Open Access

FIB‑4 index and serum α‑fetoprotein are useful predictors of hepatocellular carcinoma occurrence in hepatitis B patients with nucleos(t)ide analogs therapy

  • Authors:
    • Akifumi Kuwano
    • Masayuki Miyazaki
    • Masayoshi Yada
    • Kosuke Tanaka
    • Yuta Koga
    • Akihide Masumoto
    • Kenta Motomura
  • View Affiliations

  • Published online on: August 1, 2023     https://doi.org/10.3892/etm.2023.12140
  • Article Number: 441
  • Copyright: © Kuwano et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Current antiviral therapies cannot achieve eradication of hepatitis B virus (HBV) and can reduce but not eliminate the risk of hepatocellular carcinoma (HCC) in patients with chronic HBV infection. The present study aimed to identify the risk factors for HCC development by analyzing nucleoside analogue (NA)‑treated patients as a retrospective cohort using fibrosis‑4 index (FIB‑4 index) as a non‑invasive fibrosis marker. A total of 260 patients with HBV receiving NAs without a history of HCC between January 2001 and January 2021 were included in the present study. The incidence of HCC in patients with HBV during NA therapy and the factors contributing to HCC occurrence were identified using clinical characteristics and blood test results. Among the 260 patients, 40 patients (15.4%) developed HCC. Univariate and multivariate analysis showed that age [hazard ratio (HR), 1.03; P=0.045], male sex (HR, 3.14; P<0.01) and FIB‑4 index at 6 months after NA treatment <1.95 (HR, 4.35; P<0.01) correlated with the incidence of HCC. The cumulative incidence of HCC in patients with FIB‑4 index at 6 months after NA treatment >1.95 was significantly higher compared with that in patients with FIB‑4 index ≤1.95 (P<0.01). Multivariate analysis in patients in which serum α‑fetoprotein (AFP) level at 6 months after NA treatment was measured showed that FIB‑4 index >1.95 (HR, 8.27; P=0.014) and serum AFP level >4 ng/ml (HR, 4.26; P=0.033) contributed to HCC occurrence. FIB‑4 index at 6 months after NA treatment and serum AFP levels at 6 months after NA treatment were predictors for the development of HCC in patients with HBV during NA treatment. Further study of hepatocarcinogenesis during NA with a longer follow‑up period and larger numbers of participants is required.
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September-2023
Volume 26 Issue 3

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Kuwano A, Miyazaki M, Yada M, Tanaka K, Koga Y, Masumoto A and Motomura K: FIB‑4 index and serum α‑fetoprotein are useful predictors of hepatocellular carcinoma occurrence in hepatitis B patients with nucleos(t)ide analogs therapy. Exp Ther Med 26: 441, 2023.
APA
Kuwano, A., Miyazaki, M., Yada, M., Tanaka, K., Koga, Y., Masumoto, A., & Motomura, K. (2023). FIB‑4 index and serum α‑fetoprotein are useful predictors of hepatocellular carcinoma occurrence in hepatitis B patients with nucleos(t)ide analogs therapy. Experimental and Therapeutic Medicine, 26, 441. https://doi.org/10.3892/etm.2023.12140
MLA
Kuwano, A., Miyazaki, M., Yada, M., Tanaka, K., Koga, Y., Masumoto, A., Motomura, K."FIB‑4 index and serum α‑fetoprotein are useful predictors of hepatocellular carcinoma occurrence in hepatitis B patients with nucleos(t)ide analogs therapy". Experimental and Therapeutic Medicine 26.3 (2023): 441.
Chicago
Kuwano, A., Miyazaki, M., Yada, M., Tanaka, K., Koga, Y., Masumoto, A., Motomura, K."FIB‑4 index and serum α‑fetoprotein are useful predictors of hepatocellular carcinoma occurrence in hepatitis B patients with nucleos(t)ide analogs therapy". Experimental and Therapeutic Medicine 26, no. 3 (2023): 441. https://doi.org/10.3892/etm.2023.12140