title: [Non-invasive fibrosis indexes in predicting acute liver function deterioration after transcatheter arterial chemoembolization].
abstract: OBJECTIVE
  To investigate the ability of two non-invasive fibrosis indexes-APRI, i. e. aspartate transaminase (AST) to platelet (PLT) ratio index, and fibrosis index based on the 4 factors (FIB-4)score in predicting ALFD in patients with unresectable primary HCC and underwent TACE.
  
  
  METHODS
  Clinical data of those patients treated with TACE in Department of Interventional Radiology of the Center from Jan 2010 to Aug 2014 were investigated retrospectively. A total of 366 cases were enrolled after randomized selection, 62 (18.5%) of which developed ALFD after TACE. Child-Pugh score, APRI and FIB-4 score in every case were calculated, receiver operating characteristic (ROC) curve of each model were performed and the predictive abilities of them were assessed by area under the curve (AUC), positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity.
  
  
  RESULTS
  The AUC of Child-Pugh score, APRI and FIB-4 score were 0.783, 0.752 and 0.758 respectively, while the difference had no significance in statistics, indicating that predictive accuracies of them were similar. APRI≤1.15 and FIB-4≤3.08 had better NPV (90.6% and 93.6%) and sensitivity (65.6% and 80.0%) than Child-Pugh score>6 (NPV=85.8%, sensitivity=27.4%), PPV and specificity of them are 35.7%, 32.9%, 89.5% and 73.7%, 64.2%, 99.3% respectively.
  
  
  CONCLUSIONS
  Comparing to Child-Pugh score, APRI and FIB-4 score have similar accuracy but better NPV and sensitivity in predicting post-TACE ALFD. Thereafter they are good for selection of low-risk patients for TACE treatment. Candidates with an APRI≤1.15 or a FIB-4≤3.08 or in Child-Pugh a stage are unlikely to develop ALFD thus could receive TACE safely.
authors.affiliation: Intensive Care Unit, Cancer Center, Sun Yat-sen University; State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China.
authors.forename: Y P
authors.initials: YP
authors.lastname: Song
authors.forename: Q Y
authors.initials: QY
authors.lastname: Zhao
authors.forename: S
authors.initials: S
authors.lastname: Li
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.forename: P H
authors.initials: PH
authors.lastname: Wu
mesh_terms: D019540:Area Under Curve; D001158:Arteries; D001219:Aspartate Aminotransferases / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D004621:Embolization, Therapeutic; D006801:Humans; D008099:Liver / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000503:physiopathology*; D010976:Platelet Count; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases