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High liver fibrosis index FIB-4 highly predictive of hepatocellular carcinoma in chronic hepatitis B carriers
Beomseok Suh1,†,
Sehhoon Park2,†,
Dong Wook Shin1,3,*,
Jae Moon Yun1,
Hyung-Kook Yang4,
Su Jong Yu5,
Cheong-Il Shin6,
Jin-Soo Kim7,
Eunmi Ahn1,
Hyejin Lee1,3,
Jin Ho Park1 and
BeLong Cho1,3
DOI: 10.1002/hep.27654
Copyright © 2014 American Association for the Study of Liver Diseases
Vol. 60 Issue 6
Hepatology
Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)
Article has an altmetric score of 4
Additional Information(Show All)
Author Information
1 Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Seoul, Republic of Korea
2 Department of Internal Medicine, Division of Hematology & Medical Oncology, Seoul National University Hospital, Seoul, Republic of Korea
3 Cancer Survivorship Clinic, Seoul National University Cancer Hospital, Seoul, Republic of Korea
4 Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
5 Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
6 Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
7 Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
†
These authors contributed equally.
*CORRESPONDING AUTHOR: Dong Wook Shin, M.D., Dr.P.H., M.B.A., Department of Family Medicine & Health Promotion Center, Seoul National University Hospital, Cancer Survivorship Clinic, Seoul National University Cancer Hospital, 101 Daehakro, Jongnogu, Seoul 110-744, Republic of Korea, Tel: +82-2-2072-0847, Fax: +82-2-766-3276, E-mail: [email protected]
ABSTRACT
Screening for hepatocellular carcinoma (HCC) is clinically important as its early detection has remarkable survival benefits. We investigated the possible role of FIB-4, a recently developed noninvasive marker for liver fibrosis based on routine laboratory tests, as a clinical indicator for predicting future HCC among hepatitis B surface antigen (HBsAg) carriers. Our retrospective cohort study involved 986 Korean HBsAg carriers aged 40 or older who visited Seoul National University Hospital for health check-up. National medical service claims data was used to determine HCC incidence. Median follow-up time was 5.4 years (interquartile range 4.4 years). Adjusted for age, sex, body mass index, smoking, alcohol, and anti-viral medication for hepatitis B, compared to subjects with FIB-4 <1.25, subjects with 1.7≤ FIB-4 <2.4 showed aHR 4.57 (95% CI 1.50-13.92) and subjects with FIB-4 ≥2.4 showed aHR 21.34 (95% CI 7.73-58.92) for HCC incidence. FIB-4 was shown to have incremental predictive value to ultrasonographic liver cirrhosis for HCC incidence (C-index 0.701 vs. 0.831; P=0.001). FIB-4 was also better predictive of HCC incidence compared to that of ultrasonographic liver cirrhosis (C-index 0.775 vs. 0.701; P=0.040).
Conclusion: High FIB-4 is a highly predictive risk factor for HCC incidence among Korean HBsAg carriers. FIB-4 is a promising, easily applicable, and cost-effective clinical tool in identifying a subpopulation of HBsAg carriers who are at heightened risk. Our study needs to be replicated in larger future studies on various ethnic groups; nonetheless, our study suggests FIB-4 may play a valuable role in HCC screening among HBsAg carriers. This article is protected by copyright. All rights reserved.
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发表于 2014-12-19 12:51