用于慢性乙型肝炎患者肝细胞癌风险评估的纤维化-4，天冬氨

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Source: Eur J Gastroenterol Hepatol  |  Posted 6 days ago
Fibrosis-4, aspartate transaminase-to-platelet ratio index, and gamma-glutamyl transpeptidase-to-platelet ratio for risk assessment of hepatocellular carcinoma in chronic hepatitis B patients: comparison with liver biopsy; Kim M, Lee J, Chon Y, Ha Y, Hwang S; European Journal of Gastroenterology and Hepatology (Sep 2019)

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        Hepatitis Liver Cancer

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BACKGROUND AND AIMS It is well known that hepatocellular carcinoma (HCC) develops as a consequence of hepatic fibrosis progression. Thus, early identification of advanced liver fibrosis is very important. This study evaluated the prognostic value of FIB-4, the aspartate transaminase to-platelet ratio index (APRI), and the gamma-glutamyl transpeptidase-toplatelet ratio (GPR) for predicting HCC development using histological fibrosis stage as a reference in Asian chronic hepatitis B (CHB) patients.

METHODS A total of 444 CHB patients who underwent liver biopsy and serological tests for determining noninvasive serum fibrosis markers were enrolled. All patients were followed to monitor HCC development.

RESULTS The histological fibrosis stage showed best performance in predicting HCC development at 5 (area under the receiver operating characteristic curve [AUROC] = 0.783) and 7 years (AUROC = 0.766), followed by FIB-4 (AUROC = 0.753 at 5 years, 0.698 at 7 years), APRI (AUROC = 0.658 at 5 years, 0.572 at 7 years), and GPR (AUROC = 0.638 at 5 years, 0.603 at 7 years). When we classified risk groups according to the histological fibrosis stage (F4 vs. F0-3) and FIB-4 (FIB-4 ≥ 3.25 vs. FIB-4<3.25), patients in the high-risk group were found to have a significantly higher probability of developing HCC than those in the low-risk group (P=0.005 and 0.022, respectively, log-rank test).

CONCLUSION Our study demonstrated that FIB-4 is useful for the noninvasive prediction of HCC development, while APRI and GPR were less useful.

StephenW

资料来源：Eur J Gastroenterol Hepatol |发表于6天前
用于慢性乙型肝炎患者肝细胞癌风险评估的纤维化-4，天冬氨酸转氨酶与血小板比值指数和γ-谷氨酰转肽酶与血小板比值：与肝活检的比较; Kim M，Lee J，Chon Y，Ha Y，Hwang S;欧洲胃肠病学和肝病学杂志（2019年9月）

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        肝炎肝癌

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背景和目的众所周知，肝细胞癌（HCC）是肝纤维化进展的结果。因此，早期发现晚期肝纤维化非常重要。本研究评估了FIB-4，天冬氨酸转氨酶 - 血小板比值指数（APRI）和γ-谷氨酰转肽酶 - 血小板比值（GPR）预测HCC发展的预后价值，以组织学纤维化分期作为亚洲慢性肝炎的参考。 B（CHB）患者。

方法共有444名CHB患者接受了肝活检和血清学检查，以确定无创血清纤维化标志物。跟踪所有患者以监测HCC发展。

结果组织学纤维化分期预测HCC发展在5（受试者工作特征曲线下面积[AUROC] = 0.783）和7年（AUROC = 0.766），其次是FIB-4（5年后AUROC = 0.753，在7年时为0.698），APRI（5年时AUROC = 0.658，7年时为0.572）和GPR（5年时AUROC = 0.638,7岁时为0.603）。当我们根据组织学纤维化分期（F4与F0-3）和FIB-4（FIB-4≥3.25与FIB-4 <3.25）对风险组进行分类时，发现高风险组的患者有发生HCC的可能性显着高于低风险组（P = 0.005和0.022，对数秩检验）。

结论我们的研究表明，FIB-4可用于HCC发展的无创预测，而APRI和GPR则不太有用。

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