Liver & Intrahepatic Bile Ducts

C22WHO Vol. 1

Digestive System

Prognosis

This section is being prepared by our editorial process.

🔬 Histological Types

📚 Latest Research

2026-09-10

Ferroptosis, immune activation and MASH-related HCC.

Kuchay MS, et al

A new review published in Gut establishes a self-amplifying, bidirectional ferroptosis–immune axis in metabolic dysfunction-associated steatohepatitis (MASH) as a critical driver of hepatocellular carcinoma (HCC) development, anchored by a novel four-gene transcriptomic signature — FABP4, CAPG, QSOX1, and FXN — that maps the transition from early metabolic stress to advanced structural liver remodelling. Ferroptotic rupture of parenchymal liver cells releases damage-associated molecular patterns that activate myeloid cells and trigger pro-inflammatory cytokine release, which in turn induces Kupffer cell ferroptosis, creating a pathological feedback loop further amplified by inherited polymorphisms in PNPLA3, TM6SF2, and MBOAT7. The DTL-PROX1 axis encodes sex-specific differences in iron accumulation rates and lipid peroxidation sensitivity, enabling precise patient stratification strategies. The authors argue that therapeutically targeting this ferroptosis–immune axis offers a specific window to arrest lipotoxicity, suppress inflammation, and disrupt oncogenic priming before irreversible tissue remodelling occurs.

Gut

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2026-09-10

Ultrasound Molecular Imaging and Visualization of Immune Biomarkers: A New Paradigm for Tumor Immunotherapy Response Assessment.

Zhang Q, et al

A systematic review published in Ultrasound in Medicine & Biology establishes ultrasound molecular imaging (USMI) as a promising non-invasive tool for real-time visualization of immune biomarkers within the tumor immune microenvironment, with dedicated pre-clinical evidence across hepatocellular carcinoma, melanoma, non-small cell lung cancer, colorectal cancer, and breast cancer. The authors demonstrate that immune-targeted microbubble and nanobubble probes can dynamically track immune cell infiltration, quantitatively map checkpoint expression, and differentiate pseudoprogression and hyperprogression from true tumor progression — critical limitations of current RECIST-based anatomical assessment. Compared with PET-CT and MRI, USMI offers radiation-free, low-cost, high spatiotemporal-resolution, and repeatable whole-tumor surveillance, though translational bottlenecks including probe off-target binding, absent standardized quantitative pipelines, and deep-tissue ultrasound attenuation must be resolved before clinical adoption. The review proposes theranostic probe engineering, multi-omics integration, and standardized multi-center clinical trials as the forward path for bringing USMI into routine immunotherapy monitoring.

Ultrasound in medicine & biology

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2026-09-08

Pachymic acid exhibits synergistic antitumor efficacy with lenvatinib in hepatocellular carcinoma by targeting PPARγ to inhibit glycolysis.

Wang Z, et al

Researchers have demonstrated that pachymic acid, a natural compound, synergistically enhances the antitumor efficacy of lenvatinib — a first-line drug for hepatocellular carcinoma (HCC) — by targeting the PPARγ receptor to suppress aerobic glycolysis in cancer cells. In laboratory experiments, combining pachymic acid with lenvatinib reduced cancer cell survival to 33.3% compared to 53.3% with lenvatinib alone (p < 0.001), and in mouse tumour models, the combination group showed significantly smaller tumours (357.5 mm³ versus 483.0 mm³ with lenvatinib alone, p < 0.01). Pachymic acid alone markedly inhibited HepG2 cell proliferation, reducing glucose consumption from 5.3 to 3.4 µmol/L and lactate production from 0.7 to 0.3 µmol/L (both p < 0.001), confirming its role in disrupting the metabolic activity that fuels tumour growth. These findings suggest that combining pachymic acid with lenvatinib could offer a promising strategy to overcome lenvatinib resistance in liver cancer patients.

Medical oncology (Northwood, London, England)

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