Hepatology International

, Volume 4, Issue 4, pp 691–699 | Cite as

Fibrosis and AST to platelet ratio index predict post-operative prognosis for solitary small hepatitis B-related hepatocellular carcinoma

  • Hung-Hsu Hung
  • Chien-Wei Su
  • Chiung-Ru Lai
  • Gar-Yang Chau
  • Che-Chang Chan
  • Yi-Hsiang Huang
  • Teh-Ia Huo
  • Pui-Ching Lee
  • Wei-Yu Kao
  • Shou-Dong Lee
  • Jaw-Ching Wu
Original Article



Although advanced liver fibrosis is crucial in the development of hepatocellular carcinoma (HCC) for patients with chronic hepatitis B, whether it is associated with the recurrence of HCC after resection remains obscure. This study was aimed to compare the outcomes for patients with minimal or advanced fibrosis in solitary small hepatitis B virus (HBV)-related HCC.


This study enrolled 76 patients with small (<5 cm) solitary HBV-related HCC who underwent resection. The outcomes of patients with minimal and advanced fibrosis in non-tumor areas were compared. Serum markers were tested to assess the stage of hepatic fibrosis and to predict prognosis.


Fourteen patients with an Ishak fibrosis score of 0 or 1 were defined as having minimal fibrosis; the remaining 62 patients were defined as having advanced fibrosis. During a follow-up period of 77.0 ± 50.7 months, 41 patients died. The overall survival rate was significantly higher (P = 0.018) and recurrence rate was lower (P = 0.018) for patients in the minimal fibrosis group. Aspartate aminotransferase–platelet ratio index (APRI) exhibited the most reliable discriminative ability for predicting advanced fibrosis. The overall survival rate was significantly higher (P = 0.003) and recurrence rate was lower (P = 0.005) for patients with an APRI of 0.47 or less.


For patients with solitary small HBV-related HCC who underwent resection, minimal fibrosis is associated with a lower incidence of recurrence and with better survival. APRI could serve as a reliable marker for assessing hepatic fibrosis and predicting survival.


Aspartate aminotransferase–platelet ratio index Fibrosis Hepatitis B virus Hepatocellular carcinoma Recurrence 



The authors are grateful for the technical support provided by the Sequencing Core Facility of the National Yang-Ming University Genome Research Center (YMGC). The Sequencing Core Facility is supported by National Research Program for Genome Medicine (NRPGM), National Science Council, Taiwan. This study was supported by grants from the National Science Council (NSC93-2321-B-010-012, NSC94-2321-B-010-010, NSC95-2321-B-010-005), and Taipei Veterans General Hospital (V95C1-014, V97ER2-016, V97B1-015, Center of Excellence for Cancer Research at TVGH DOH99-TD-C-111-007), Taipei, Taiwan.


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Copyright information

© Asian Pacific Association for the Study of the Liver 2010

Authors and Affiliations

  • Hung-Hsu Hung
    • 1
  • Chien-Wei Su
    • 1
    • 2
  • Chiung-Ru Lai
    • 3
  • Gar-Yang Chau
    • 2
    • 4
  • Che-Chang Chan
    • 1
    • 2
  • Yi-Hsiang Huang
    • 1
    • 2
  • Teh-Ia Huo
    • 1
    • 5
  • Pui-Ching Lee
    • 1
  • Wei-Yu Kao
    • 1
  • Shou-Dong Lee
    • 1
  • Jaw-Ching Wu
    • 2
    • 6
  1. 1.Division of Gastroenterology, Department of MedicineTaipei Veterans General HospitalTaipeiTaiwan
  2. 2.Department of Medicine, Institute of Clinical Medicine, School of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  3. 3.Department of Pathology and Laboratory MedicineTaipei Veterans General HospitalTaipeiTaiwan
  4. 4.Division of General Surgery, Department of SurgeryTaipei Veterans General HospitalTaipeiTaiwan
  5. 5.Institute of Pharmacology, School of MedicineNational Yang-Ming UniversityTaipeiTaiwan
  6. 6.Department of Medical Research and EducationTaipei Veterans General HospitalTaipeiTaiwan

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