Abstract

BACKGROUND: Although both hepatic fibrosis progression and hepatitis C virus (HCV) contribute to hepatocellular carcinoma (HCC) development, early detection of HCC remains challenging. Therefore, we evaluated clinical markers of fibrosis in HCV patients to improve early HCC diagnosis.

MATERIAL AND METHODS: Our retrospective study included 711 chronic HCV patients: 249 HCC patients and 462 non-HCC patients. To investigate the predictive ability of non-invasive scores for diagnosing HCC development, we compared 4 blood indices: fibrosis index based on 4 factors (FIB-4), aspartate aminotransferase-to-platelet count ratio index (APRI), aspartate aminotransferase-to-alanine aminotransferase ratio (AAR), and gamma-glutamyl transpeptidase-to-platelet count ratio (GPR).

RESULTS: HCC patients had significantly higher scores for all fibrosis indices compared to chronic HCV patients without HCC. Moreover, the diagnostic performance of FIB-4 (area under curve, AUC: 0.961) was superior to that of APRI, AAR, and GPR (AUC: 0.636, 0.746, and 0.661, respectively) for prediction of HCC. FIB-4 also out-performed other indices in the prediction of cirrhotic cases, with an AUC of 0.775 compared to other scores, which ranged from an AUC of 0.597 to 0.671.

CONCLUSIONS: Together, these results suggest that FIB-4 is an appropriate diagnostic indicator of liver cirrhosis and HCC in chronic HCV patients in China.

Keywords: Carcinoma, Hepatocellular, Hepatitis C, Liver Cirrhosis, Aged, Alanine Transaminase, Aspartate Aminotransferases, Biomarkers, Tumor, Disease Progression, Hepacivirus, Hepatitis C, Chronic, Liver Neoplasms, Middle Aged, Platelet Count, Prognosis, Retrospective Studies, Severity of Illness Index, gamma-Glutamyltransferase