2-folds, reaching values below the cirrhosis cut-off (11.8 kPa) in a proportion of selleck chem inhibitor patients who maintained evidence of cirrhosis. This observation may explain the worse diagnostic performance of FS in treated versus untreated patients. Altogether, these data indicate the non-linear correlation between the kinetics of LS and histological staging during antiviral treatment. Applications This study suggests that LS provides a useful non-invasive tool to monitor not only fibrosis, but overall liver disease in the chronic HBV carrier. In monitoring CHB patients, LS appears useful to highlight major changes of liver disease and to warrant a more appropriate timing for control liver biopsies.

Terminology HBV-inactive carriers mean chronic HBV infection without liver damage caused by HBV, characterized by low HBV-DNA serum levels, persistently normal ALT and undetectable levels of IgM anti-HBc, a marker of HBV-induced liver disease (below the cut-off for CHB). Biochemical remission means transient ALT normalization (spontaneous or induced by antiviral treatment) in patients with CHB. Peer review In this study, authors perform a cross-sectional and longitudinal analysis of LS in HBV carriers, correlating this variable with stage of disease, liver inflammation and other factors that could influence FS measurements. They found a good diagnostic accuracy to detect cirrhosis and fibrosis higher than S3. The work is well performed and conclusions are correctly sustained.

Footnotes Supported by Educational grants from the Italian Ministry of Health, ��ERASMO�� 2005 Peer reviewer: Juan Ram��n Larrubia, PhD, Gastroenterology Unit and Liver Research Unit, Guadalajara University Hospital, University of Alcal��, Guadalajara 19002, Spain S- Editor Li DL L- Editor Roberts SE E- Editor Lin YP
Adenocarcinoma of the pancreas remains one of the most difficult malignancies to treat. The incidence has steadily increased over the past four decades (Gudjonsson, 1987), and its prognosis is still dismal, despite tremendous efforts in early diagnosis and therapy. The 5-year survival rate is less than 5% with a complete surgical resection (Gudjonsson, 1987), ranking this cancer fourth among the leading causes of cancer death (Parker et al, 1996). Unfortunately, at the time of diagnosis, the majority of patients (80�C90%) have locally or metastatic inoperable tumours.

Radiation therapy (RT) alone or in combination with chemotherapy showed modest efficacy in local control AV-951 and palliation (Andre et al, 2000; Kornek et al, 2000; Azria et al, 2002). Despite these intensive efforts to improve the efficacy of conventional therapy, no satisfactory progress in dealing with this cancer has been made. Accordingly, new treatment modalities are required for this tumour. Current interest has focused on biological response modifiers as antineoplastic agents.