Introduction

It is proven that platelets play an important role in growth, invasion, and angiogenesis of a variety of tumors. The mean platelet volume (MPV) indicates platelet activation and is altered in malignancies such as hepatocellular carcinoma (HCC).

Aims & Methods

The aim of this study was to explore the association between MPV and prognosis in HCC according to the Barcelona-Clinic Liver Cancer (BCLC) Staging Classification. This retrospective study performed between January 2020 and December 2021 included 92 patients with HCC who did not receive antiplatelet therapy. The overall survival was compared, and the predictors of overall survival were analyzed. High mean platelet volume (MPV) was defined as ≥median value of the cohort (≥ 8 fL). All the patients were divided into the normal and lower MPV groups according to the median MPV. We used receiver operating characteristic (ROC) curves to assess the prognostic value of MPV.

Results

Among 92 patients, high MPV was present in 50 (54.3%) and was associated with favorable baseline tumor characteristics: diameter of the largest nodule less than 3 cm (77.4 vs. 22.6%, p=0,01), less extrahepatic spread (16.7 vs. 83.3%, p=0.004), less macrovascular invasion (2 vs. 52.4%, p < 0.001), and lower BCLC stages (2 vs. 100% BCLC C/D; p< 0.001) as compared to patients with normal MPV. In receiver operating characteristic (ROC) curve analysis, MPV presented 93.3% of sensitivity and 69.4% of specificity at the criterion <8.5 fL (area under the curve (AUC) = 0.706) to predict higher BCLC stages (C/D).

Conclusion

Higher MPV is associated with better outcome in patients with advanced HCC. These findings may prompt further clinical research on additive antiplatelet therapy in the prevention and management of HCC.

Introduction

Colonic diverticulosis is a prevalent gastrointestinal condition that is often diagnosed incidentally. However, its association with chronic polyps and rectal hemorrhoids remains underexplored, particularly in the northern region of Saudi Arabia.

Aims & Methods

This study aimed to assess the relationship between colonic diverticulosis and colonic conditions while considering demographic and clinical factors. This retrospective observational study was conducted at a tertiary referral center over four years. Data from 4,014 patients who underwent colonoscopy were analyzed. Statistical tests, including chi-square and independent sample t-tests, were used to determine associations between diverticulosis, polyps, hemorrhoids, and bowel preparation adequacy.

Results

Diverticulosis was observed in 14.2% of the patients, with a higher prevalence among males (16.1%) than among females (12.1%) (p < 0.001). Patients with diverticulosis were significantly older (mean age 61.35 years) than those without diverticulosis (mean age 48.25 years) (p < 0.001). Hemorrhoids were more frequent in patients with diverticulosis (18.6%) than in those without diverticulosis (11.9%) (p < 0.001). A similar association was found between diverticulosis and polyps, with the polyp prevalence being higher in patients with diverticulosis (21.4%) than in those without (11.7%) (p < 0.001). Additionally, inadequate bowel preparation was more common among patients with diverticulosis (17.1%) than among those with adequate bowel preparation (13.6%) (p = 0.023).

Conclusion

This study highlights a significant association between colonic diverticulosis and the presence of polyps and hemorrhoids. Older age and male sex were identified as the key risk factors. These findings emphasize the importance of targeted screening and optimized bowel preparation in at-risk patients. Further research is required to explore the underlying pathophysiological mechanisms and to develop preventive strategies.
Keywords: Diverticulosis; Hemorrhoids; Chronic Polyps

References

1 Nallapeta NS, Farooq U, Patel K. Diverticulosis. StatPearls. Treasure Island (FL): StatPearls Publishing 2025.
2 Tursi A, Scarpignato C, Strate LL, et al. Colonic diverticular disease. Nat Rev Dis Primers. 2020;6:20. doi: 10.1038/s41572-020-0153-5

Introduction

Microscopic colitis (MC) is an inflammatory condition of the large intestine. Primarily diagnosed in middle-aged and older adults, the age-specific incidence of the disease peaks in patients 75-79 years of age. While MC is associated with a reduced quality of life, large-scale studies on the association with future psychiatric disorders are lacking.

Aims & Methods

Due to the burden of symptoms as well as inflammatory similarities between MC and certain psychiatric disorders, we hypothesized that patients with MC were at an increased risk of psychiatric disease. Using the nationwide histopathology cohort ESPRESSO, we identified 5,816 patients in Sweden with MC. These patients were matched, according to birth year, sex, and county, with reference individuals (n=21,509) from the general population. All individuals with previously recorded psychiatric disorders or dispensation of medication indicative of psychiatric morbidity were excluded. Our main outcome measure was a pre-devised collection of ICD-codes, all indicating psychiatric disease. Moreover, to control for the impact of intrafamilial confounding, full siblings to patients with MC were identified, and in a sensitivity analysis, used as reference population. Adjusted hazard ratios were computed using Cox proportional hazards modelling. Our main analysis included adjustments for the matching factors (birth year, county, sex) as well as educational attainment (as a proxy for socioeconomic status) and inflammatory bowel disease, celiac disease, and type 1 diabetes.

Results

From 2006-2021, 519 patients with MC and 1,313 reference individuals were diagnosed with psychiatric disorders (9.9 vs. 6.5 events per 1,000 person-years), corresponding to one extra case of psychiatric disorder in 29 patients with MC over 10 years. After adjustments, this represented a hazard ratio (HR) of 1.57 (95% confidence interval [CI]=1.42-1.74). We found significantly elevated estimates up to 10 years after MC diagnosis and similar HRs in lymphocytic and collagenous colitis. More specifically, we observed increased risks for unipolar depression, anxiety disorders, stress-related disorders, substance abuse, and suicide attempts in patients with MC.
Our result was robust across several sensitivity analyses
(Table 1).

Conclusion

Patients with MC are at increased risk of incident psychiatric disorders compared to the general population. Specifically, this increased risk applies to unipolar depression, anxiety disorders, stress-related disorders, substance abuse, and suicide attempts. The increased risk was most pronounced among older patients with MC.

References

NA

Disclosure

Dr Ludvigsson has coordinated a study for the Swedish IBD quality register (SWIBREG). That study received funding from the Janssen Corporation. Dr Ludvigsson has also received financial support from MSD to develop a paper reviewing national healthcare registers in China. Dr Ebrahimi has served as an advisory board member for Boehringer Ingelheim. Dr Pardi has consulted for Immunic Therapeutics, Takeda, AbbVie, Boehringer Ingelheim, and Lilly.