| Autor: |
Inoue, Jun, Akahane, Takehiro, Kobayashi, Tomoo, Kimura, Osamu, Sato, Kosuke, Ninomiya, Masashi, Iwata, Tomoaki, Takai, Satoshi, Kisara, Norihiro, Sato, Toshihiro, Nagasaki, Futoshi, Miura, Masahito, Nakamura, Takuya, Umetsu, Teruyuki, Sano, Akitoshi, Tsuruoka, Mio, Onuki, Masazumi, Sawahashi, Satoko, Niitsuma, Hirofumi, Masamune, Atsushi |
| Předmět: |
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| Zdroj: |
Hepatology Research; Feb2024, Vol. 54 Issue 2, p131-141, 11p |
| Abstrakt: |
Aim: Nucleos(t)ide analogs do not completely prevent hepatocellular carcinoma (HCC) in chronic hepatitis B virus infection. This study aimed to evaluate the dynamics of a non‐invasive liver fibrosis marker, the Fibrosis‐4 (FIB‐4) index, for predicting HCC development. Methods: Among a total of 882 chronically hepatitis B virus infection‐infected patients who were treated with nucleos(t)ide analogs, 472 patients without HCC history whose FIB‐4 at baseline and 1 year of treatment was obtained were evaluated for the incidence of HCC. Results: The median FIB‐4 was 2.00 at baseline and was significantly reduced to 1.58 at 1 year (P < 0.001), but the reduction was small at 2 years or later. When a receiver operating characteristic analysis of FIB‐4 was performed to predict HCC within 5 years, the area under the curve of FIB‐4 at 1 year was higher than that at baseline (0.676 vs. 0.599). The HCC incidence was significantly higher in patients with FIB‐4 ≥1.58 than in those with FIB‐4 <1.58 (14.8% vs. 3.6% at 10 years, P < 0.001). Additionally, an abnormal alanine aminotransferase (≥31 U/L) at 1 year was an independent risk for HCC. When a fibrosis and alanine aminotransferase‐1 (FAL‐1) score was evaluated as an applicable number of FIB‐4 ≥1.58, and alanine aminotransferase ≥31 as 0, 1, and 2, the HCC risk in patients with score 2 was significantly higher than in those with score 1 or score 0 (24.1% vs. 9.8% vs. 0.7% at 10 years, P < 0.001). Conclusions: FIB‐4 ≥1.58 and alanine aminotransferase ≥31 at 1 year of nucleos(t)ide analog was an independent risk factor for HCC development, and a score using these factors stratified the risk of HCC. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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