Diagnostic accuracy of APRI and FIB-4 for predicting hepatitis B virus-related liver fibrosis accompanied with hepatocellular carcinoma

Xiao, Guangqin; Zhu, Feng; Wang, Min; Zhang, Hang; Ye, Dawei; Yang, Jiayin; Jiang, Li; Liu, Chang; Yan, Lü-Nan; Qin, Renyi

doi:10.1016/j.dld.2016.06.001

Cited by 26 publications

(23 citation statements)

References 51 publications

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“…It has been revealed that there is a significant role of liver fibrosis on progression and metastasis of HCC, especially for patients who had comorbidity of HBV infection [20][21][22]. In the current study, we found the preoperative LSM value measured though FibroScan was an independent prognostic factor for HBV-related HCC patients.…”

Section: Discussionsupporting

confidence: 54%

Clinical Significance of Preoperative Liver Stiffness Measurements in Primary HBV-Positive Hepatocellular Carcinoma

Chen

Zhang

et al. 2017

Future Oncol.

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Aim: To analyze clinical significance of preoperative liver stiffness measurement (LSM) by FibroScan in postcurative resection hepatitis B virus (HBV) related hepatocellular carcinoma (HCC). Patients & methods:A total of 263 patients underwent preoperative LSM and curative operation for primary HBV-positive HCC were enrolled. The correlation between preoperative LSM and survival was analyzed. Results: All patients were stratified into two groups using the optimal cut-off value (13.2 kPa) of LSM using the receiveroperating characteristic. Patients with an LSM ≥13.2 kPa had poorer overall survival (median, 61.3 vs 48.2 months, hazard ratio: 0.15; p = 0.009) and recurrence-free survival (median, 60.4 vs 47.0 months; hazard ratio: 0.32; p = 0.011) than patients with an LSM <13.2 kPa and LSM also have been confirmed as independent predictor for survival for HCC. Discussion: This could potentially guide patient stratification and individualized treatment. Conclusion: Preoperative LSM can be considered as an independent prognostic factor for HBV-positive HCC after curative resection.

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Section: Discussionsupporting

confidence: 54%

Clinical Significance of Preoperative Liver Stiffness Measurements in Primary HBV-Positive Hepatocellular Carcinoma

Chen

Zhang

et al. 2017

Future Oncol.

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“…In the univariate analyses, the maximum tumor diameter, venous invasion, and MVD were determined as significant risk factors for lymph node metastasis in hindgut NET. The maximum tumor diameter and the presence of lymphovascular invasion are generally known as important predictive factors for any tumor [ 3 , 13 – 21 ]. However, results of our multivariate logistic regression analysis of lymph node metastasis revealed that the maximum tumor diameter alone was an independent predictor of lymph node metastasis, whereas lymphovascular invasion and MVD was not the predictor of lymph node metastasis.…”

Section: Discussionmentioning

confidence: 99%

Risk factors associated with the progression and metastases of hindgut neuroendocrine tumors: a retrospective study

Okubo¹,

Kasajima²,

Suzuki³

et al. 2017

BMC Cancer

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BackgroundThe worldwide incidence of neuroendocrine tumors (NETs) has increased remarkably, with the hindgut being the second most common site for such tumors. However, the mechanisms underlying progression and metastasis of hindgut NETs are unclear. A retrospective study was conducted to elucidate these mechanisms.MethodsClinicopathological data of cases of hindgut NET between April 1996 and September 2015 were analyzed, retrospectively. Patients with neuroendocrine carcinoma were excluded. Formalin-fixed paraffin-embedded tissues of hindgut NET cases were subjected to detailed morphometric and immunohistochemical analyses. Statistical analyses were performed using the non-parametric Mann-Whitney U test, Spearman’s correlation coefficient, and chi-squared test. Multivariate logistic regression analysis was conducted as appropriate for the data set.ResultsFifty-six hindgut NET cases were considered. Microvessel density and lymphatic microvessel density were identified as significant risk factors for venous and lymphatic invasion. There was a positive correlation between microvessel density and the maximum tumor diameter. Multivariate logistic regression analysis revealed that the maximum tumor diameter alone was an independent predictor of lymph node metastasis, whereas lymphovascular invasion and MVD was not the predictor of lymph node metastasis. There were no significant correlations between the Ki-67 labeling index and any of the parameters evaluated including age, sex, the maximum tumor diameter, venous invasion, lymphatic invasion, microvessel density, lymphatic microvessel density, and lymph node metastasis.ConclusionsAngiogenic mechanisms may play important roles in the progression of hindgut NET. Otherwise, the maximum tumor diameter alone was an independent predictor of lymph node metastasis in hindgut NETs. Moreover, our study raises the question of whether the presence of lymphovascular invasion, in endoscopically obtained hindgut NET tissues, is an absolute indication for additional surgery or not.

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“…However, some authors have reported that these models are not very robust for evaluating liver fibrosis in HBV-positive patients [8]. Our previous study demonstrated that the accuracy of APRI and FIB-4 for predicting liver fibrosis related by HBV was moderate, which was different from the results of the original articles [9,10]. Another novel model was established based on 372 chronic HBV infection patients [11].…”

Section: Introductionmentioning

confidence: 94%

Preoperatively staging liver fibrosis using noninvasive method in Hepatitis B virus-infected hepatocellular carcinoma patients

et al. 2016

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BackgroundAdvanced liver fibrosis can result in serious complications (even patient’s death) after partial hepatectomy. Preoperatively percutaneous liver biopsy is an invasive and expensive method to assess liver fibrosis. We aim to establish a noninvasive model, on the basis of preoperative biomarkers, to predict liver fibrosis in hepatocellular carcinoma (HCC) patients with hepatitis B virus (HBV) infection.MethodsThe HBV-infected liver cancer patients who had received hepatectomy were retrospectively and prospectively enrolled in this study. Univariate analysis was used to compare the variables of the patients with mild to moderate liver fibrosis and with severe liver fibrosis. The significant factors were selected into binary logistic regression analysis. Factors determined to be significant were used to establish a noninvasive model. Then the diagnostic accuracy of this novel model was examined based on sensitivity, specificity and area under the receiver-operating characteristic curve (AUC).ResultsThis study included 2,176 HBV-infected HCC patients who had undergone partial hepatectomy (1,682 retrospective subjects and 494 prospective subjects). Regression analysis indicated that total bilirubin and prothrombin time had positive correlation with liver fibrosis. It also demonstrated that blood platelet count and fibrinogen had negative correlation with liver fibrosis. The AUC values of the model based on these four factors for predicting significant fibrosis, advanced fibrosis and cirrhosis were 0.79-0.83, 0.83-0.85 and 0.85-0.88, respectively.ConclusionThe results showed that this novel preoperative model was an excellent noninvasive method for assessing liver fibrosis in HBV-infected HCC patients.

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Diagnostic accuracy of APRI and FIB-4 for predicting hepatitis B virus-related liver fibrosis accompanied with hepatocellular carcinoma

Cited by 26 publications

References 51 publications

Clinical Significance of Preoperative Liver Stiffness Measurements in Primary HBV-Positive Hepatocellular Carcinoma

Clinical Significance of Preoperative Liver Stiffness Measurements in Primary HBV-Positive Hepatocellular Carcinoma

Risk factors associated with the progression and metastases of hindgut neuroendocrine tumors: a retrospective study

Preoperatively staging liver fibrosis using noninvasive method in Hepatitis B virus-infected hepatocellular carcinoma patients

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