title: Non-invasive prediction of hepatocellular carcinoma development using serum fibrosis marker in chronic hepatitis C patients.
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.
authors: Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, 1-26-1 Kyonan-cho, Musashino, Tokyo, 180-8610, Japan.
authors: Nobuharu
authors: N
authors: Tamaki
authors: Masayuki
authors: M
authors: Kurosaki
authors: Shuya
authors: S
authors: Matsuda
authors: Masaru
authors: M
authors: Muraoka
authors: Yutaka
authors: Y
authors: Yasui
authors: Shoko
authors: S
authors: Suzuki
authors: Takanori
authors: T
authors: Hosokawa
authors: Ken
authors: K
authors: Ueda
authors: Kaoru
authors: K
authors: Tsuchiya
authors: Hiroyuki
authors: H
authors: Nakanishi
authors: Jun
authors: J
authors: Itakura
authors: Yuka
authors: Y
authors: Takahashi
authors: Yasuhiro
authors: Y
authors: Asahina
authors: Namiki
authors: N
authors: Izumi
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000201:enzymology / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood* / Q000201:enzymology / Q000473:pathology / Q000821:virology; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D016016:Proportional Hazards Models; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase