Prevalence of Low FIB-4 in MASLD-Related Hepatocellular Carcinoma: A Multicentre Study.
MASH
hepatoma
liver cancer
surveillance
Journal
Alimentary pharmacology & therapeutics
ISSN: 1365-2036
Titre abrégé: Aliment Pharmacol Ther
Pays: England
ID NLM: 8707234
Informations de publication
Date de publication:
27 Oct 2024
27 Oct 2024
Historique:
revised:
17
09
2024
received:
31
08
2024
accepted:
04
10
2024
medline:
28
10
2024
pubmed:
28
10
2024
entrez:
28
10
2024
Statut:
aheadofprint
Résumé
Major society guidelines recommend the fibrosis-4 index (FIB-4) as the initial step to risk stratifying people with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to evaluate the proportion of people with MASLD-related hepatocellular carcinoma (HCC) and a low FIB-4. This cohort study included 613 consecutive adults (33% female) diagnosed with MASLD-related HCC from January 2008 to August 2023 at seven international centres in Australia, India, Japan, South Korea, Singapore and the United States. The primary objective was to determine the proportion of participants with a low FIB-4, defined as FIB-4 < 1.3, or < 2 if age > 65 years, in people without cirrhosis. The mean (±SD) age and body mass index were 71 (±11) years and 27 (±7) kg/m More than a quarter of those with MASLD-related HCC without cirrhosis have a low FIB-4. The proposed clinical care pathways may not identify these people for further evaluation.
Sections du résumé
BACKGROUND
BACKGROUND
Major society guidelines recommend the fibrosis-4 index (FIB-4) as the initial step to risk stratifying people with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to evaluate the proportion of people with MASLD-related hepatocellular carcinoma (HCC) and a low FIB-4.
METHODS
METHODS
This cohort study included 613 consecutive adults (33% female) diagnosed with MASLD-related HCC from January 2008 to August 2023 at seven international centres in Australia, India, Japan, South Korea, Singapore and the United States. The primary objective was to determine the proportion of participants with a low FIB-4, defined as FIB-4 < 1.3, or < 2 if age > 65 years, in people without cirrhosis.
RESULTS
RESULTS
The mean (±SD) age and body mass index were 71 (±11) years and 27 (±7) kg/m
CONCLUSION
CONCLUSIONS
More than a quarter of those with MASLD-related HCC without cirrhosis have a low FIB-4. The proposed clinical care pathways may not identify these people for further evaluation.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Singapore Ministry of Health's National Medical Research Council
ID : MOH-001370
Organisme : Singapore Ministry of Health's National Medical Research Council
ID : MOH-001566
Organisme : NUHS Clinician Scientist Programme
ID : NCSP2.0/2023/NUHS/DH
Organisme : NCATS NIH HHS
ID : 5UL1TR001442
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01DK061734
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01DK130190
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01DK106419
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01DK121378
Pays : United States
Organisme : NIDDK NIH HHS
ID : R01DK124318
Pays : United States
Organisme : NIDDK NIH HHS
ID : P30DK120515
Pays : United States
Organisme : NHLBI NIH HHS
ID : P01HL147835
Pays : United States
Organisme : John C Martin Foundation
ID : RP124
Informations de copyright
© 2024 John Wiley & Sons Ltd.
Références
Z. M. Younossi, A. B. Koenig, D. Abdelatif, Y. Fazel, L. Henry, and M. Wymer, “Global Epidemiology of Nonalcoholic Fatty Liver Disease‐Meta‐Analytic Assessment of Prevalence, Incidence, and Outcomes,” Hepatology 64, no. 1 (2016): 73–84.
C. Estes, Q. M. Anstee, M. T. Arias‐Loste, et al., “Modeling NAFLD Disease Burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and the United States for the Period 2016–2030,” Journal of Hepatology 69, no. 4 (2018): 896–904.
K. Riazi, H. Azhari, J. H. Charette, et al., “The Prevalence and Incidence of NAFLD Worldwide: A Systematic Review and Meta‐Analysis,” Lancet Gastroenterology & Hepatology 7, no. 9 (2022): 851–861.
D. Q. Huang, H. B. El‐Serag, and R. Loomba, “Global Epidemiology of NAFLD‐Related HCC: Trends, Predictions, Risk Factors and Prevention,” Nature Reviews Gastroenterology & Hepatology 18, no. 4 (2021): 223–238.
R. Loomba and A. J. Sanyal, “The Global NAFLD Epidemic,” Nature Reviews. Gastroenterology & Hepatology 10, no. 11 (2013): 686–690.
N. W. S. Chew, C. H. Ng, D. J. H. Tan, et al., “The Global Burden of Metabolic Disease: Data From 2000 to 2019,” Cell Metabolism 35, no. 3 (2023): 414–428.e413.
D. J. H. Tan, C. H. Ng, M. Muthiah, et al., “Rising Global Burden of Cancer Attributable to High BMI From 2010 to 2019,” Metabolism, Clinical and Experimental 152 (2024): 155744.
L. A. Adams, J. F. Lymp, J. St Sauver, et al., “The Natural History of Nonalcoholic Fatty Liver Disease: A Population‐Based Cohort Study,” Gastroenterology 129, no. 1 (2005): 113–121.
Z. M. Younossi, M. Stepanova, J. Ong, et al., “Nonalcoholic Steatohepatitis Is the Most Rapidly Increasing Indication for Liver Transplantation in the United States,” Clinical Gastroenterology and Hepatology 19, no. 3 (2021): 580–589.e585.
J. H. Koh, C. H. Ng, B. Nah, D. J. H. Tan, R. Loomba, and D. Q. Huang, “NASH Is the Leading Cause of Hepatocellular Carcinoma in Liver Transplant Candidates,” Clinical Gastroenterology and Hepatology 22, no. 1 (2024): 197–199.e3.
D. Q. Huang, A. G. Singal, Y. Kono, D. J. H. Tan, H. B. El‐Serag, and R. Loomba, “Changing Global Epidemiology of Liver Cancer From 2010 to 2019: NASH is the Fastest Growing Cause of Liver Cancer,” Cell Metabolism 34, no. 7 (2022): 969–977.e962.
M. E. Rinella, B. A. Neuschwander‐Tetri, M. S. Siddiqui, et al., “AASLD Practice Guidance on the Clinical Assessment and Management of Nonalcoholic Fatty Liver Disease,” Hepatology 77, no. 5 (2023): 1797–1835.
F. Kanwal, J. H. Shubrook, L. A. Adams, et al., “Clinical Care Pathway for the Risk Stratification and Management of Participants With Nonalcoholic Fatty Liver Disease,” Gastroenterology 161, no. 5 (2021): 1657–1669.
F. Tacke, P. Horn, V. Wai‐Sun Wong, et al., “EASL‐EASD‐EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction‐Associated Steatotic Liver Disease (MASLD),” Journal of Hepatology 81, no. 3 (2024): 492–542.
F. E. Mózes, J. A. Lee, E. A. Selvaraj, et al., “Diagnostic Accuracy of Non‐Invasive Tests for Advanced Fibrosis in Participants With NAFLD: An Individual Patient Data Meta‐Analysis,” Gut 71, no. 5 (2022): 1006–1019.
G. Xiao, S. Zhu, X. Xiao, L. Yan, J. Yang, and G. Wu, “Comparison of Laboratory Tests, Ultrasound, or Magnetic Resonance Elastography to Detect Fibrosis in Participants With Nonalcoholic Fatty Liver Disease: A Meta‐Analysis,” Hepatology 66, no. 5 (2017): 1486–1501.
M. Chang, D. Chang, S. Kodali, et al., “Degree of Discordance Between FIB‐4 and Transient Elastography: An Application of Current Guidelines on General Population Cohort,” Clinical Gastroenterology and Hepatology 22, no. 7 (2024): 1453–1461.e1452.
V. Ajmera, K. Tesfai, E. Sandoval, et al., “Validation of AGA Clinical Care Pathway and AASLD Practice Guidance for Nonalcoholic Fatty Liver Disease in a Prospective Cohort of Participants With Type 2 Diabetes,” Hepatology 79, no. 5 (2024): 1098–1106.
D. J. H. Tan, C. H. Ng, S. Y. Lin, et al., “Clinical Characteristics, Surveillance, Treatment Allocation, and Outcomes of Non‐Alcoholic Fatty Liver Disease‐Related Hepatocellular Carcinoma: A Systematic Review and Meta‐Analysis,” Lancet Oncology 23, no. 4 (2022): 521–530.
C. Vitellius, E. Desjonqueres, M. Lequoy, et al., “MASLD‐Related HCC: Multicentre Study Comparing Participants With and Without Cirrhosis,” JHEP Reports 6, no. 10 (2024): 1–8.
J. G. Stine, B. J. Wentworth, A. Zimmet, et al., “Systematic Review With Meta‐Analysis: Risk of Hepatocellular Carcinoma in Non‐Alcoholic Steatohepatitis Without Cirrhosis Compared to Other Liver Diseases,” Alimentary Pharmacology & Therapeutics 48, no. 7 (2018): 696–703.
R. Loomba, J. K. Lim, H. Patton, and H. B. El‐Serag, “AGA Clinical Practice Update on Screening and Surveillance for Hepatocellular Carcinoma in Participants With Nonalcoholic Fatty Liver Disease: Expert Review,” Gastroenterology 158, no. 6 (2020): 1822–1830.
“EASL‐EASD‐EASO Clinical Practice Guidelines for the Management of Non‐Alcoholic Fatty Liver Disease,” Journal of Hepatology 64, no. 6 (2016): 1388–1402.
M. Noureddin, J. L. Chan, K. Barradas, et al., “Attribution of Nonalcoholic Steatohepatitis as an Etiology of Cirrhosis for Clinical Trials Eligibility: Recommendations From the Multi‐stakeholder Liver Forum,” Gastroenterology 159, no. 2 (2020): 422–427.e421.
A. G. Singal, J. M. Llovet, M. Yarchoan, et al., “AASLD Practice Guidance on Prevention, Diagnosis, and Treatment of Hepatocellular Carcinoma,” Hepatology 78, no. 6 (2023): 1922–1965.
A. Barnard Giustini, G. N. Ioannou, C. Sirlin, and R. Loomba, “Review Article: Available Modalities for Screening and Imaging Diagnosis of Hepatocellular Carcinoma‐Current Gaps and Challenges,” Alimentary Pharmacology & Therapeutics 57, no. 10 (2023): 1056–1065.
R. K. Sterling, E. Lissen, N. Clumeck, et al., “Development of a Simple Noninvasive Index to Predict Significant Fibrosis in Participants With HIV/HCV Coinfection,” Hepatology 43, no. 6 (2006): 1317–1325.
W. P. Harbin, N. J. Robert, and J. T. Ferrucci, Jr., “Diagnosis of Cirrhosis Based on Regional Changes in Hepatic Morphology: A Radiological and Pathological Analysis,” Radiology 135, no. 2 (1980): 273–283.
M. Kudo, R. Q. Zheng, S. R. Kim, et al., “Diagnostic Accuracy of Imaging for Liver Cirrhosis Compared to Histologically Proven Liver Cirrhosis. A Multicenter Collaborative Study,” Intervirology 51, no. Suppl 1 (2008): 17–26.
S. McPherson, S. F. Stewart, E. Henderson, A. D. Burt, and C. P. Day, “Simple Non‐Invasive Fibrosis Scoring Systems can Reliably Exclude Advanced Fibrosis in Participants With Non‐Alcoholic Fatty Liver Disease,” Gut 59, no. 9 (2010): 1265–1269.
B. Suh, S. Park, D. W. Shin, et al., “High Liver Fibrosis Index FIB‐4 is Highly Predictive of Hepatocellular Carcinoma in Chronic Hepatitis B Carriers,” Hepatology 61, no. 4 (2015): 1261–1268.
S. H. Loosen, K. Kostev, V. Keitel, F. Tacke, C. Roderburg, and T. Luedde, “An Elevated FIB‐4 Score Predicts Liver Cancer Development: A Longitudinal Analysis From 29,999 Participants With NAFLD,” Journal of Hepatology 76, no. 1 (2022): 247–248.
G. Cholankeril, J. R. Kramer, J. Chu, et al., “Longitudinal Changes in Fibrosis Markers are Associated With Risk of Cirrhosis and Hepatocellular Carcinoma in Non‐Alcoholic Fatty Liver Disease,” Journal of Hepatology 78, no. 3 (2023): 493–500.
F. E. Mózes, J. A. Lee, Y. Vali, et al., “Performance of Non‐Invasive Tests and Histology for the Prediction of Clinical Outcomes in Participants With Non‐Alcoholic Fatty Liver Disease: An Individual Participant Data Meta‐Analysis,” Lancet Gastroenterology & Hepatology 8, no. 8 (2023): 704–713.
A. G. Shah, A. Lydecker, K. Murray, B. N. Tetri, M. J. Contos, and A. J. Sanyal, “Comparison of Noninvasive Markers of Fibrosis in Participants With Nonalcoholic Fatty Liver Disease,” Clinical Gastroenterology and Hepatology 7, no. 10 (2009): 1104–1112.
S. McPherson, T. Hardy, J. F. Dufour, et al., “Age as a Confounding Factor for the Accurate Non‐Invasive Diagnosis of Advanced NAFLD Fibrosis,” American Journal of Gastroenterology 112, no. 5 (2017): 740–751.
N. D. Parikh, M. Mehta, and E. B. Tapper, “FIB4 and APRI for Cirrhosis Detection in a Privately Insured National Cohort,” JHEP Reports 6, no. 1 (2023): 100925.
I. Graupera, M. Thiele, M. Serra‐Burriel, et al., “Low Accuracy of FIB‐4 and NAFLD Fibrosis Scores for Screening for Liver Fibrosis in the Population,” Clinical Gastroenterology and Hepatology 20, no. 11 (2022): 2567–2576.e2566.