title: FIB-4 index for assessing the prognosis of hepatocellular carcinoma in patients with Child-Pugh class A liver function.
abstract: OBJECTIVE
  We evaluated the prognosis of hepatocellular carcinoma (HCC) patients with Child-Pugh (C-P) class A based on FIB-4 index, which is a liver fibrosis marker.
  
  
  METHODS
  A total of 915 HCC patients with C-P class A were investigated. We assessed the prognosis using FIB-4 index, and factors associated with survival rates were analyzed in these patients.
  
  
  RESULTS
  When patients were categorized according to FIB-4 index as <2.0 (n = 93), ≥ 2.0 and <4.0 (n = 311), and ≥ 4.0 (n = 511), survival rates at 5 years were 70.5% [95% confidence interval (CI) 59.0-79.9], 56.4% (95% CI 50.1-62.5), and 47.1% (95% CI 42.2-52.1), respectively. Patients with FIB-4 index <2.0 had a higher survival rate than the other groups (≥ 4.0 vs ≥ 2.0 and <4.0, p = 0.010; ≥ 2.0 and <4.0 vs <2.0, p = 0.028). We were able to predict prognosis in patients with C-P score 5 by FIB-4 index, but survival rate did not significantly differ in patients with C-P score 6. Multivariate analysis identified C-P score, FIB-4 index [≥ 2.0 and <4.0; hazard ratios (HRs) 1.638 (95% CI 1.084-2.474); p = 0.019/≥ 4.0; HR 1.828 (95% CI 1.217-2.744); p = 0.004], Lens culinaris agglutinin-reactive α-fetoprotein, tumor size, number, vascular invasion, antiviral therapy, and hepatectomy as independent predictive factors for survival.
  
  
  CONCLUSIONS
  The FIB-4 index is useful for assessing prognosis in HCC patients with C-P class A, especially those with C-P score 5.
authors: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, 4-86, Minaminokawa-cho, Ogaki, Gifu, 503-8052, Japan, tahkun56@gmail.com.
authors: Takanori
authors: T
authors: Ito
authors: Takashi
authors: T
authors: Kumada
authors: Hidenori
authors: H
authors: Toyoda
authors: Toshifumi
authors: T
authors: Tada
mesh_terms: D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D015415:Biomarkers / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology*; D008111:Liver Function Tests / Q000379:methods; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
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