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non-invasive tests for the prediction of primary hepatocellular carcinoma

World Journal of Gastroenterology 2020年第24期26卷 3326-3343页

作者： Giovanni Marasco Antonio Colecchia Giovanni Silva Benedetta Rossini Leonardo Henry Eusebi Federico Ravaioli Elton Dajti Luigina Vanessa Alemanni Luigi Colecchia Matteo Renzulli Rita Golfieri Davide Festi Department of Medical and Surgical Sciences(DIMEC) University of BolognaBologna 40138Italy Unit of Gastroenterology Borgo Trento University Hospital of VeronaVerona 37126Italy Radiology Unit Sant’Orsola Malpighi HospitalUniversity of BolognaBologna 40138Italy

Hepatocellular carcinoma(HCC)is one of the most common malignancies in the world and it is one of the main complications of cirrhosis and portal *** in the presence of a well-established follow-up protocol for cirrhotic patients,to date poor data are available on predictive markers for primary HCC occurrence in the setting of compensated advanced chronic liver disease patients(cACLD).The gold standard method to evaluate the prognosis of patients with cACLD,beyond liver fibrosis assessed with histology,is the measurement of the hepatic venous pressure gradient(HVPG).An HVPG≥10 mmHg has been related to an increased risk of HCC in cACLD ***,these methods are burdened by additional costs and risks for patients and are mostly available only in referral *** the last decade increasing research has focused on the evaluation of several,simple,non-invasive tests(NITs)as predictors of HCC *** reviewed the currently available literature on biochemical and ultrasound-based scores developed for the noninvasive evaluation of liver fibrosis and portal hypertension in predicting primary *** found that the most reliable methods to assess HCC risk were the liver stiffness measurement,the aspartate aminotransferase to platelet ratio index score and the fibrosis-4 *** promising NITs need further investigations and validation for different liver disease aetiologies.

关键词： non-invasive test Fibrosis-4 index Hepatocellular carcinoma Liver stiffness measurement Spleen stiffness measurement Albi

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invasive and non-invasive diagnosis of cirrhosis and portal hypertension

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World Journal of Gastroenterology 2014年第15期20卷 4300-4315页

作者： Moon Young Kim Woo Kyoung Jeong Soon Koo Baik Department of Internal Medicine Yonsei University Wonju College of MedcineWonju Severance Christan HospitalWonju 220-701South Korea Department of Radiology and Center for Imaging Science Samsung Medical CenterSungkyunkwan University School of MedicineSeoul 440-746South Korea

With advances in the management and treatment of advanced liver disease,including the use of antiviral therapy,a simple,one stage description for advanced fibrotic liver disease has become *** refining the diagnosis of cirrhosis to reflect disease heterogeneity is essential,current diagnostic tests have not kept pace with the progression of this new *** biopsy and hepatic venous pressure gradient measurement are the gold standards for the estimation of hepatic fibrosis and portal hypertension(PHT),respectively,and they have diagnostic and prognostic ***,they are invasive and,as such,cannot be used repeatedly in clinical *** ideal noninvasive test should be safe,easy to perform,inexpensive,reproducible as well as to give numerical and accurate results in real *** should be predictive of long term outcomes related with fibrosis and PHT to allow prognostic ***,many types of noninvasive alternative tests have been developed and are under *** particular,imaging and ultrasound based tests,such as transient elastography,have shown promising *** most of these noninvasive tests effectively identify severe fibrosis and PHT,the methods available for diagnosing moderate disease status are still insufficient,and further investigation is essential to predict outcomes and individualize therapy in this field.

关键词： Hepatic fibrosis Portal hypertension Liver biopsy Hepatic venous pressure gradient non-invasive test Transient elastography

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Metabolic-associated Fatty Liver Disease as Assessed by the Fatty Liver Index Among Migrant and non-migrant Ghanaian Populations

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Journal of Clinical and Translational Hepatology 2021年第4期9卷 494-502页

作者： Anne-Marieke van Dijk Sjoerd Dingerink Felix Patience Chilunga Karlijn Anna Catharina Meeks Silver Bahendeka Matthias Bernd Schulze Ina Danquah Tracy Bonsu Osei Erik Serné Charles Agyemang Adriaan Georgius Holleboom Department of Vascular Medicine Amsterdam UMClocation AMCAmsterdamthe Netherlands Department of Public Health Amsterdam UMClocation AMCAmsterdam Public Health Research InstituteAmsterdamthe Netherlands Center for Research on Genomics and Global Health National Human Genome Research InstituteNational Institutes of HealthBethesdaMDUSA MKPGMS-Uganda Martyrs University KampalaUganda Department of Molecular Epidemiology German Institute of Human Nutrition Potsdam-RehbrueckeNuthetalGermany Institute of Nutritional Science University of PotsdamNuthetalGermany Heidelberg Institute of Global Health(HIGH) Universitaetsklinikum HeidelbergHeidelbergGermany Department of Vascular Medicine Amsterdam UMClocation VUmcthe Netherlands

Background and Aims:Metabolic-associated fatty liver disease(MAFLD)is driven by high caloric intake and sedentary *** towards high income countries may induce these driving factors;yet,the influence of such on the prevalence of MAFLD is clearly ***,we investigated the Fatty Liver Index(FLI),a proxy of steatosis in MAFLD,after migration of Ghanaian ***:Cross-sectional data of 5282 rural,urban and migrant participants from the Research on Obesity and Diabetes among African Migrants(also known as RODAM)study were analyzed with logistic regression for geographical differences in FLI and associations with type 2 diabetes mellitus(T2DM),waist-to-hip ratio,and 10-year predicted risk of atherosclerotic cardiovascular disease(ASCVD).Results:Both FLI and the proportion with an FLI indicative of MAFLD steatosis(FLI≥60)were higher in migrants compared with *** of elevated FLI(FLI≥60)in non-migrant males was 4.2%compared to 28.9%in *** females,a similar gradient was observed,from 13.6%to 36.6%*** to rural residents,the odds for a FLI≥60 were higher in migrants living in urban Europe(odds ratio[OR]9.02,95%confidence interval[CI]:5.02–16.20 for men,and 4.00,95%CI:3.00–5.34 for women).Compared to controls,the ORs for FLI≥60 were 2.43(95%CI:1.73–3.41)for male T2DM cases and 2.02(95%CI:1.52–2.69)for female T2DM ***-unit higher FLI was associated with an elevated(≥7.5%)10-year ASCVD risk(OR:1.051,95%CI:1.041–1.062 for men,and 1.020,95%CI:1.015–1.026 for women).Conclusions:FLI as a proxy for MAFLD increased stepwise in Ghanaians from rural areas,through urban areas,to *** results clearly warrant awareness for MAFLD in migrant population as well as confirmation with imaging modalities.

关键词： Fatty liver non-invasive test Migration African population

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Utility of FibroScan-based scoring systems to narrow the risk group of nonalcoholic fatty liver disease with comorbidities

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World Journal of Gastrointestinal Pathophysiology 2022年第3期13卷 96-106页

作者： Kouichi Miura Hiroshi Maeda Naoki Morimoto Shunji Watanabe Mamiko Tsukui Yoshinari Takaoka Hiroaki Nomoto Rie Goka Kazuhiko Kotani Hironori Yamamoto Department of Medicine Division of GastroenterologyJichi Medical University School of Medicine3311-1 YakushijiShimotsuke 329-0498TochigiJapan Division of Community and Family Medicine Center for Community MedicineJichi Medical University3311-1 YakushijiShimotsuke 329-0498Japan

BACKGROUND Vibration-controlled transient elastography(VCTE)is proposed as a second step of examination to assess liver fibrosis in patients with nonalcoholic fatty liver disease(NAFLD)after triaging by the fibrosis-4(FIB-4)***,VCTEbased scoring systems,including FibroScan-AST(FAST),Agile 3+,and Agile 4,emerged to determine the status of ***,the significance of these scoring systems remains unknown in narrowing the high-risk group of NAFLD patients with comorbidities,including hepatocellular carcinoma(HCC)and esophagogastric varices(EGV).AIM To clarify the significance of VCTE-based scoring systems to narrow the high-risk group of NAFLD patients with *** We performed a cross-sectional study to investigate the usefulness of VCTE-based scoring systems and other fibrosis markers to narrow the high-risk group of patients with ***-4 index was used for the first *** groups of FAST,Agile 3+,and Agile 4 were stratified according to the published *** the 191 patients with NAFLD,there were 26(14%)and 25 patients(13%)with HCC and EGV,*** When 1.3 was used as a cutoff value,the FIB-4 index narrowed the risk group to 120 patients,in which all patients with HCC and/or EGV were *** risk group of Agile 3+could subsequently narrow the risk *** prevalence of HCC and EGV at this step were 33%(26/80)and 31%(25/80),*** further narrowing of EGV,Agile 4 aggregated the patients with EGV into 43 patients,of whom 23(53%)had *** failed to narrow the risk group of patients with *** 2.6 was used as a cutoff value of the FIB-4 index,three patients with HCC and two patients with EGV were missed at the first *** Agile 3+and Agile 4 are useful to narrow the NAFLD patient group,in which patients may have HCC and/or EGV.

关键词： nonalcoholic fatty liver disease Vibration controlled transient elastography non-invasive test Hepatocellular carcinoma Varix

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Changing liver stiffness predict regression in advanced fibrosis patients with chronic hepatitis B,but not in moderate fibrosis patients

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Gastroenterology & Hepatology Research 2023年第1期5卷 13-18页

作者： Zhengxin Li Tingting Zhu Zhimin Zhao Li Shen Gaofeng Chen Hongtu Gu Chenghai Liu Shuguang Hospital Shanghai University of Traditional Chinese MedicineShanghai 201203China Shanghai Key Laboratory of Traditional Chinese Clinical Medicine Shanghai 201203China Gongli Hospital of Shanghai Pudong New Area Shanghai 200135China

Background and objective:Liver stiffness measurement(LSM)may effectively correlate to the presence of liver fibrosis,but it is controversial to use for the prediction of clinical ***,we aimed to evaluate the predictive value of liver stiffness for the regression of liver ***:In this study,we collected data from a clinical cohort of patients who are received anti-virus therapies for 48 weeks.180 naive chronic hepatitis B(CHB)patients,who received paired LSM and liver biopsy with pre-and post-treatments were *** methods(FibroScan and iLivTouch)test ***:The area under the receiver operating characteristics curve(AUROC)of changing LSM for fibrosis regression is higher in advanced fibrosis patients(F5/6)than in moderate fibrosis patients(F3/4)in both FibroScan(0.719,95%CI,0.590–0.848;P=0.003;vs 0.617,95%CI,0.379–0.856,P=0.282)and iLivTouch(0.707,95%CI,0.567–0.847;P=0.011;vs 0.583,95%CI,0.422–0.744;P=0.377).A higher kappa value was received in advanced stage than in moderate stage both in FibroScan(0.392,P=0.001 vs 0.265,P=0.053)and iLivTouch(0.326,P=0.019 vs 0.030,P=0.833).Cut-off set as 4.10 kPa(sen,69.4%;spe,73.9%)in FibroScan,as 4.25 kPa(sen,56.8%;spe,72.2%)in ***:The changing LSM can be used for predicting the liver fibrosis regression in advanced stage of CHB patients.

关键词： chronic hepatitis B liver stiffness measurement liver fibrosis non-invasive test

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