title: Preoperatively staging liver fibrosis using noninvasive method in hepatitis B virus-infected hepatocellular carcinoma patients.
abstract: BACKGROUND
  Advanced liver fibrosis can result in serious complications (even patient's death) after partial hepatectomy. Preoperatively percutaneous liver biopsy is an invasive and expensive method to assess liver fibrosis. We aim to establish a noninvasive model, on the basis of preoperative biomarkers, to predict liver fibrosis in hepatocellular carcinoma (HCC) patients with hepatitis B virus (HBV) infection.
  
  
  METHODS
  The HBV-infected liver cancer patients who had received hepatectomy were retrospectively and prospectively enrolled in this study. Univariate analysis was used to compare the variables of the patients with mild to moderate liver fibrosis and with severe liver fibrosis. The significant factors were selected into binary logistic regression analysis. Factors determined to be significant were used to establish a noninvasive model. Then the diagnostic accuracy of this novel model was examined based on sensitivity, specificity and area under the receiver-operating characteristic curve (AUC).
  
  
  RESULTS
  This study included 2,176 HBV-infected HCC patients who had undergone partial hepatectomy (1,682 retrospective subjects and 494 prospective subjects). Regression analysis indicated that total bilirubin and prothrombin time had positive correlation with liver fibrosis. It also demonstrated that blood platelet count and fibrinogen had negative correlation with liver fibrosis. The AUC values of the model based on these four factors for predicting significant fibrosis, advanced fibrosis and cirrhosis were 0.79-0.83, 0.83-0.85 and 0.85-0.88, respectively.
  
  
  CONCLUSIONS
  The results showed that this novel preoperative model was an excellent noninvasive method for assessing liver fibrosis in HBV-infected HCC patients.
authors.affiliation: Department of General Surgery, Guizhou Provincial People's Hospital, Guiyang, China.|Department of Hepato-Pancreato-Biliary Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.|Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Hengyi
authors.initials: H
authors.lastname: Gao
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhu
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Dawei
authors.initials: D
authors.lastname: Ye
authors.affiliation: Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Jiayin
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of State Key Laboratory of Biotherapy and Pathology, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Li
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of State Key Laboratory of Biotherapy and Pathology, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Chang
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Renyi
authors.initials: R
authors.lastname: Qin
authors.affiliation: Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Lunan
authors.initials: L
authors.lastname: Yan
authors.affiliation: Department of Hepato-Pancreato-Biliary Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.|Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Guangqin
authors.initials: G
authors.lastname: Xiao
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001663:Bilirubin / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000378:metabolism / Q000473:pathology / Q000601:surgery / Q000821:virology*; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006498:Hepatectomy; D019694:Hepatitis B, Chronic / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000378:metabolism; D008113:Liver Neoplasms / Q000378:metabolism / Q000473:pathology / Q000601:surgery / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010976:Platelet Count; D057234:Preoperative Period; D011446:Prospective Studies; D011516:Prothrombin / Q000378:metabolism; D012044:Regression Analysis; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D011516:Prothrombin; D005340:Fibrinogen; D001663:Bilirubin
keywords: hepatitis B virus; hepatocellular carcinoma; liver fibrosis; noninvasive; preoperatively