Dong J, Xu X-h, Ke M-y, Xiang J-x, Liu W-y, Liu X-m, Wang B, Zhang X-f, Lv Y
Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China; Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, China.
Department of Hepatobiliary Surgery, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China; Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, China.
Eur J Surg Oncol. 2016 May;42(5):722-7. doi: 10.1016/j.ejso.2016.02.009. Epub 2016 Feb 18.
The fibrosis score 4 (FIB-4) score is a useful tool to determine the degree of hepatic fibrosis. Liver fibrosis and cirrhosis are well-known predictors of postoperative complications after hepatectomy. This study examined the impact of FIB-4 on postoperative short-term outcomes of patients with hepatocellular carcinoma (HCC).
Three hundred and fifty patients undergoing hepatectomy for HCC between 2008 and 2013 were enrolled. The receiver operating characteristic (ROC) curve analysis was performed to determine the cutoff value of the FIB-4. Univariate and multivariate analysis was performed to identify the risk factors. The correlation of the preoperative FIB-4 value with clinicopathological parameters was examined.
Postoperative complications were observed in 202 (57.7%) patients. The optimal cutoff value of the FIB-4 was set at 2.88 and 3.85 for postoperative complications and intraoperative blood loss respectively. It was also an independent prognostic factor for postoperative complications (hazard ratio [HR], 1.202; 95% CI, 1.076-1.344; P = 0.001) and intraoperative blood loss (HR, 1.196; 95% CI, 1.091-1.343; P < 0.001) by multivariate analysis. The FIB-4 was significantly correlated with age, liver function, coagulation function, blood loss, intraoperative blood transfusion (all P < 0.05).
Preoperative FIB-4 is a useful index to predict postoperative outcomes in patients with HCC. The FIB-4 should be assessed routinely for hepatocellular carcinoma patients.
纤维化4（FIB-4）评分是确定肝纤维化程度的有用工具。肝纤维化和肝硬化是肝切除术后术后并发症的众所周知的预测指标。本研究探讨了FIB-4对肝细胞癌（HCC）患者术后短期结局的影响。
纳入2008年至2013年间350例行HCC肝切除术的患者。进行受试者操作特征（ROC）曲线分析以确定FIB-4的临界值。进行单因素和多因素分析以确定危险因素。研究术前FIB-4值与临床病理参数的相关性。
202例（57.7%）患者出现术后并发症。FIB-4的最佳临界值分别设定为2.88和3.85，用于术后并发症和术中失血。多因素分析显示，它也是术后并发症（风险比[HR]，1.202；95%可信区间，1.076-1.344；P = 0.001）和术中失血（HR，1.196；95%可信区间，1.091-1.343；P < 0.001）的独立预后因素。FIB-4与年龄、肝功能、凝血功能、失血量、术中输血均显著相关（均P < 0.05）。
术前FIB-4是预测HCC患者术后结局的有用指标。对于肝细胞癌患者，应常规评估FIB-4。
