Novel combined fibrosis-based index predicts the long-term outcomes of hepatocellular carcinoma after hepatic resection
Novel combined fibrosis-based index predicts the long-term outcomes of hepatocellular carcinoma after hepatic resection
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DOI：
10.1007/s10147-021-02111-7
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发表时间：
2022-01-11
影响因子：
3.3
通讯作者：
Ikegami，Toru
中科院分区：
文献类型：
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作者：
Yanagaki，Mitsuru;Shirai，Yoshihiro;Ikegami，Toru
目的肝纤维化影响肝再生和手术效果。纤维化-4（FIB-4）指数与肝纤维化和肝硬化密切相关。本研究旨在研究FIB-4指数和维生素K缺乏或拮抗剂诱导的蛋白质-II（PIVKA-II）（PIVKA-II-FIB-4指数评分）的组合在接受肝细胞癌（HCC）根治性切除术的患者中的预后意义。我们回顾性研究了FIB-4指数与无病生存率和总生存率的关系，根据受试者工作特征（ROC）分析，FIB-4指数的最佳截止值为3.44。在多变量分析中，高PIVKA-II和FIB-4指数值是无病生存期（分别为P= 0.013和P = 0.005）和总生存期（分别为P= 0.048和P < 0.001）的独立预测因子。我们将PIVKA-II和FIB-4指数水平分为两组（高与低），并通过每次测量的总和（高，1;低，0）计算新评分（PIVKA-II-FIB-4指数评分; 0-2）。PIVKA-II-FIB-4指数评分为0、1和2的患者的5年总生存率分别为84.9、74.4和47.1%结论术前PIVKA-II和FIB-4联合检测可作为肝癌切除术后的预后指标，这表明综合评分对于评估癌症病例的肝纤维化状态很有用。
AimLiver fibrosis influences liver regeneration and surgical outcomes. The fibrosis-4 (FIB-4) index is strongly associated with liver fibrosis and cirrhosis. This study aimed to examine the prognostic significance of the combination of FIB-4 index and Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) (PIVKA-II–FIB-4 index score) in patients who underwent curative resection for hepatocellular carcinoma (HCC).MethodsWe included 284 patients who underwent elective hepatic resection for HCC between January 2000 and December 2018. We retrospectively investigated how FIB-4 index is related to disease-free survival and overall survival.ResultsAccording to a receiver operating characteristic (ROC) analysis, the optimal cutoff value of the FIB-4 index was 3.44. In a multivariate analysis, high PIVKA-II and FIB-4 index values were independent predictors of both disease-free survival (P= 0.013 andP= 0.005, respectively) and overall survival (P= 0.048 andP< 0.001, respectively). We classified the PIVKA-II and FIB-4 index levels into two groups (high vs. low) and calculated a new score (PIVKA-II–FIB-4 index score; 0–2) by the sum of each measurement (high, 1; low, 0). The 5 year overall survival rates of patients with PIVKA-II–FIB-4 index scores of 0, 1, and 2 were 84.9, 74.4, and 47.1%, respectively (P< 0.001).ConclusionThe combination of the preoperative PIVKA-II and FIB-4 index may be a prognostic factor of HCC after hepatic resection, suggesting that the combined score is useful in assessing the liver fibrosis status in cancer cases.