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Abate ML, Caviglia GP. Chronic Hepatitis C: Pathophysiology and Clinical Issues. BIOLOGY 2022; 11:1737. [PMID: 36552247 PMCID: PMC9775126 DOI: 10.3390/biology11121737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022]
Abstract
Globally, it is estimated that 56 [...].
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Caviglia GP, Troshina G, Santaniello U, Rosati G, Bombaci F, Birolo G, Nicolosi A, Saracco GM, Ciancio A. Long-Term Hepatocellular Carcinoma Development and Predictive Ability of Non-Invasive Scoring Systems in Patients with HCV-Related Cirrhosis Treated with Direct-Acting Antivirals. Cancers (Basel) 2022; 14:828. [PMID: 35159094 PMCID: PMC8834182 DOI: 10.3390/cancers14030828] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 02/07/2023] Open
Abstract
Patients with hepatitis C virus (HCV)-related cirrhosis treated with direct-acting antivirals (DAA) are still at risk of developing hepatocellular carcinoma (HCC). We investigated the accuracy of non-invasive scoring systems (NSS) for the prediction of de novo HCC development in patients treated with DAA on long-term follow-up (FU). We analyzed data from 575 consecutive patients with cirrhosis and no history of HCC who achieved a sustained virologic response (SVR) to DAA therapy. NSS (i.e., Forns index, APRI, FIB-4, ALBI, and aMAP) were calculated at 3 months after the end of therapy. Performance for de novo HCC prediction was evaluated in terms of area under the curve (AUC) and Harrell's C-index. During a median FU of 44.9 (27.8-58.6) months, 57 (9.9%) patients developed de novo HCC. All five NSS were associated with the risk of de novo HCC. At multivariate analysis, only the ALBI score resulted in being significantly and independently associated with de novo HCC development (adjusted hazard ratio = 4.91, 95% CI 2.91-8.28, p < 0.001). ALBI showed the highest diagnostic accuracy for the detection of de novo HCC at 1-, 3-, and 5-years of FU, with AUC values of 0.81 (95% CI 0.78-0.85), 0.71 (95% CI 0.66-0.75), and 0.68 (95% CI 0.59-0.76), respectively. Consistently, the best predictive performance assessed by Harrell's C-statistic was observed for ALBI (C-index = 0.70, 95% CI 0.62-0.77). ALBI score may represent a valuable and inexpensive tool for risk stratification and the personalization of an HCC surveillance strategy for patients with cirrhosis and previous history of HCV infection treated with DAA.
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Affiliation(s)
- Gian Paolo Caviglia
- Liver Unit, Department of Medical Sciences, University of Torino, 10126 Turin, Italy; (G.T.); (U.S.); (G.R.); (F.B.); (G.B.); (A.N.); (G.M.S.)
| | - Giulia Troshina
- Liver Unit, Department of Medical Sciences, University of Torino, 10126 Turin, Italy; (G.T.); (U.S.); (G.R.); (F.B.); (G.B.); (A.N.); (G.M.S.)
| | - Umberto Santaniello
- Liver Unit, Department of Medical Sciences, University of Torino, 10126 Turin, Italy; (G.T.); (U.S.); (G.R.); (F.B.); (G.B.); (A.N.); (G.M.S.)
| | - Giulia Rosati
- Liver Unit, Department of Medical Sciences, University of Torino, 10126 Turin, Italy; (G.T.); (U.S.); (G.R.); (F.B.); (G.B.); (A.N.); (G.M.S.)
| | - Francesco Bombaci
- Liver Unit, Department of Medical Sciences, University of Torino, 10126 Turin, Italy; (G.T.); (U.S.); (G.R.); (F.B.); (G.B.); (A.N.); (G.M.S.)
| | - Giovanni Birolo
- Liver Unit, Department of Medical Sciences, University of Torino, 10126 Turin, Italy; (G.T.); (U.S.); (G.R.); (F.B.); (G.B.); (A.N.); (G.M.S.)
| | - Aurora Nicolosi
- Liver Unit, Department of Medical Sciences, University of Torino, 10126 Turin, Italy; (G.T.); (U.S.); (G.R.); (F.B.); (G.B.); (A.N.); (G.M.S.)
| | - Giorgio Maria Saracco
- Liver Unit, Department of Medical Sciences, University of Torino, 10126 Turin, Italy; (G.T.); (U.S.); (G.R.); (F.B.); (G.B.); (A.N.); (G.M.S.)
- Gastroenterology Unit, Department of General and Specialistic Medicine, A.O.U. Città della Salute e della Scienza—Molinette Hospital, 10126 Turin, Italy
| | - Alessia Ciancio
- Liver Unit, Department of Medical Sciences, University of Torino, 10126 Turin, Italy; (G.T.); (U.S.); (G.R.); (F.B.); (G.B.); (A.N.); (G.M.S.)
- Gastroenterology Unit, Department of General and Specialistic Medicine, A.O.U. Città della Salute e della Scienza—Molinette Hospital, 10126 Turin, Italy
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Nicolosi A, Pellicano R, Caviglia GP. Surveillance of cirrhotic patients using the protein induced by vitamin K absence or antagonist II (PIVKA-II). Minerva Med 2022; 113:106-108. [PMID: 35313441 DOI: 10.23736/s0026-4806.21.07952-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Aurora Nicolosi
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Rinaldo Pellicano
- Unit of Gastroenterology, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy
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Caviglia GP, Armandi A, Rosso C, Gaia S, Aneli S, Rolle E, Abate ML, Olivero A, Nicolosi A, Guariglia M, Ribaldone DG, Carucci P, Saracco GM, Bugianesi E. Biomarkers of Oncogenesis, Adipose Tissue Dysfunction and Systemic Inflammation for the Detection of Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease. Cancers (Basel) 2021; 13:2305. [PMID: 34064999 PMCID: PMC8151983 DOI: 10.3390/cancers13102305] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/30/2021] [Accepted: 05/07/2021] [Indexed: 02/08/2023] Open
Abstract
Current surveillance strategy for patients with nonalcoholic fatty liver disease (NAFLD) at risk of hepatocellular carcinoma (HCC) development is unsatisfactory. We aimed to investigate the diagnostic accuracy of alpha-fetoprotein (AFP), protein induced by vitamin K absence or antagonist-II (PIVKA-II), glypican-3 (GPC-3), adiponectin, leptin and interleukin-6 (IL-6), alone or in combination, for the discrimination between NAFLD patients with or without HCC. The biomarkers were investigated in a cohort of 191 NAFLD patients (median age 62, 54-68 years; 121 males and 70 females) with advanced fibrosis/cirrhosis, 72 of whom had a diagnosis of HCC. PIVKA-II showed the best performance for the detection of HCC with an area under the curve (AUC) of 0.853, followed by adiponectin (AUC = 0.770), AFP (AUC = 0.763), GPC-3 (AUC = 0.759) and by IL-6 (AUC = 0.731), while the leptin values were not different between patients with and without HCC. The accuracy of the biomarkers' combination was assessed by a stratified cross-validation approach. The combination of age, gender, PIVKA-II, GPC-3 and adiponectin further improved the diagnostic accuracy (AUC = 0.948); the model correctly identified the 87% of the patients. In conclusion, we developed a model with excellent accuracy for the detection of HCC that may be useful to improve the surveillance of NAFLD patients at risk of tumor development.
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Affiliation(s)
- Gian Paolo Caviglia
- Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.A.); (C.R.); (S.A.); (M.L.A.); (A.O.); (A.N.); (M.G.); (D.G.R.); (G.M.S.)
| | - Angelo Armandi
- Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.A.); (C.R.); (S.A.); (M.L.A.); (A.O.); (A.N.); (M.G.); (D.G.R.); (G.M.S.)
| | - Chiara Rosso
- Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.A.); (C.R.); (S.A.); (M.L.A.); (A.O.); (A.N.); (M.G.); (D.G.R.); (G.M.S.)
| | - Silvia Gaia
- Gastroenterology Unit, A.O.U. Città della Salute e della Scienza, 10126 Torino, Italy; (S.G.); (E.R.); (P.C.)
| | - Serena Aneli
- Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.A.); (C.R.); (S.A.); (M.L.A.); (A.O.); (A.N.); (M.G.); (D.G.R.); (G.M.S.)
- Department of Biology, University of Padua, 35122 Padova, Italy
| | - Emanuela Rolle
- Gastroenterology Unit, A.O.U. Città della Salute e della Scienza, 10126 Torino, Italy; (S.G.); (E.R.); (P.C.)
| | - Maria Lorena Abate
- Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.A.); (C.R.); (S.A.); (M.L.A.); (A.O.); (A.N.); (M.G.); (D.G.R.); (G.M.S.)
| | - Antonella Olivero
- Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.A.); (C.R.); (S.A.); (M.L.A.); (A.O.); (A.N.); (M.G.); (D.G.R.); (G.M.S.)
| | - Aurora Nicolosi
- Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.A.); (C.R.); (S.A.); (M.L.A.); (A.O.); (A.N.); (M.G.); (D.G.R.); (G.M.S.)
| | - Marta Guariglia
- Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.A.); (C.R.); (S.A.); (M.L.A.); (A.O.); (A.N.); (M.G.); (D.G.R.); (G.M.S.)
| | - Davide Giuseppe Ribaldone
- Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.A.); (C.R.); (S.A.); (M.L.A.); (A.O.); (A.N.); (M.G.); (D.G.R.); (G.M.S.)
| | - Patrizia Carucci
- Gastroenterology Unit, A.O.U. Città della Salute e della Scienza, 10126 Torino, Italy; (S.G.); (E.R.); (P.C.)
| | - Giorgio Maria Saracco
- Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.A.); (C.R.); (S.A.); (M.L.A.); (A.O.); (A.N.); (M.G.); (D.G.R.); (G.M.S.)
- Gastroenterology Unit, A.O.U. Città della Salute e della Scienza, 10126 Torino, Italy; (S.G.); (E.R.); (P.C.)
| | - Elisabetta Bugianesi
- Department of Medical Sciences, University of Turin, 10126 Torino, Italy; (A.A.); (C.R.); (S.A.); (M.L.A.); (A.O.); (A.N.); (M.G.); (D.G.R.); (G.M.S.)
- Gastroenterology Unit, A.O.U. Città della Salute e della Scienza, 10126 Torino, Italy; (S.G.); (E.R.); (P.C.)
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