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Diagnostic performance of non-invasive liver fibrosis scores in patients with early-intermediate hepatocellular carcinoma

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Název: Diagnostic performance of non-invasive liver fibrosis scores in patients with early-intermediate hepatocellular carcinoma
Autoři: Schrecker, Christopher, Schulze, Falko, Trojan, Jörg, Bechstein, Wolf Otto, Zeuzem, Stefan, Koch, Christine
Zdroj: J Cancer Res Clin Oncol
Informace o vydavateli: Springer Science and Business Media LLC, 2024.
Rok vydání: 2024
Témata: Liver Cirrhosis, Cirrhosis, Liver Cirrhosis/diagnosis [MeSH], FIB-4, Liver Neoplasms/diagnosis [MeSH], Research, Humans [MeSH], Carcinoma, Hepatocellular/diagnosis [MeSH], APRI, Retrospective Studies [MeSH], Fibrosis, HCC, 03 medical and health sciences, Carcinoma, Hepatocellular, 0302 clinical medicine, Liver Neoplasms, Humans, Retrospective Studies
Popis: Purpose Hepatocellular carcinoma (HCC) arises in individuals with underlying liver disease. Diagnosing the degree of hepatic fibrosis helps to determine the severity of the underlying liver disease and may influence therapeutic decisions in HCC patients. Non-invasive fibrosis scores can be used to estimate the degree of fibrosis in liver disease patients, but most of these scores were developed in patients with viral hepatitis and without HCC. This study explored the ability of the Fibrosis-4 Index (FIB-4), the AST/Platelet Ratio Index (APRI), and the AST/ALT ratio to diagnose or exclude advanced fibrosis (METAVIR F3/4 versus F0-2) in patients with early-intermediate, potentially resectable HCC. Methods We retrospectively reviewed 119 patients who underwent hepatic resection for HCC at a tertiary centre (2007–2019), 75 of whom had advanced fibrosis (prevalence 63%). Histological assessment of the surgical liver specimen was used as a reference standard for the degree of fibrosis. Results Overall diagnostic performance was highest for the FIB-4 Index, with an area under the receiver operating characteristic curve (AUROC) of 0.82, compared with 0.78 for APRI, and 0.56 for the AST/ALT ratio. Using established cut-off values, FIB-4 achieved a 90% positive predictive value at the higher cut-off (3.25) and a 90% negative predictive value at the lower cut-off (1.45). Conclusion The FIB-4 Index could reliably diagnose or exclude advanced fibrosis in patients with early-intermediate HCC, and may thus have a role in guiding therapeutic decisions in these patients.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1432-1335
DOI: 10.1007/s00432-024-05708-3
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/38602548
https://repository.publisso.de/resource/frl:6499020
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....d67f6e9d405ecb5ffb2bc8c518d8c2e6
Databáze: OpenAIRE
Popis
Abstrakt:Purpose Hepatocellular carcinoma (HCC) arises in individuals with underlying liver disease. Diagnosing the degree of hepatic fibrosis helps to determine the severity of the underlying liver disease and may influence therapeutic decisions in HCC patients. Non-invasive fibrosis scores can be used to estimate the degree of fibrosis in liver disease patients, but most of these scores were developed in patients with viral hepatitis and without HCC. This study explored the ability of the Fibrosis-4 Index (FIB-4), the AST/Platelet Ratio Index (APRI), and the AST/ALT ratio to diagnose or exclude advanced fibrosis (METAVIR F3/4 versus F0-2) in patients with early-intermediate, potentially resectable HCC. Methods We retrospectively reviewed 119 patients who underwent hepatic resection for HCC at a tertiary centre (2007–2019), 75 of whom had advanced fibrosis (prevalence 63%). Histological assessment of the surgical liver specimen was used as a reference standard for the degree of fibrosis. Results Overall diagnostic performance was highest for the FIB-4 Index, with an area under the receiver operating characteristic curve (AUROC) of 0.82, compared with 0.78 for APRI, and 0.56 for the AST/ALT ratio. Using established cut-off values, FIB-4 achieved a 90% positive predictive value at the higher cut-off (3.25) and a 90% negative predictive value at the lower cut-off (1.45). Conclusion The FIB-4 Index could reliably diagnose or exclude advanced fibrosis in patients with early-intermediate HCC, and may thus have a role in guiding therapeutic decisions in these patients.
ISSN:14321335
DOI:10.1007/s00432-024-05708-3