Abstract
BackgroundAdvanced 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.MethodsThe 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).ResultsThis 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.ConclusionThe results showed that this novel preoperative model was an excellent noninvasive method for assessing liver fibrosis in HBV-infected HCC patients.
Highlights
The hepatocellular carcinoma (HCC) patients are often accompanied with different degrees of liver fibrosis [1,2]
The results showed that this novel preoperative model was an excellent noninvasive method for assessing liver fibrosis in hepatitis B virus (HBV)-infected HCC patients
The results showed that two coagulation function indexes (PT and international normalized ratio (INR)) of the patients with cirrhosis increased visibly, with all P values less than 0.001
Summary
The hepatocellular carcinoma (HCC) patients are often accompanied with different degrees of liver fibrosis [1,2]. Severe hepatic fibrosis or cirrhosis can lead to serious complications after partial hepatectomy, and even may cause patients’ death from liver failure [3]. Getting liver tissue by percutaneous liver biopsy or liver excision is still the traditional method for the assessment of liver fibrosis It is an invasive www.impactjournals.com/oncotarget and expensive procedure which restricts its widespread implementation in clinical practice, especially in the areas of poor medical conditions. This invasive method makes patients having heavy pain feeling, bleeding, and even death. 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
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