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

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Title: Diagnostic performance of non-invasive liver fibrosis scores in patients with early-intermediate hepatocellular carcinoma
Authors: Schrecker, Christopher, Schulze, Falko, Trojan, Jörg, Bechstein, Wolf Otto, Zeuzem, Stefan, Koch, Christine
Source: J Cancer Res Clin Oncol
Publisher Information: Springer Science and Business Media LLC, 2024.
Publication Year: 2024
Subject Terms: 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
Description: 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.
Document Type: Article
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Language: English
ISSN: 1432-1335
DOI: 10.1007/s00432-024-05708-3
Access URL: https://pubmed.ncbi.nlm.nih.gov/38602548
https://repository.publisso.de/resource/frl:6499020
Rights: CC BY
Accession Number: edsair.doi.dedup.....d67f6e9d405ecb5ffb2bc8c518d8c2e6
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  Data: Diagnostic performance of non-invasive liver fibrosis scores in patients with early-intermediate hepatocellular carcinoma
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  Data: <searchLink fieldCode="AR" term="%22Schrecker%2C+Christopher%22">Schrecker, Christopher</searchLink><br /><searchLink fieldCode="AR" term="%22Schulze%2C+Falko%22">Schulze, Falko</searchLink><br /><searchLink fieldCode="AR" term="%22Trojan%2C+Jörg%22">Trojan, Jörg</searchLink><br /><searchLink fieldCode="AR" term="%22Bechstein%2C+Wolf+Otto%22">Bechstein, Wolf Otto</searchLink><br /><searchLink fieldCode="AR" term="%22Zeuzem%2C+Stefan%22">Zeuzem, Stefan</searchLink><br /><searchLink fieldCode="AR" term="%22Koch%2C+Christine%22">Koch, Christine</searchLink>
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  Data: <searchLink fieldCode="DE" term="%22Liver+Cirrhosis%22">Liver Cirrhosis</searchLink><br /><searchLink fieldCode="DE" term="%22Cirrhosis%22">Cirrhosis</searchLink><br /><searchLink fieldCode="DE" term="%22Liver+Cirrhosis%2Fdiagnosis+[MeSH]%22">Liver Cirrhosis/diagnosis [MeSH]</searchLink><br /><searchLink fieldCode="DE" term="%22FIB-4%22">FIB-4</searchLink><br /><searchLink fieldCode="DE" term="%22Liver+Neoplasms%2Fdiagnosis+[MeSH]%22">Liver Neoplasms/diagnosis [MeSH]</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Humans+[MeSH]%22">Humans [MeSH]</searchLink><br /><searchLink fieldCode="DE" term="%22Carcinoma%2C+Hepatocellular%2Fdiagnosis+[MeSH]%22">Carcinoma, Hepatocellular/diagnosis [MeSH]</searchLink><br /><searchLink fieldCode="DE" term="%22APRI%22">APRI</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+Studies+[MeSH]%22">Retrospective Studies [MeSH]</searchLink><br /><searchLink fieldCode="DE" term="%22Fibrosis%22">Fibrosis</searchLink><br /><searchLink fieldCode="DE" term="%22HCC%22">HCC</searchLink><br /><searchLink fieldCode="DE" term="%2203+medical+and+health+sciences%22">03 medical and health sciences</searchLink><br /><searchLink fieldCode="DE" term="%22Carcinoma%2C+Hepatocellular%22">Carcinoma, Hepatocellular</searchLink><br /><searchLink fieldCode="DE" term="%220302+clinical+medicine%22">0302 clinical medicine</searchLink><br /><searchLink fieldCode="DE" term="%22Liver+Neoplasms%22">Liver Neoplasms</searchLink><br /><searchLink fieldCode="DE" term="%22Humans%22">Humans</searchLink><br /><searchLink fieldCode="DE" term="%22Retrospective+Studies%22">Retrospective Studies</searchLink>
– Name: Abstract
  Label: Description
  Group: Ab
  Data: 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.
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        Value: 10.1007/s00432-024-05708-3
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      – Text: English
    Subjects:
      – SubjectFull: Liver Cirrhosis
        Type: general
      – SubjectFull: Cirrhosis
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      – SubjectFull: Liver Cirrhosis/diagnosis [MeSH]
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      – SubjectFull: APRI
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      – SubjectFull: Fibrosis
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