Zeng Zhan, Han Yifan, Li Wengang, Chen Hongyu, Lin Ning, Yu Yanyan, Xu Xiaoyuan
Department of Infectious Diseases, Peking University First Hospital, Beijing, China.
Department of Gastroenterology, Peking University First Hospital, Beijing, China.
Cancer Med. 2025 Jan;14(1):e70535. doi: 10.1002/cam4.70535.
Exploring fibrosis index-4 (FIB-4)'s predictive value for HBV-related hepatocellular carcinoma (HCC) in assessing recurrence following stereotactic body radiation therapy (SBRT) in patients with HBV-related HCC.
HBV-related HCC patients who underwent SBRT were retrospectively enrolled from March 2012 to March 2020. Patients were divided into recurrence and non-recurrence groups based on the HCC recurrence situation. Baseline data were collected from all patients before treatment and at 3 and 6 months after treatment, and FIB-4 was calculated at the corresponding time points. Risk factors were selected using Cox regression. The FIB-4 was stratified for survival analysis.
One hundred and fifty-two patients were included. With a mean age of 53.5 years old, 94.1% of them had liver cirrhosis. The median recurrence-free survival (RFS) time for recurrent patients was 17.5 months. The tumor response rate of SBRT was 94.8%. HCC recurrence rates at 12, 24, 36, 48, and 60 months were 19.7% (30/152), 38.2% (58/152), 48.0% (73/152), 52.0% (79/152), and 53.3% (81/152), respectively. Cox regression showed that baseline FIB-4 (95% CI: 1.030 ~ 1.144, p = 0.002) and 3 tumor nodules (95% CI: 3.727 ~ 260.663, p = 0.002) are risk factors for HCC recurrence. Patients with a baseline FIB-4 > 6.55 were at a higher risk of HCC recurrence than those with a baseline FIB-4 < 6.55 (p < 0.001).
Baseline FIB-4 is a risk factor for recurrence after SBRT in patients with HBV-related HCC, and the predictive threshold for FIB-4 is higher in patients with cirrhosis. For patients who received radiotherapy, postoperative FIB-4 levels are elevated.
探讨纤维化指数-4（FIB-4）对乙肝相关肝细胞癌（HCC）患者在接受立体定向体部放疗（SBRT）后评估复发情况的预测价值。
回顾性纳入2012年3月至2020年3月期间接受SBRT的乙肝相关HCC患者。根据HCC复发情况将患者分为复发组和未复发组。收集所有患者治疗前、治疗后3个月和6个月的基线数据，并在相应时间点计算FIB-4。采用Cox回归选择危险因素。对FIB-4进行分层以进行生存分析。
共纳入152例患者。平均年龄53.5岁，其中94.1%有肝硬化。复发患者的无复发生存（RFS）时间中位数为17.5个月。SBRT的肿瘤缓解率为94.8%。12、24、36、48和60个月时HCC复发率分别为19.7%（30/152）、38.2%（58/152）、48.0%（73/152）、52.0%（79/152）和53.3%（81/152）。Cox回归显示，基线FIB-4（95%CI：1.030～1.144，p = 0.002）和3个肿瘤结节（95%CI：3.727～260.663，p = 0.002）是HCC复发的危险因素。基线FIB-4＞6.55的患者比基线FIB-4＜6.55的患者HCC复发风险更高（p＜0.001）。
基线FIB-4是乙肝相关HCC患者SBRT后复发的危险因素，且肝硬化患者FIB-4的预测阈值更高。对于接受放疗的患者，术后FIB-4水平升高。
