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Tian YB, Niu H, Xu F, Shang-Guan PW, Song WW. ALBI score combined with FIB-4 index to predict post-hepatectomy liver failure in patients with hepatocellular carcinoma. Sci Rep 2024; 14:8034. [PMID: 38580647 PMCID: PMC10997654 DOI: 10.1038/s41598-024-58205-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 03/26/2024] [Indexed: 04/07/2024] Open
Abstract
Post-hepatectomy liver failure (PHLF) is a potentially life-threatening complication following liver resection. Hepatocellular carcinoma (HCC) often occurs in patients with chronic liver disease, which increases the risk of PHLF. This study aimed to investigate the ability of the combination of liver function and fibrosis markers (ALBI score and FIB-4 index) to predict PHLF in patients with HCC. Patients who underwent hepatectomy for HCC between August 2012 and September 2022 were considered for inclusion. Multivariable logistic regression analysis was used to identify factors associated with PHLF, and ALBI score and FIB-4 index were combined based on their regression coefficients. The performance of the combined ALBI-FIB4 score in predicting PHLF and postoperative mortality was compared with Child-Pugh score, MELD score, ALBI score, and FIB-4 index. A total of 215 patients were enrolled in this study. PHLF occurred in 35 patients (16.3%). The incidence of severe PHLF (grade B and grade C PHLF) was 9.3%. Postoperative 90-d mortality was 2.8%. ALBI score, FIB-4 index, prothrombin time, and extent of liver resection were identified as independent factors for predicting PHLF. The AUC of the ALBI-FIB4 score in predicting PHLF was 0.783(95%CI: 0.694-0.872), higher than other models. The ALBI-FIB4 score could divide patients into two risk groups based on a cut-off value of - 1.82. High-risk patients had a high incidence of PHLF of 39.1%, while PHLF just occurred in 6.6% of low-risk patients. Similarly, the AUCs of the ALBI-FIB4 score in predicting severe PHLF and postoperative 90-d mortality were also higher than other models. Preoperative ALBI-FIB4 score showed good performance in predicting PHLF and postoperative mortality in patients undergoing hepatectomy for HCC, superior to the currently commonly used liver function and fibrosis scoring systems.
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Affiliation(s)
- Yi-Bo Tian
- Department of Hepatobiliary Surgery, Jincheng People's Hospital, Jincheng, 048026, Shanxi Province, China
- Department of Emergency, Jincheng General Hospital, Jincheng, 048000, Shanxi Province, China
| | - Hong Niu
- Department of Gastroenterology, Jincheng General Hospital, Jincheng, 048000, Shanxi Province, China
| | - Feng Xu
- Department of General Surgery, Jincheng General Hospital, Jincheng, 048000, Shanxi Province, China.
| | - Peng-Wei Shang-Guan
- Department of General Surgery, Jincheng General Hospital, Jincheng, 048000, Shanxi Province, China
| | - Wei-Wei Song
- Department of Medical Quality Control, Jincheng General Hospital, Jincheng, 048000, Shanxi Province, China
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Namakchian M, Rabizadeh S, Seifouri S, Asadigandomani H, Bafrani MA, Seifouri K, Avanaki FA, Rajab A, Nakhjavani M, Esteghamati A. Fibrosis score 4 index has an independent relationship with coronary artery diseases in patients with metabolic-associated fatty liver disease. Diabetol Metab Syndr 2023; 15:57. [PMID: 36964605 PMCID: PMC10039491 DOI: 10.1186/s13098-023-01031-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/15/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Metabolic-associated fatty liver disease (MAFLD), one of the most common liver diseases, is detected in patients with concomitant hepatic steatosis and Type 2 Diabetes (T2D). We looked into the relationship between Fibrosis-4 (FIB-4) index and coronary artery diseases (CAD) in patients with MAFLD, to further look into the efficiency of FIB-4 in screening for CAD among patients with MAFLD. METHOD In this study, we included 1664 patients with MAFLD (T2D, who also had hepatic steatosis) during 2012-2022 and divided them into 2 groups; CAD and non-CAD. Demographic, Anthropometric indices, liver function tests, lipid profile and FIB-4 index of all patients were evaluated and compared. RESULT Among the 1644 patients (all have MAFLD), 364(21.4%) had CAD. Patients with MAFLD and CAD were more probable to be hypertensive, have longer duration of diabetes and be older (with p-values < 0.001). After adjustment for confounding factors, in a multivariable logistic regression model, FIB4 showed a significant independent relationship with concomitant MAFLD and CAD. Upper Tertile FIB-4 had an odds ratio of 3.28 (P-value = 0.002) to predict CAD. Furthermore, in Receiver Operating Characteristic (ROC) Curve analysis with the maximum Youden Index, a FIB-4 cut-off of 0.85 (AUC = 0.656, 95% CI 0.618-0.693, P < 0.001) noted to predict CAD in patients with MAFLD. CONCLUSION This study showed that the FIB-4 score independently correlates with CAD in patients with MAFLD.
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Affiliation(s)
- Maryam Namakchian
- Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, 13145-784 Iran
| | - Soghra Rabizadeh
- Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, 13145-784 Iran
| | - Sara Seifouri
- Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, 13145-784 Iran
| | - Hassan Asadigandomani
- Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, 13145-784 Iran
| | - Melika Arab Bafrani
- Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, 13145-784 Iran
| | - Kiana Seifouri
- Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, 13145-784 Iran
| | - Foroogh Alborzi Avanaki
- Departments of Gastroenterology and Hepatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Armin Rajab
- Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, 13145-784 Iran
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, 13145-784 Iran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Hospital Complex, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, 13145-784 Iran
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Kokubo R, Saito K, Yamada T, Tanaka T, Tajima Y, Suzuki K. Comparison of Liver Fibrosis and Function Indices with Extracellular Volume using Dual-Energy CT: A Retrospective Study. Curr Med Imaging 2022; 18:1180-1185. [PMID: 35392787 DOI: 10.2174/1573405618666220407100237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/05/2022] [Accepted: 01/31/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Dual-energy computed tomography (DECT) enables the direct measurement of iodine accumulation in the extracellular space. OBJECTIVE To compare measures of liver fibrosis and function with extracellular volume (ECV) from iodine/water images using DECT. METHODS Data was obtained from 119 consecutive patients who underwent abdominal DECT. A region of interest was set in the right lobe of the liver, pancreas, spleen, and aorta on iodine density images. ECV was calculated using the following formula: ECV = (1 hematocrit) × [iodine concentration in the liver (or pancreas, spleen) / iodine concentration in the aorta]. The severity of liver fibrosis was estimated using the aminotransferase/platelet ratio index (APRI) and the Fibrosis-4 (FIB-4) index. Liver function was assessed by the Child-Pugh classification and albumin-bilirubin (ALBI) grade. Data were analyzed by Spearman rank correlation coefficient, one-way analysis of variance, and post hoc analysis. RESULTS The correlation between ECV and fibrosis indices (APRI and FIB-4) was only significant and with a weak magnitude for the liver ECV quantification at the equilibrium phase (r=0.25 and r=0.20, respectively). The correlations between liver function index and ECV quantification were more robust than with fibrosis index. The highest correlations (r=0.50) were found between ALBI grade and liver ECV at the equilibrium phase. Liver ECV value at the equilibrium phase were significant difference between ALBI grade 1 vs. 2 and grade 1 vs. 3. CONCLUSION Liver ECV quantification by DECT is more suitable for evaluating liver function than liver fibrosis severity.
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Affiliation(s)
- Reiji Kokubo
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Kazuhiro Saito
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Takafumi Yamada
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Taro Tanaka
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Yu Tajima
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Kunihito Suzuki
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
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Ide T, Koga H, Nakano M, Hashimoto S, Yatsuhashi H, Higuchi N, Nakamuta M, Oeda S, Eguchi Y, Shakado S, Sakisaka S, Yoshimaru Y, Sasaki Y, Honma Y, Harada M, Seike M, Maeshiro T, Miuma S, Nakao K, Mawatari S, Ido A, Nagata K, Matsumoto S, Takami Y, Sohda T, Kakuma T, Torimura T. Direct-acting antiviral agents do not increase the incidence of hepatocellular carcinoma development: a prospective, multicenter study. Hepatol Int. 2019;13:293-301. [PMID: 30820753 DOI: 10.1007/s12072-019-09939-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 02/12/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND While achieving sustained virological response (SVR) following interferon-based or direct-acting antiviral agent (DAA) treatments reduces the incidence of hepatocellular carcinoma (HCC), an increase in unexpected early occurrence or recurrence of HCC after hepatitis C virus elimination by DAA treatments has been reported. We prospectively investigated the incidence and risk factors of HCC after DAA treatment in a large multicenter cohort in Japan. METHODS Patients with chronic hepatitis C with or without cirrhosis who were treated with DAAs and obtained SVR were enrolled. DAAs were administered for 3 or 6 months. A total of 2552 patients were enrolled. RESULTS Of these, 70 patients (2.7%) developed HCC. The 12-, 24-, and 36-month cumulative HCC incidences were 1.3%, 2.9%, and 4.9% in all patients; 2.5%, 5.2%, and 10.0% in those with cirrhosis; and 0.9%, 2.1%, and 2.9% in those without cirrhosis, respectively. Multivariate analysis revealed age, sex, gamma-glutamyl transpeptidase level, and fibrosis-4 index to be independent factors associated with HCC. Patients with these four factors had an approximately six-to-sevenfold increased risk for HCC development. Five patients with large and early tumor occurrence did not receive contrast imaging examinations before treatment. CONCLUSION Although the results of our prospective study suggested that achieving SVR by DAA treatment reduces the incidence of HCC, HCC development still occurs. Careful follow-up is important in patients with risk factors.
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