title: Liver stiffness measurement for risk assessment of hepatocellular carcinoma.
abstract: OBJECTIVE
  Liver fibrosis is a risk factor for hepatocellular carcinoma (HCC), but at what fibrotic stage the risk for HCC is increased has been poorly investigated quantitatively. This study aimed to determine the appropriate cut-off value of liver stiffness for HCC concurrence by FibroScan, and its clinical significance in hepatitis B virus (HBV), hepatitis C virus (HCV) and non-B, non-C (NBNC) liver disease.
  
  
  METHODS
  Subjects comprised 1002 cases (246 with HCC and 756 without HCC) with chronic liver disease (HBV, 104; HCV, 722; and NBNC, 176).
  
  
  RESULTS
  Liver stiffness was significantly greater in all groups with HCC, and the determined cut-off value for HCC concurrence was more than 12.0 kPa in those with HCV, more than 8.5 kPa in those with HBV and more than 12.0 kPa in those with NBNC. Liver stiffness of more than 12.0 kPa was an independent risk factor for new HCC development in HCV. For HCV, risk factors for HCC concurrence were old age, male sex, low albumin, low platelets and liver stiffness, while for HBV they were old age, low platelets and liver stiffness, and for NBNC they were old age, elevated α-fetoprotein and liver stiffness.
  
  
  CONCLUSIONS
  Liver stiffness cut-off values and their association with HCC concurrence were different depending on the etiology. In HCV, liver stiffness of more than 12.0 kPa was an independent risk factor for new HCC development. Collectively, determining the fibrotic cut-off values for HCC concurrence would be important in evaluating HCC risks.
authors: First Department of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan.
authors: Akihisa
authors: A
authors: Tatsumi
authors: Shinya
authors: S
authors: Maekawa
authors: Mitsuaki
authors: M
authors: Sato
authors: Nobutoshi
authors: N
authors: Komatsu
authors: Mika
authors: M
authors: Miura
authors: Fumitake
authors: F
authors: Amemiya
authors: Yasuhiro
authors: Y
authors: Nakayama
authors: Taisuke
authors: T
authors: Inoue
authors: Minoru
authors: M
authors: Sakamoto
authors: Nobuyuki
authors: N
authors: Enomoto
keywords: FibroScan; hepatocellular carcinoma; liver fibrosis