Autophagy is a catabolic process involved in cellular homeostasis under basal and stressed conditions. Autophagy is crucial for normal liver physiology and the pathogenesis of liver diseases. During the last decade, the function of autophagy in hepatocellular carcinoma (HCC) has been evaluated extensively. Currently, autophagy is thought to play a dual role in HCC, i.e., autophagy is involved in tumorigenesis and tumor suppression. Recent investigations of autophagy have suggested that autophagy biomarkers can facilitate HCC prognosis and the establishment of therapeutic approaches. In this review, we briefly summarize the current understanding of autophagy and discuss recent evidence for its role in HCC.

Young Sin Cho, Yoo Jin Lee, Jeong Eun Shin, Hye-Kyung Jung, Seon-Young Park, Seung Joo Kang, Kyung Ho Song, Jung-Wook Kim, Hyun Chul Lim, Hee Sun Park, Seong-Jung Kim, Ra Ri Cha, Ki Bae Bang, Chang Seok Bang, Sung Kyun Yim, Seung-Bum Ryoo, Bong Hyeon Kye, Woong Bae Ji, Miyoung Choi, In-Kyung Sung, and Suck Chei Choi,; the Korean Society of Neurogastroenterology and Motility. J Neurogastroenterol Motil 2023;29:271-305. https://doi.org/10.5056/jnm23066

Fibrosis is characterized by a proliferation of fibroblasts and excessive extracellular matrix following chronic inflammation, and this replacement of organ tissue with fibrotic tissue causes a loss of function. Inflammatory bowel disease (IBD) is a chronic inflammation of the gastrointestinal tract, and intestinal fibrosis is common in IBD patients, resulting in several complications that require surgery, such as a stricture or penetration. This review describes the pathogenesis and various factors involved in intestinal fibrosis in IBD, including cytokines, growth factors, epithelial-mesenchymal and endothelial-mesenchymal transitions, and gut microbiota. Furthermore, histopathologic findings and scoring systems used for stenosis in IBD are discussed, and differences in the fibrosis patterns of ulcerative colitis and Crohn’s disease are compared. Biomarkers and therapeutic agents targeting intestinal fibrosis are briefly mentioned at the end.

Lee YJ, et al. J Korean Med Sci. 2014 Sep;29(9):1247-1252. http://dx.doi.org/10.3346/jkms.2014.29.9.1247

Yonghoon Choi, Young Hoon Youn, Seung Joo Kang, Jeong Eun Shin, Young Sin Cho, Yoon Suk Jung, Seung Yong Shin, Cheal Wung Huh, Yoo Jin Lee, Hoon Sup Koo, Kwangwoo Nam, Hong Sub Lee, Dong Hyun Kim, Ye Hyun Park, Min Cheol Kim, Hyo Yeop Song, Sung-Hoon Yoon, Sang Yeol Lee, Miyoung Choi, Moo-In Park, and In-Kyung Sung; the Korean Society of Neurogastroenterology and Motility. J Neurogastroenterol Motil 2025;31:133-69. https://doi.org/10.5056/jnm25007

The presence of ulcer in early gastric cancer (EGC) is important for the feasibility of endoscopic resection, only a few studies have examined the clinicopathological implications of endoscopic ulcer in EGC. To determine the role of endoscopic ulcer as a predictor of clinical behaviors in EGC. Data of 3,270 patients with EGC who underwent surgery between January 2005 and December 2012 were reviewed. Clinicopathological characteristics were analyzed in relation to the presence and stage of ulcer in EGC. Based on endoscopic findings, the stage of ulcer was categorized as active, healing, or scar. Logistic regression analysis was performed to analyze factors associated with lymph node metastasis (LNM). 2,343 (71.7%) patients had endoscopic findings of ulceration in EGC. Submucosal (SM) invasion, LNM, lymphovascular invasion (LVI), perineural invasion, and undifferentiated-type histology were significantly higher in ulcerative than non-ulcerative EGC. Comparison across different stages of ulcer revealed that SM invasion, LNM, and LVI were significantly associated with the active stage, and that these features exhibited significant stage-based differences, being most common at the active stage, and least common at the scar stage. The presence of endoscopic ulcer and active status of the ulcer were identified as independent risk factors for LNM. Ulcerative EGC detected by endoscopy exhibited more aggressive behaviors than non-ulcerative EGC. Additionally, the endoscopic stage of ulcer may predict the clinicopathological behaviors of EGC. Therefore, the appearance of ulcers should be carefully evaluated to determine an adequate treatment strategy for EGC.