一年纤维化4指数有助于确定接受抗病毒治疗的非肝硬化慢性

StephenW

One-year Fibrosis-4 index helps identify minimal HCC risk in non-cirrhotic chronic hepatitis B patients with antiviral treatment

    Tai-Chung Tseng, Jonggi Choi, Mindie H. Nguyen, Cheng-Yuan Peng, Spyros Siakavellas, George Papatheodoridis, Chia-Chi Wang, Young-Suk Lim, Hsueh-Chou Lai, Huy N. Trinh, Christopher Wong, Clifford Wong, Jian Zhang, Jiayi Li & Jia-Horng Kao

Hepatology International volume 15, pages105–113(2021)Cite this article

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Abstract
Background and aims

Fibrosis-4 (FIB-4) index is a HCC predictor in chronic hepatitis B (CHB) patients. However, little is known about whether FIB-4 helps identify non-cirrhotic CHB patients with minimal HCC risk after prolonged nucleos(t)ide analogue (NA) therapy.
Methods

A total of 1936 ethnically diverse, non-cirrhotic CHB patients were enrolled in this retrospective multi-national study. All patients received prolonged NA treatment, including entecavir and tenofovir disoproxil fumarate. We explored whether FIB-4 cutoff of 1.30, a marker indicative of mild fibrosis severity, could stratify HCC risks in these patients.
Results

A total of 48 patients developed HCC after a mean follow-up of 6.98 years. FIB-4 level at 1 year after treatment (1-year FIB-4) was shown to be associated with HCC development and was superior to pre-treatment FIB-4 value. When patients were stratified by 1-year FIB-4 of 1.30, the high FIB-4 group was at an increased HCC risk compared to the low FIB-4 group, with a hazard ratio of 4.87 (95% confidence interval: 2.48–9.55). Multivariable analysis showed that sex and 1-year FIB-4 were independent predictors, with none of the 314 female patients with low 1-year FIB-4 developing HCC. Finally, 1-year FIB-4 of 1.30 consistently stratified HCC risks in patients with low PAGE-B score, a score composed of baseline age, sex and platelet count, and the annual incidence rate of HCC was 0.11% in those with PAGE-B < 10 + 1-year FIB-4 < 1.30.
Conclusions

In non-cirrhotic CHB patients receiving prolonged NA therapy, 1-year FIB-4 < 1.30 is useful for identifying those with minimal HCC risk by combining with female sex or low PAGE-B score.

StephenW

一年纤维化4指数有助于确定接受抗病毒治疗的非肝硬化慢性乙型肝炎患者的最低HCC风险

    曾大中，崔钟基，阮敏（Mandie H.Nguyen），彭成元，Spyros Siakavellas，乔治·帕帕特奥多里迪斯（George Papatheodoridis），王家琪，林永淑，许学来，许慧婷，王若琳，黄智超，张健，李佳宜＆高佳鸿

国际肝病杂志第15卷，105-113（2021）页

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抽象的
背景和目标

Fibreosis-4（FIB-4）指数是慢性乙型肝炎（CHB）患者的HCC预测因子。但是，关于FIB-4是否有助于在长期核苷酸类似物（NA）治疗后，以最小的HCC风险来鉴定非肝硬化CHB患者。
方法

这项回顾性多国研究共纳入了1936个种族多样化，非肝硬化的CHB患者。所有患者均接受了延长的NA治疗，包括恩替卡韦和替诺福韦二富马酸富马酸酯。我们探讨了FIB-4临界值1.30是否指示这些患者的HCC风险分层，该临界值指示轻度纤维化严重程度。
结果

在平均随访6.98年后，共有48例患者发展为HCC。治疗后1年（1年FIB-4）的FIB-4水平与肝癌的发生有关，并且优于治疗前FIB-4的水平。当患者按1年FIB-4（1.30）进行分层时，高FIB-4组与低FIB-4组相比具有更高的HCC风险，危险比为4.87（95％置信区间：2.48–9.55 ）。多变量分析显示，性别和1年FIB-4是独立的预测因素，在314名1年FIB-4低的女性患者中，没有一例会发展为HCC。最后，在PAGE-B评分低，由基线年龄，性别和血小板计数组成的评分以及PAGE-B患者的HCC年发生率为0.11％的患者中，1年FIB-4（1.30）持续对HCC风险进行分层。 B <10 + 1年FIB-4 <1.30。
结论

在接受长期NA治疗的非肝硬化CHB患者中，通过结合女性或PAGE-B评分低，一年FIB-4 <B1.30可用于识别HCC风险最低的患者。

StephenW

https://link.springer.com/articl ... c_springer_20210217