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e134
Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
finding was different from that observed after stratifying patients
according to Child-Pugh score; indeed, advanced liver disease
was associated with decrease in Bacteroides, Parabacteroides,
Faecalibacterium, Veillonella, Clostriudium, Oscillospira and Blautia
(adj. p-value <0.05).
Conclusions:
GM composition is influenced by nutritional status
in patients with liver cirrhosis. Although the increase in beneficial
bacteria such as Lactobacilli may suggest a possible compensatory
mechanism, metabolomic analyses should be performed to reveal
the significance of these alterations and to evaluate potential
therapeutic approaches.
P.01.10
CLINICAL OUTCOME OF IMMUNOSUPPRESSION IN PATIENTS
WITH AUTOIMMUNE HEPATITIS: A SICILIAN COHORT STUDY
Costantino A.*, Alessi N., La Mantia M., Craxì A., Almasio P.L.
Universita’ degli Studi di Palermo, Palermo, Italy
Background and aim:
Autoimmune Hepatitis (AIH) is a disease
with unknown aetiology. It predominantly affects female patients,
and is characterized by elevated transaminase and immunoglobulin
G levels, circulating autoantibodies and interface hepatitis at liver
biopsy. AIH is responsive to immunosuppressive treatment, which
should be started to promote remission and long-term survival.
The aim of this work was to assess the clinical, biochemical and
serological features associated with clinical outcome of AIH Sicilian
patients.
Material and methods:
Clinical, biochemical immunological
features and treatment response of 99 sicilian patients with AIH
have been evaluated.
Results:
We included 99 cases (mean age of 50.4 years, 86 women).
Type 1 has been found in 92 cases. Liver fibrosis and cirrhosis have
been found in 61.9% and 24.1% respectively. Combination of steroids
and azathioprine or steroid alone was used in 76 patients. Complete
remission has been documented in 69% of patients, whereas partial/
null response has noticed in remaining patients. At multivariate
time-dependent analysis complete responders showed a lower
risk of disease progression, or the onset of complications such as
portal hypertension (p<0.0001), thrombocytopenia (p<0.0001),
esophageal varices, increase of liver stiffness, hepatic cirrhosis, liver
failure, hepatocellular carcinoma (HCC) and death.
Conclusions:
AIH appears to have similar features in male and
female patients. The combination of azathioprine and steroids has
proven to be an appropriate therapy in the setting of AIH, reducing
the risk of the aforementioned disease progression.
P.02 Pancreas
P.02.1
VITAMIN D DEFICIENCY AS A RISK FACTOR IN PANCREATIC
NEUROENDOCRINE NEOPLASMS: REPORT FROM A SERIES AT A
SINGLE INSTITUTE
Cavalcoli F.*, Fanetti I., Zilli A., Rossi R.E., Conte D., Massironi S.
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Unità di
Gastroenterologia ed Endoscopia, Milano, Italy
Background and aim:
Vitamin D deficiency (VitDdef) is
hypothesized to represent a risk factor in several neoplasms (i.e.
colorectal cancer, pancreatic cancer, hepatocellular carcinoma). To
our knowledge, vitamin D levels have not been previously evaluated
in patients newly diagnosed with pancreatic neuroendocrine
neoplasms (pNENs).
Aim:
to determine whether VitDdef may represent a risk factor for
pNENs and whether may be associated with overall survival (OS)
and progression-free survival (PFS).
Material and methods:
From September 2009 to September 2014,
pNEN was newly diagnosed in 47 patients (M/F= 17/30, median age
61 yrs, range 26-86 yrs). Grading was G1, G2 and G3 in 32 (68.1%),
14 (29.8%) and one (2.1%) patient, respectively. Again, TNM stage
was I, II, III and IV in 16, 17, 2 and 12 cases, respectively. Serum
25-hydroxyvitamin D (25OHvitD) levels were measured at baseline
in all the patients and its deficiency was defined when facing with
values <20 ng/mL. Again, the possible associations of 25OHvitD
levels with PFS and OS was evaluated by the Cox proportional
hazards regression. The possible correlation between 25OHvitD and
disease grading and staging was also considered.
Results:
Median 25OHvitD levels were 12.5 ng/ml (range 4-29.5);
in detail, they were < 20 ng/ml in 38 patients (80%) with 20 cases
(42.5%) showing levels even < 10 ng/ml. No correlation was observed
between serum 25OHvitD and disease grading and staging. At Cox
proportional hazards regression, serum 25OHvitD levels did not
result associated with OS or PFS (p= n.s.).
Conclusions:
Among patients with pNENs, VitDdef was highly
prevalent. The role of VitDdef in both the disease pathogenesis
and progression remains to be clarified. The growing awareness of
the role of vitamin D of pNENs could lead to improved therapeutic
strategies. Further studies are needed to confirm this observation.
P.02.2
SYSTEMATIC REVIEW AND META-ANALYSIS: PREVALENCE OF
INCIDENTALLY DETECTED PANCREATIC CYSTIC LESIONS IN
ASYMPTOMATIC INDIVIDUALS
Zerboni G.*, Capurso G., Signoretti M., Delle Fave G.
Ospedale Sant’Andrea, Roma, Italy
Background and aim:
Pancreatic cystic lesions (PCLs) are frequently
occasionally detected in patients undergoing cross-sectional
imaging investigations for other medical indications. As most PCLs
would require follow-up, it is important to know their expected
prevalence in asymptomatic individuals. However, published studies
are heterogeneous, and a wide range of PCLs’ prevalence has been
reported. We therefore aimed at performing a systematic review
and meta-analysis to determine the rate of PCLs in asymptomatic
individuals.
Material and methods:
a systematic search was conducted and
studies investigating the prevalence of occasionally detected PCLs
asymptomatic subjects were included. The prevalence of positive
studies for PCLs was pooled across studies. A random effect model
was used with assessment of heterogeneity by the I2statistic.
Results:
10 studies including 13.147 patients were included in
the meta-analysis. All studies were unicentre, and all but one
retrospective. Four studies were conducted in the US, 4 in Europe,
1 in Japan and 1 in Brasil. The pooled prevalence of positive tests
for PCLs was 11% (95% CI 6%–20%) with important heterogeneity
(I2=99%). Four studies employed MRCP and showed a higher
pooled prevalence of 26% (95% CI 13%–45%) with still important
heterogeneity (I2=98%), while studies not employing MRCP had a
lower prevalence rate of PCLs (5.9%; 95% CI 3%–11%). The 6 studies
investigating subjects with a mean age>55 years showed a higher
rate of PCLs (16%; 95% CI 7%–32%; I2=98%). Only 3 studies reported
the pooled prevalence of PCLs defined as IPMN, with a pooled rate
of 16% (95% CI 5%–44%) with important heterogeneity (I2=98%).
Country of origin, year of publication and number of patients did
not explain heterogeneity.