSCT, with 5.6%, 28.8% and 29.7% of drop‐out rate of transplantation in upfront, CT and HMA groups (P =.030), respectively. Overall therapy‐related mortality (TRM), cytoreductive therapy and transplant‐related mortality was 13.0%, 32.4% and 28.4% (P =.028), and 5‐year overall survival (OS) was 73.6%, 43.4% and 46.9% (P =.033). Multivariate analysis showed that CT and HMA were risk factors for TRM and OS, and transplantation was a protective factor for OS. In transplant patients, 3‐year cumulative incidence of relapse was 10.6%, 20.4% and 20.3% (P =.033), 5‐year TRM was 14.5%, 20.0% and 17.6% (P =.651), OS was 77.3%, 64.3% and 68.8% (P =.047) and DFS was 74.0%, 63.0% and 65.8% (P =.042). Multivariate analysis showed that CT was a risk factor for DFS, while CT, HMA and poor karyotype were risk factors for relapse. Results suggested that pretransplant cytoreductive therapy was not associated with better outcomes in the patients who had undergone transplantation. Therefore, upfront transplantation may be preferable for MDS patients. What's new? Whether patients with myelodysplastic syndrome undergoing allogeneic hematopoietic stem cell transplantation benefit from pre‐transplant cytoreductive therapy remains controversial. This study comparing the outcomes of upfront transplantation with those of pre‐transplant cytoreductive therapy includes both patients who ultimately received transplantation and those who dropped out due to cytoreductive therapy‐related adverse effects. The results suggest that pre‐transplant cytoreductive therapy did not improve survival because adverse effects led a proportion of patients to drop out of transplantation. Moreover, pre‐transplant cytoreductive therapy may increase relapse compared to upfront transplantation. Therefore, upfront transplantation may be preferable for myelodysplastic syndrome patients. [ABSTRACT FROM AUTHOR]