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

Abstract

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.

A retrospective discussion of the prognostic value of combining prothrombin time(PT) and fibrinogen(Fbg) in patients with Hepatocellular carcinoma

“…And the associations between coagulation system and cancer have been frequently studied 16 . First of all, many studies have demonstrated that coagulation system has an effect on the solid tumors, such as ESCC 10 , penile cancer 17 , HCC 18 , lung cancer 11 and so on. Secondly, hematological system diseases have been reported related to this 19 , 20 .…”

Detection of Epstein Barr Virus in Hepatocellular Carcinoma Patients in Suez Canal Region: A Case-Control Study

“…Moreover, we found that prothrombin time and INR values were higher in HCC and CLD groups than controls, while no difference between HCC and CLD groups was noticed. When predicting the prognosis of cancers, coagulation parameter may be used, as solid tumors such as HCC are affected by the coagulation system (26) . A study by Goa et al (26) found that prothrombin time was higher in HCC patients than non-HCC patients.…”

“…When predicting the prognosis of cancers, coagulation parameter may be used, as solid tumors such as HCC are affected by the coagulation system (26) . A study by Goa et al (26) found that prothrombin time was higher in HCC patients than non-HCC patients. A prolonged prothrombin time indicates the liver's potential for biosynthesis.…”