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Non-invasive prediction of hepatocellular carcinoma development using serum fibrosis marker in chronic hepatitis C patients

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

The FIB-4 index is a simple formula to predict liver fibrosis. This study aimed to evaluate the utility of the FIB-4 index and associated time-course changes as a predictor of hepatocellular carcinoma (HCC) development.

Methods

A total of 171 chronic hepatitis C patients who underwent paired liver biopsies and 875 patients who underwent a single liver biopsy (validation group) were investigated during mean follow-up periods of 6.4 and 5.9 years, respectively. All patients had received interferon therapy and had not achieved a sustained virological response. Factors associated with HCC development were analyzed in these patients.

Results

HCC developed in 30 patients in the paired biopsy group and 89 patients in the validation group. Univariate analysis demonstrated that the FIB-4 index >3.25 and change in the FIB-4 index per year (ΔFIB-4/year) ≥0.3 were predictive factors for HCC development in both groups. Multivariate analysis in the combined population revealed that these two factors were independent. The hazard ratio (HR) for the FIB-4 index >3.25 was 2.7 (p < 0.001) and ΔFIB-4/year ≥0.3 was 1.8 (p = 0.003). Patients with a FIB-4 index >3.25 and a ΔFIB-4/year ≥0.3 were defined as high risk, and those with a FIB-4 index ≤3.25 and a ΔFIB-4/year <0.3 were defined as low risk. The HR of HCC development in patients at high risk was 7.3 (95 % confidence interval 4.3–12.5, p < 0.001).

Conclusions

It was possible to define a group at high risk of developing HCC by intermittently measuring the FIB-4 index and considering time-course changes in this index.

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Acknowledgments

This study was supported by a Grant-in-Aid from Ministry of Health, Labor and Welfare, Japan.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, 1-26-1 Kyonan-cho, Musashino, Tokyo, 180-8610, Japan

    Nobuharu Tamaki, Masayuki Kurosaki, Shuya Matsuda, Masaru Muraoka, Yutaka Yasui, Shoko Suzuki, Takanori Hosokawa, Ken Ueda, Kaoru Tsuchiya, Hiroyuki Nakanishi, Jun Itakura, Yuka Takahashi & Namiki Izumi

  2. Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan

    Yasuhiro Asahina

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  1. Nobuharu Tamaki
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  2. Masayuki Kurosaki
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Correspondence to Namiki Izumi.

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Tamaki, N., Kurosaki, M., Matsuda, S. et al. Non-invasive prediction of hepatocellular carcinoma development using serum fibrosis marker in chronic hepatitis C patients. J Gastroenterol 49, 1495–1503 (2014). https://doi.org/10.1007/s00535-013-0914-y

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  • DOI: https://doi.org/10.1007/s00535-013-0914-y

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