Background and Aim: The histological diagnosis of autoimmune hepatitis (AIH) is challenging. A new consensus recommendation was provided by the International AIH Pathology Group to address the problems in the histological diagnosis. The purpose of this study is to compare the 2008 ‘simplified’ criteria for AIH with the ‘consensus recommendation’ of 2022 in terms of diagnostic sensitivity. Materials and Methods: A retrospective analysis was conducted on pathological specimens of patients diagnosed with Autoimmune Hepatitis (AIH) between 2010 and 2022. Out of 188 patients enlisted, 88 were selected based on exclusion criteria. The specimens were examined by two experienced hepatopathologists and a resident pathologist. All specimens were analyzed using both the “simplified” criteria and the new consensus recommendations. Results: Out of a total of 78 patients, the 2022 consensus recommendations raised the diagnostic category of 16 patients (20.5%) to a higher level. Six patients who were previously diagnosed as “atypical” were now considered “possible AIH”, while 10 patients with a “compatible” diagnosis were elevated to “likely AIH” category. No patients were found to fall into a lower diagnostic category according to the new recommendations. A significant difference in diagnostic sensitivity was observed between the 2008 criteria and the 2022 consensus report (p

Background/Objectives: Gastric intestinal metaplasia (GIM) is a recognized premalignant condition for gastric cancer (GC), but long-term outcomes and predictors of progression remain incompletely understood. This study aimed to evaluate the progression of GIM and identify factors associated with malignant transformation. Methods: In this retrospective single-center study, 1204 adult patients with histologically confirmed GIM and at least 12 months of follow-up after esophagogastroduodenoscopy (EGD) were analyzed. Clinical and pathological variables, including GIM extent, Helicobacter pylori status, family history of GC, demographic factors, and residence in endemic regions, were assessed. Patients were stratified into high- and low-risk groups according to established criteria, and progression to GC or other neoplasms was recorded. Results: During a mean follow-up of 38.6 months, 49.1% of patients had no detectable GIM at the end of follow-up, 48.7% remained unchanged, and 2.2% showed disease progression. Among progressed cases, adenocarcinoma accounted for 66.7%, dysplasia for 29.6%, and SCC for 3.7%. Progression was significantly more common among males, older patients, and those with antrum + corpus involvement. The overall progression rate from GIM to adenocarcinoma was 1.5% (approximately 0.45% per patient-year). No significant difference in progression or survival was observed between high- and low-risk groups. Conclusions: The long-term malignant transformation rate of GIM is low. Male sex and extensive gastric involvement were associated with higher progression rates, while H. pylori was not predictive of malignant transformation. These findings support individualized surveillance strategies for patients with GIM, while routine surveillance of antrum-limited GIM may provide minimal benefit but increase healthcare burden.

Background/Aims: The International Autoimmune Hepatitis (AIH) Group recommends the new histological criteria (HC) (2022) and modified immunoserological testing for diagnosing AIH. The diagnostic utility of the 2022 HC was evaluated. The simplified criteria were also updated with the 2022 HC and immunoserological testing and assessed the diagnostic performance. Materials and Methods: The data of 207 patients (111 AIH, 33 primary biliary cholangitis, 35 drug-induced liver injury, and 28 metabolic dysfunction–associated fatty liver disease) were evaluated. Results: The 2022 HC and the 2008 simplified HC showed 95% vs. 88% sensitivity and 82% vs. 49% specificity for possible/compatible AIH. For likely/typical AIH, sensitivity was 60% vs. 42% and specificity was 98% vs. 95% for the 2022 HC and the 2008 HC, respectively. The area under the curve (AUC) was better for the 2022 HC than for the 2008 simplified HC (0.932 vs. 0.771, P < .001). The updated simplified criteria had a sensitivity comparable with the simplified criteria (88% vs. 87%) but a better specificity (94% vs. 80%) for prob able AIH. The sensitivity was slightly lower (57% vs. 63%), but the specificity was greater (97% vs. 89%) for definitive AIH. The AUC was higher in the updated simplified criteria than in the simplified criteria (0.959 vs. 0.894, P = .016). Conclusion: The 2022 HC showed better sensitivity and specificity than the 2008 simplified HC for AIH. The updated simplified criteria worked well with improved accuracy of AIH diagnosis. Our results suggest that the diagnostic algorithm of AIH should be modified based on recent recommendations. Cite this article as: Moral K, Efe C, Sert A, et al. Evaluation of histological criteria and immunoserological testing of simplified criteria for the diagnosis of autoimmune hepatitis. Turk J Gastroenterol. Published online September 18, 2025. doi: 10.5152/ tjg.2025.25402.

Chronic hepatitis B (CHB) remains a major cause of cirrhosis and hepatocellular carcinoma worldwide. Although liver biopsy is the reference standard for fibrosis staging, its limitations have prompted the development of noninvasive serum-based indices. This study aimed to compare aminotransferase-to-platelet ratio index (APRI), Fibrosis-4 index (FIB-4), Fibrosis-5 index (FIB-5), Fibrosis-6 index (FIB-6), and serum fibrozis indeksi (S-Index) with histology in patients with CHB. A total of 191 CHB patients who underwent liver biopsy between 2012 and 2024 were retrospectively analyzed. Fibrosis was staged using the METAVIR system and classified as non-significant (F0–F2) or significant (F3–F4). Serum-based fibrosis indices were calculated, and their diagnostic performance was assessed using receiver operating characteristic (ROC) analysis. Of the 191 patients, 75 (39.3%) had significant fibrosis (SF). APRI, FIB-4, FIB-6, and S-Index were significantly higher in patients with SF, whereas FIB-5 showed no discriminatory value. ROC analysis demonstrated modest accuracy overall: APRI (area under the curve [AUC] 0.661) provided the highest sensitivity but low specificity (88.0% and 38.8% respectively, P < .001), while FIB-4 (AUC 0.601, specificity 86.2% sensitivity 37.3%, P = .019) and FIB-6 (AUC 0.608, specificity 87.1%, sensitivity 44%, P = .014) were more specific but less sensitive. S-Index showed intermediate performance (AUC 0.601, specificity 62.07% sensitivity 58.67%, P = .021). Serum-based indices demonstrated limited but clinically relevant ability to discriminate SF in CHB, with modest AUC values. Despite their suboptimal diagnostic accuracy, their noninvasive, low-cost, and accessible nature supports their potential role in clinical practice. APRI showed high sensitivity but low specificity, limiting its standalone screening utility. FIB-4 and FIB-6 displayed relatively balanced performance, while S-Index showed modest but consistent accuracy. Overall, these scores may serve as adjunctive tools rather than definitive diagnostic methods and could have a role in longitudinal monitoring. Further validation in larger, multicenter prospective studies is warranted.

Duodenum divertiküllerinn tahmini insidansı %15-22 arasındadır ve büyük çoğunluğu asemptomatiktir.Duodenum divertikülleri kolondan sonra divertiküllerin en sık görüldüğü ikinci yerdir. Konjenital ve edinilmiş olmak üzere 2 tipi vardır. Konjenital divertiküller son derece nadir görülür ve bağırsak duvarının tüm katmanlarından oluşmaktadır. En sık görülen tip, yalnızca mukus ve seröz katmanlar içeren sekonder edinilmiş psödodivertiküllerdir. Hastların sadece yaklaşık %5’inde divertikülit veya perforasyon/kanama nedeniyle epigastrik ağrı, bulantı ve kusma gibi semptomlar gösterebilir. 1cm’den büyük olan hastalar veya divertikülü periampuller yerleşimli hastaların çeşitli komorbidite ve komplikasyonlarla semptomatik olarak ortaya çıkma ihtimalleri daha yüksektir. Komplikasyonları divertikülit, kanama, perforasyon, pankreatit ve safra obstrüksiyonudur: Tanıda seçilecek ilk yöntem Bilgisayarlı Tomografidir. Asemptomatik hastalarda herhangi bir tedavi önerilmemektedir. Perforasyon vakalarında konservatif tedavi nazogastrik dekompresyon ve geniş spektrumlu antibiyotik tedavisini içerir.