Gao Hengyi, Zhu Feng, Wang Min, Zhang Hang, Ye Dawei, Yang Jiayin, Jiang Li, Liu Chang, Qin Renyi, Yan Lunan, Xiao Guangqin
Department of General Surgery, Guizhou Provincial People's Hospital, Guiyang, China.
Department of Hepato-Pancreato-Biliary Surgery, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Oncotarget. 2017 Jan 17;8(3):4289-4300. doi: 10.18632/oncotarget.14024.
Advanced 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.
The 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).
This 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.
The results showed that this novel preoperative model was an excellent noninvasive method for assessing liver fibrosis in HBV-infected HCC patients.
晚期肝纤维化可导致肝部分切除术后出现严重并发症（甚至患者死亡）。术前经皮肝穿刺活检是一种评估肝纤维化的侵入性且昂贵的方法。我们旨在基于术前生物标志物建立一种非侵入性模型，以预测乙型肝炎病毒（HBV）感染的肝细胞癌（HCC）患者的肝纤维化情况。
对接受肝切除术的HBV感染肝癌患者进行回顾性和前瞻性纳入本研究。采用单因素分析比较轻度至中度肝纤维化患者和重度肝纤维化患者的变量。将有显著意义的因素纳入二元逻辑回归分析。确定具有显著意义的因素用于建立非侵入性模型。然后基于敏感性、特异性和受试者操作特征曲线下面积（AUC）来检验该新模型的诊断准确性。
本研究纳入了2176例接受肝部分切除术的HBV感染HCC患者（1682例回顾性研究对象和494例前瞻性研究对象）。回归分析表明总胆红素和凝血酶原时间与肝纤维化呈正相关。还表明血小板计数和纤维蛋白原与肝纤维化呈负相关。基于这四个因素的模型预测显著纤维化、晚期纤维化和肝硬化的AUC值分别为0.79 - 0.83、0.83 - 0.85和0.85 - 0.88。
结果表明，这种新的术前模型是评估HBV感染HCC患者肝纤维化的一种优秀的非侵入性方法。
