每週自動更新 · AI 整理
腸胃肝膽健康・醫學週報
整合台灣熱門醫學新聞與頂尖期刊（NEJM・Lancet）肝・膽・胃・腸・減重・代謝領域最新研究，每週自動更新
本週熱門
台灣醫學新聞 TOP 5
日本推理大師東野圭吾大腸癌病逝 醫籲：大腸癌早期常無症狀，定期篩檢別輕忽
日本知名作家東野圭吾傳因大腸癌病逝，享壽67歲。醫師提醒大腸癌早期幾乎無症狀，呼籲符合資格民眾定期接受糞便潛血與大腸鏡篩檢，及早發現瘜肉並切除可有效降低惡化風險。
2026台灣消化系內視鏡醫學會年會7/25-26登場 國內外專家齊聚
2026台灣消化系內視鏡醫學會年會於7月25至26日舉行，邀集美、日內視鏡醫學會會長等重量級學者，聚焦大腸癌篩檢、胃癌防治與內視鏡數位轉型，並示範TIF等創新技術與實作課程。
5月健保新制上路 7大救命藥納給付 癌症病友最高年省216萬
健保5月起將7項救命新藥納入給付，涵蓋多種癌症與罕見疾病治療，估計癌症病友最高一年可省下逾200萬元自費負擔，減輕重症家庭經濟壓力。
2026癌症論壇 專家揭露癌症最新延命、續命策略
2026癌症論壇中，專家分享多發性骨髓瘤四合一標靶治療可望維持逾6年、降低45%死亡風險；肝癌則以免疫治療為第一線，合併質子治療可將兩年存活率由53%提升至77%。
抗癌預算加碼至68億 衛福部打造「健康台灣」拚2030癌症死亡率降1/3
衛福部宣布抗癌相關預算加碼至68億元，攜手民間推動「健康台灣」計畫，強化癌症篩檢與新藥可近性，目標於2030年將癌症標準化死亡率降低三分之一。
頂尖期刊
NEJM 近期研究
A Phase 3 Trial of Semaglutide in Metabolic Dysfunction–Associated Steatohepatitis
In a phase 3 trial, once-weekly semaglutide 2.4 mg in patients with biopsy-confirmed MASH and F2-F3 fibrosis produced significantly higher rates of MASH resolution without worsening of fibrosis, and improved fibrosis, versus placebo, alongside weight loss and cardiometabolic benefits.
第三期試驗顯示，每週一次 semaglutide 2.4 mg 治療 F2–F3 纖維化的 MASH 患者，相較安慰劑顯著提高脂肪肝炎緩解率、改善肝纖維化且不惡化，同時帶來體重下降與心血管代謝改善，為 MASH 藥物治療的重要里程碑。
Efruxifermin in Compensated Liver Cirrhosis Caused by MASH
Efruxifermin, a long-acting FGF21 analogue, was evaluated in patients with compensated cirrhosis (F4) due to MASH. A significantly greater proportion of treated patients achieved at least one-stage improvement in fibrosis than placebo, supporting FGF21-based therapy in advanced fibrotic liver disease.
Efruxifermin 為長效 FGF21 類似物，用於 MASH 造成之代償性肝硬化（F4）患者。試驗顯示相較安慰劑，能顯著提高「至少改善一級肝纖維化」的比例，為晚期肝纖維化與肝硬化提供新的藥物治療方向。
Noninvasive Assessment of Liver Fibrosis
This review summarizes noninvasive tools for assessing liver fibrosis, including serum-based scores such as FIB-4 and elastography (VCTE, MRE). It outlines a sequential testing strategy to risk-stratify patients with MASLD, reduce unnecessary biopsies, and guide referral of those at risk of advanced fibrosis.
本篇綜述整理肝纖維化非侵入性評估工具，包括血清指標（如 FIB-4）與彈性造影（VCTE、MRE），並提出分階段檢測策略，用於 MASLD 患者風險分層、減少不必要的肝切片，並協助辨識需轉診的晚期纖維化高風險族群。
頂尖期刊
Lancet 近期研究
The glucagon and GLP-1 receptor dual agonist DD01 for MASLD and steatohepatitis (DD01-DN-02): 12-week phase 2 results
In a phase 2, randomised, double-blind, placebo-controlled trial, the liver-targeted glucagon/GLP-1 receptor dual agonist DD01 significantly reduced liver fat content over 12 weeks in participants with MASLD/MASH, with improvements in liver enzymes and metabolic parameters and an acceptable safety profile.
第二期隨機雙盲安慰劑對照試驗顯示，肝臟標靶的升糖素／GLP-1 雙受體促效劑 DD01 治療 12 週，可顯著降低 MASLD/MASH 患者肝臟脂肪含量，並改善肝功能指標與代謝參數，安全性可接受，為脂肪肝新藥再添選擇。
Semaglutide with or without zalfermin in participants with fibrosis and cirrhosis due to MASH
In a phase 2 trial of participants with advanced MASH including compensated cirrhosis, semaglutide improved liver fibrosis without worsening inflammation, even in early cirrhosis. Adding the FGF21 analogue zalfermin did not significantly outperform placebo, but findings support GLP-1 therapy in advanced fibrotic MASH.
針對晚期 MASH（含代償性肝硬化）患者的第二期試驗顯示，semaglutide 能改善肝纖維化且不惡化發炎，即使早期肝硬化亦然；併用 FGF21 類似物 zalfermin 未顯著優於安慰劑。結果支持 GLP-1 藥物用於晚期纖維化 MASH 患者。
頂尖期刊
JAMA 近期研究
Dapagliflozin and Acute Kidney Injury Following Cardiac Surgery: A Randomized Clinical Trial
Acute kidney injury affects 2%-50% of patients after elective cardiac surgery, with no established preventive medication. This randomized clinical trial evaluated whether initiating the SGLT2 inhibitor dapagliflozin before elective cardiac surgery reduces postoperative acute kidney injury.
選擇性心臟手術後急性腎損傷（AKI）發生率高達 2–50%，目前缺乏有效預防藥物。此隨機臨床試驗評估術前開始使用 SGLT2 抑制劑 dapagliflozin，是否能降低心臟手術後 AKI 的發生，為 SGLT2i 於此情境提供臨床證據。
Finerenone in Patients With Chronic Kidney Disease Due to Glomerular Diseases: A Randomized Clinical Trial
Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, reduces kidney function loss in CKD, but its effect in CKD due to glomerular diseases was unknown. This randomized clinical trial assessed the efficacy and safety of finerenone in reducing albuminuria and kidney function decline in this population.
非類固醇礦物皮質素受體拮抗劑 finerenone 已知能降低 CKD 腎功能惡化風險，但對腎絲球疾病所致 CKD 的效果尚不明。此隨機臨床試驗評估 finerenone 在此族群減少蛋白尿與腎功能惡化的療效與安全性。
Weight Loss in Older Patients With Persistent Atrial Fibrillation: The LOSE-AF Randomized Clinical Trial
Excess body weight is a strong risk factor for atrial fibrillation, and weight loss is recommended for patients with obesity and AF. Because existing evidence derives from younger patients and weight loss in older adults could precipitate frailty, LOSE-AF evaluated structured weight loss in older patients with persistent AF.
過重是心房顫動的重要危險因子，指引建議肥胖合併 AF 者減重，但既有證據多來自年輕族群，老年人減重恐引發衰弱。LOSE-AF 試驗評估老年持續性 AF 患者接受結構化減重對心律與健康結果的影響。
An AI-Based OCT System to Detect Diabetic Macular Edema: A Prospective Validation and Noninferiority Randomized Clinical Trial
Diabetic retinopathy screening with fundus photographs is standard but yields many false-positive referrals for diabetic macular edema (DME). This prospective validation and noninferiority randomized trial evaluated an AI-based optical coherence tomography (OCT) system to detect DME and reduce unnecessary specialist referrals.
糖尿病視網膜病變以眼底攝影篩檢為全球標準，但常導致大量偽陽性、增加眼科轉診負擔。此前瞻性驗證與非劣性隨機試驗評估整合 AI 的光學同調斷層掃描（OCT）系統偵測糖尿病黃斑部水腫，以減少不必要的專科轉診。
頂尖期刊
Gastroenterology 近期研究
AI-Assisted Risk Stratification in Stage II Colorectal Cancer: Multi-Institutional Validation of Semantically-Enhanced Deep Learning
Researchers developed SEMIL, integrating vision-language foundation models with multiple instance learning for automated invasive-front assessment from H&E slides in stage II colorectal cancer. Across 1,608 slides in three cohorts, SEMIL outperformed non-semantic methods and independently stratified prognosis, including within guideline-defined high-risk patients.
第二期大腸癌是否需輔助化療取決於復發風險評估。研究者開發結合視覺-語言基礎模型的深度學習系統 SÉMIL，自 H&E 病理切片自動評估腫瘤侵襲前緣。於 1608 張切片、三世代驗證中，其預後分層能力優於傳統方法，並在指引定義高風險族群中維持一致表現。
Serotonergic signaling in gastric physiology and motility disorders
This review synthesizes the role of serotonin (5-HT) in gastric sensorimotor function and motility disorders. 5-HT4 agonists are the most guideline-supported agents for gastroparesis, while newer, more selective agents such as naronapride may offer benefit with lower cardiovascular risk than older drugs like cisapride.
血清素（5-HT）是腸胃功能重要調節者。本綜述整理 5-HT 在胃感覺運動功能與腸神經發育的角色，及其在胃輕癱、功能性消化不良等動力障礙的病理與治療意義。5-HT4 促效劑最受指引支持，新藥 naronapride 等更具選擇性、心血管風險較低。
AGA Clinical Practice Update on Management of Clostridioides difficile Infection in Inflammatory Bowel Disease: Expert Review
Clostridioides difficile infection (CDI) drives flares and poor outcomes in inflammatory bowel disease (IBD), which carries higher CDI risk, severity, and recurrence. This AGA expert review provides 12 best-practice statements on diagnosis, antibiotic choice (prefer fidaxomicin, avoid metronidazole), continuing immunosuppression, and microbiome-based therapies.
困難梭菌感染（CDI）是發炎性腸病（IBD）病情惡化與不良預後的重要因素，IBD 患者的 CDI 風險、嚴重度與復發率均較高。AGA 專家更新提供 12 項最佳實務建議，涵蓋診斷、抗生素選擇（優先 fidaxomicin、避免 metronidazole）、持續免疫治療與微生物相療法。
Epithelial FOXP3 Orchestrates O-Glycosylated IL6 Secretion to Drive Pancreatic Fibrocarcinogenesis
In human tissues and mouse models, the transcription factor FOXP3 in precancerous pancreatic epithelium transactivated GALNT1, driving O-glycosylation and secretion of IL6, which engaged gp130 on stellate cells to fuel a self-reinforcing fibrotic loop. A fasting-mimicking diet suppressed this axis and ameliorated fibrosis.
胰臟纖維化是胰臟癌治療抗性與器官衰竭的特徵。研究發現前癌病灶上皮細胞內的轉錄因子 FOXP3 透過活化 GALNT1、促進 IL6 的 O-醣基化與分泌，經 gp130 啟動星狀細胞的正回饋纖維化。模擬禁食飲食可抑制此路徑，為早期攔截胰臟纖維化癌變提供標靶。
頂尖期刊
Hepatology 近期研究
Implications of new obesity definitions in the classification and outcomes of patients with MASLD
Among 12,583 patients with MASLD, applying EASO and Lancet Commission obesity definitions reclassified 20%-34% of non-BMI-obese patients as obese, but these groups did not have higher liver-related event risk than non-obese counterparts. Risk rose only as waist-to-height ratio approached 0.6.
以 12583 名 MASLD 患者分析 BMI、EASO 及 Lancet 委員會三種肥胖定義。新定義將 20–34% 原本非肥胖者重新歸類為肥胖，但這些新歸類族群的肝臟相關事件風險並未升高；僅當腰高比接近 0.6 時風險才明顯增加，顯示新定義未優於單用 BMI。
Context-dependent STAT3 signaling in liver fibrosis
STAT3 is a signaling hub integrating inflammatory, metabolic, and fibrogenic signals, translated through post-translational modifications, epigenetics, and metabolic reprogramming into cell-specific phenotypes. Evidence most supports a pro-fibrotic role in hepatic stellate cells; context-matched STAT3 modulation may inform future anti-fibrotic strategies.
STAT3 是整合發炎、代謝與纖維化訊號的樞紐，透過轉錄後修飾、表觀遺傳與代謝重塑呈現細胞特異性表現。本綜述指出 STAT3 活化在肝星狀細胞多具促纖維化作用，並探討情境匹配式 STAT3 調控作為抗纖維化策略的挑戰與前景。
Head-to-head comparison between vibration-controlled transient elastography and histology in predicting liver-related events due to MASLD
In 3,532 MASLD patients with both liver stiffness measurement (LSM) by vibration-controlled transient elastography and biopsy, 3.6% developed liver-related events over 56.6 months. LSM and histology showed comparable prognostic performance (5-year AUROC 0.870 vs 0.869), supporting LSM as a noninvasive surrogate endpoint.
3532 名同時接受肝彈性造影（VCTE）與肝切片的 MASLD 患者中，追蹤 56.6 個月共 3.6% 發生肝臟相關事件。VCTE 的肝硬度測量與組織學預後能力相當（5 年 AUROC 0.870 vs 0.869），顯示非侵入性 VCTE 可作為臨床試驗的替代終點。
Development and validation of a noninvasive score for at-risk MASH in individuals with obesity
At-risk metabolic dysfunction-associated steatohepatitis (MASH) elevates liver-related and all-cause mortality. Using routine clinical indicators, investigators developed and validated a noninvasive score to identify at-risk MASH in individuals with obesity, supporting earlier screening and referral, including in the bariatric setting.
高風險 MASH 會提高肝臟相關與全因死亡風險。研究以常規臨床指標開發並驗證一套非侵入性評分，用於辨識肥胖族群中的高風險 MASH 患者，協助在減重手術等情境下及早篩檢與轉介。
主題專區
糖尿病・代謝 近期研究
Effects of time-restricted eating on markers of glucose metabolism in individuals with prediabetes or type 2 diabetes: a systematic review and meta-analysis
This systematic review and meta-analysis investigated the effects of time-restricted eating (TRE) on glucose metabolism and regulation in individuals with prediabetes or type 2 diabetes, pooling trials to assess changes in fasting glucose, HbA1c, and related markers, providing evidence for time-based dietary intervention.
此系統性回顧與統合分析探討限時進食（TRE）對前期糖尿病或第二型糖尿病者葡萄糖代謝與調控的影響，綜合多項試驗評估其對空腹血糖、HbA1c 等指標的改善效果，為以時間為基礎的飲食介入提供實證依據。
Acute mild cold exposure with shivering reduces 24 h glucose levels in individuals with type 2 diabetes but not prediabetes
This study assessed the acute effects of mild cold exposure with shivering on glucose homeostasis in metabolically compromised individuals. Twenty-four-hour glucose levels fell significantly in people with type 2 diabetes but not in those with prediabetes, suggesting cold-induced energy expenditure more strongly affects established diabetes.
研究評估急性寒冷伴顫抖對代謝異常者葡萄糖恆定的影響。結果顯示第二型糖尿病患者在寒冷顫抖後 24 小時血糖顯著下降，但糖尿病前期族群則無此效果，提示寒冷誘發的能量消耗對已確診糖尿病者的血糖代謝作用較明顯。
Sleep Optimization to Improve Glycemic Targets in Adults With Type 1 Diabetes: A Randomized Controlled Parallel Intervention Trial
This randomized controlled trial compared a sleep intervention (Sleep-Opt) with an attention control (Healthy Living) in adults with type 1 diabetes who had short or irregular sleep, evaluating effects on glycemic targets and psychological outcomes and highlighting the role of sleep management in diabetes care.
此隨機對照試驗比較睡眠介入（Sleep-Opt）與注意力對照（健康生活）對睡眠不足或不規律的第一型糖尿病成人之影響，評估睡眠優化對血糖達標與心理健康結果的助益，凸顯睡眠管理在糖尿病照護中的角色。
主題專區
慢性腎臟病（CKD） 近期研究
ISN International Expert Forum: Exploring the Nexus of Cardiovascular-Kidney-Metabolic (CKM) Health
The cardiovascular-kidney-metabolic (CKM) framework recognizes interconnected drivers of cardiovascular disease, CKD, diabetes, and obesity. This ISN international expert forum synthesizes CKM risk stratification, lifestyle interventions, guideline-directed therapies, and emerging treatments, emphasizing early integrated case-finding while highlighting gaps such as therapeutic inertia and fragmented care.
心臟-腎臟-代謝（CKM）架構整合心血管病、慢性腎病、糖尿病與肥胖的相互驅動因子。國際腎臟學會專家論壇綜整 CKM 風險分層、生活型態介入、指引導向治療與新興療法，強調早期整合式篩檢與長期心腎風險評估，並點出治療惰性與照護分散等落差。
Sodium-Glucose Cotransporter 2 Inhibitors in Patients with Primary Aldosteronism
In 24,074 patients with primary aldosteronism treated with mineralocorticoid receptor antagonists, adding an SGLT2 inhibitor was associated after matching with lower three-year all-cause mortality (12% vs 18%) and significantly reduced major adverse cardiovascular and kidney events, supporting this combined cardiorenal-protective strategy.
台大團隊分析 24074 名原發性醛固酮增多症（PA）患者，發現在礦物皮質素受體拮抗劑（MRA）基礎上加用 SGLT2 抑制劑，經配對後三年全因死亡率由 18% 降至 12%，並顯著降低主要心血管與腎臟不良事件，支持此組合改善 PA 患者長期預後。
Validation of the PREVENT Equations in a CKD Population: A Nationwide Veterans Analysis
In a large CKD population, the AHA PREVENT equations showed overall c-indices of 0.651 (CVD), 0.633 (ASCVD), and 0.673 (HF), declining with advancing kidney disease. PREVENT-ASCVD calibrated better than the older Pooled Cohort Equations, and albuminuria add-on equations improved discrimination in earlier CKD.
研究於大型 CKD 族群驗證美國心臟協會 PREVENT 心血管風險方程式。整體 c-index：CVD 0.651、ASCVD 0.633、HF 0.673，隨腎功能惡化而下降；PREVENT-ASCVD 校準優於舊有 PCE。加入尿白蛋白指標可提升較早期 CKD 的鑑別度。
歷史紀錄