FIB‑4 index and NAFLD fibrosis score are useful indicators for screening high‑risk groups of non‑viral hepatocellular carcinoma

Imai,Kenji; Takai,Koji; Unome,Shinji; Miwa,Takao; Hanai,Tatsunori; Suetsugu,Atsushi; Shimizu,Masahito

doi:10.3892/mco.2023.2676

FIB‑4 index and NAFLD fibrosis score are useful indicators for screening high‑risk groups of non‑viral hepatocellular carcinoma

Authors:
- Kenji Imai
- Koji Takai
- Shinji Unome
- Takao Miwa
- Tatsunori Hanai
- Atsushi Suetsugu
- Masahito Shimizu
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Affiliations: Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, Gifu 501‑1194, Japan
Published online on: August 24, 2023 https://doi.org/10.3892/mco.2023.2676
Article Number: 80
Copyright: © Imai et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Non‑viral hepatocellular carcinoma (HCC) tends to appear in non‑cirrhotic livers, rendering it difficult to screen for a high‑risk group. The present study aimed to identify the most suitable indicator for screening high‑risk groups of non‑viral HCC. A total of 190 patients with non‑viral HCC, including 126 with non‑alcoholic fatty liver disease (NAFLD)/non‑alcoholic steatohepatitis (NASH), were enrolled in the present study. A total of two cut‑off values, for low and high levels of fibrosis, were set for each of the indicators, including the Child‑Pugh score (CPS; 6 and 7), platelet counts (15.8 and 10x10⁴/µl), albumin‑bilirubin (ALBI) score (‑2.60 and ‑2.27), fibrosis 4 index (FIB‑4 index; 1.30 and 2.67) and NAFLD fibrosis score (NFS; ‑1.455 and 0.675). The ratio of the number of patients who fell outside the cut‑off value for all patients was defined as the overlooking rate. The overlooking rates of CPS, platelet counts, ALBI score, FIB‑4 index and NFS for the low fibrosis cut‑off value were 41.0, 48.9, 35.8, 4.2 and 5.8%, respectively. When performing analysis limited to the NAFLD cases, those of the FIB‑4 index and NFS were 4.8 and 6.3%, respectively. Those for the high fibrosis cut‑off value were 79.5, 73.2, 62.6, 30.0 and 37.4%, respectively. On the whole, the present study demonstrates that the cut‑off values of ≥1.30 for the FIB‑4 index or ≥‑1.455 for the NFS may be used to screen high‑risk groups of HCC among patients with non‑viral hepatitis.

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