Preoperatively staging liver fibrosis using noninvasive method in Hepatitis B virus-infected hepatocellular carcinoma patients
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Hengyi Gao1,2,4, Feng Zhu2, Min Wang2, Hang Zhang2, Dawei Ye3, Jiayin Yang4, Li Jiang5, Chang Liu5, Renyi Qin2, Lunan Yan4 and Guangqin Xiao2,4
1 Department of General Surgery, Guizhou Provincial People’s Hospital, Guiyang, China
2 Department of Hepato-Pancreato-Biliary Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
3 Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
4 Department of Liver Surgery, West China Hospital of Sichuan University, Chengdu, China
5 Department of State Key Laboratory of Biotherapy and Pathology, West China Hospital of Sichuan University, Chengdu, China
Guangqin Xiao, email:
Keywords: hepatocellular carcinoma, liver fibrosis, hepatitis B virus, preoperatively, noninvasive
Received: June 03, 2016 Accepted: December 05, 2016 Published: December 19, 2016
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.
Conclusion: The results showed that this novel preoperative model was an excellent noninvasive method for assessing liver fibrosis in HBV-infected HCC patients.
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