Infection with hepatitis viruses, FIB-4 index and risk of hepatocellular carcinoma in southern Italy: a population-based cohort study
| Autor: | Enrico Girardi, Diego Serraino, Paola Scognamiglio, Diana Verdirosi, Valerio Ciullo, Mario Fusco, Pietro Di Cicco, Pierluca Piselli, Michele D’Orazio, Paolo De Paoli, Saverio Virdone, Silvia Franceschi, Luigino Dal Maso |
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| Rok vydání: | 2016 |
| Předmět: |
Liver fibrosis index
Cancer Research medicine.medical_specialty Epidemiology Population medicine.disease_cause lcsh:RC254-282 Gastroenterology lcsh:Infectious and parasitic diseases 03 medical and health sciences 0302 clinical medicine Internal medicine medicine lcsh:RC109-216 Viral hepatitis education Liver diseases Hepatitis B virus education.field_of_study medicine.diagnostic_test biology business.industry Hepatitis C lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease digestive system diseases Cancer registry Relative risk Infectious Diseases Oncology Alanine transaminase 030220 oncology & carcinogenesis Liver biopsy Hepatocellular carcinoma biology.protein 030211 gastroenterology & hepatology Southern Italy business Research Article |
| Zdroj: | Infectious Agents and Cancer Infectious Agents and Cancer, Vol 11, Iss 1, Pp 1-8 (2016) |
| ISSN: | 1750-9378 |
| DOI: | 10.1186/s13027-016-0101-x |
| Popis: | Background The incidence of hepatocellular carcinoma (HCC) and its association with hepatitis C (HCV) and hepatitis B virus (HBV) infections, FIB-4 index and liver enzymes was assessed in an area of the province of Naples covered by a population-based cancer registry. Methods We conducted a cohort investigation on 4492 individuals previously enrolled in a population-based seroprevalent survey on HCV and HBV infections. The diagnosis of HCC was assessed through a record linkage with the cancer registry. Hepatic metabolic activity was measured through serum alanine transaminase, aspartate aminotransferase, gamma-glutamyl-transferase, and platelet. The FIB-4 index was used as a marker of fibrosis. We computed HCC incidence rates (IR) for 100,000 (105) person-years of observation, and multivariable hazard ratios (HR) with 95 % confidence intervals (CI) to assess risk factors for HCC. Results Twenty two cases of HCC were diagnosed during follow-up (IR = 63.3 cases/105). Significantly increased HCC risks were documented in individuals with higher than normal liver enzymes and low platelet count; in the 239 HCV RNA-positives (HR = 61.8, 95 % CI:13.3–286); and in the 95 HBsAg-positives (HR = 75.0) –as compared to uninfected individuals. The highest FIB-4 score was associated with a 17.6-fold increased HCC risk. Conclusions An elevated FIB-4 index turned out to be an important predictor of HCC occurrence. Although the standard method to assess hepatic fibrosis in chronic hepatitis remains the histologic staging of liver biopsy specimen, the assessment of FIB-4 in HCV RNA-positive individuals may help in identifying the highest HCC-risk individuals who need anti-HCV treatment most urgently. |
| Databáze: | OpenAIRE |
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