Fibrosis-4 index, a predictor for prognosis of hepatocellular carcinoma patients after curative hepatectomy even in hepatitis B virus dominant populations

Abstract

Purpose Liver fibrosis plays an important role in the development of hepatocellular carcinoma (HCC) and determining its prognosis. Although many staging systems and liver reserve models have been developed without the intention of predicting prognosis of HCC, some studies have investigated their prognostic values in HCC after curative liver resection (LR). The aim of this study is to evaluate prognostic value of non-invasive biomarkers after curative LR. Methods Between 2006 and 2013, HCC patients underwent LR were included and total 962 patients were enrolled. All non-invasive biomarkers (fibrosis 4 index (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), AAR-to-platelet ratio index (AARPRI), and albumin-bilirubin (ALBI) score) were measured at the time of HCC diagnosis. To binarize each biomarker, an optimal cut-off value for fibrosis stage was selected using the value of minimum distance from the left-upper corner of the receiver operating characteristic curve with a specificity >60%. We performed Cox regression analysis on 2-year recurrence-free survival (RFS) and overall survival (OS). Results The area under curve values for FIB-4 and APRI were the largest for fibrosis stage compared to other biomarkers, 0.669 (95% confidential interval (CI), 0.610–0.719) and 0.748 (95% CI, 0.692–0.800), respectively. Between those two indices, FIB-4 is considered a statistically significant prognostic factor of RFS in HCC patients after LR. The HR for 2-year RFS and OS were 1.81 (95% CI, 1.18–2.77; P = 0.007) and 2.36 (95% CI, 0.99–5.65; P = 0.054), respectively. Conclusion FIB-4 is identified as a statistically significant predictor of HCC prognosis after curative LR even in HBV dominant populations.

Novel serum biomarker of Golgi protein 73 for the diagnosis of clinically significant portal hypertension in patients with compensated cirrhosis

“…We looked forward to verifying that differences in GP73 expression might also correlate with the liver function status of the enrollees, so the MELD and Child‐Pugh score, which reflects the function of liver reserve, was calculated based on the above data. AAR = AST/ALT; ALBI = 0.66 × log 10 bilirubin (µmol/L)‐0.085 × albumim (g/L) 17 . Serum GP73 level was quantitatively measured by chemiluminescence immunoassay kits.…”

“…AAR = AST/ALT; ALBI = 0.66 × log 10 bilirubin (µmol/L)-0.085 × albumim (g/L). 17 Serum GP73 level was quantitatively measured by chemiluminescence immunoassay kits. The operation procedure is carried out in strict accordance with the manufacturer's protocol.…”

Liver resection in selective hepatocellular carcinoma with Vp3 or Vp4 portal vein tumor thrombosis improves prognosis

“…The surveillance protocol post-surgery at our center has been previously described. 12 , 13 Abdominal computed tomography (CT) was conducted every 3 months or when recurrence was suspected. Magnetic resonance imaging and/or positron emission tomography scans were used if CT could not definitively detect recurrence.…”