f933c219667378e89b58f686e031942d pmc_9103029.pdf b5ac0d51100dacd1ef26aeb71fc862eb8ddfd2d5 pmc_9103029.pdf bb7bd813ecf12f0158f89a42509034ec4aa578dd063a5ca61007c74c094bfe20 pmc_9103029.pdf Title: Non-Invasive Tests of Liver Fibrosis Help in Predicting the Development of Hepatocellular Carcinoma among Patients with NAFLD Subject: Background: The potential role of non-invasive tests (NITs) for liver fibrosis for hepatocellular carcinoma (HCC) prediction remains poorly known. Methods: Retrospective analysis of a NAFLD cohort from a single university hospital in Barcelona, Spain. Incidence rates and cumulative incidence for the overall cohort, as well as cirrhotic and non-cirrhotic patients were calculated. Logistic regression analyses were carried out to investigate risk factors of HCC. Results: From the entire cohort of 1040 patients, 996 patients (95.8%) were analyzed, in whom 35 cases of HCC were detected, of which 26 (72.4%) HCC incident cases were newly diagnosed during a median follow-up of 2.5 (1.9–3.6) years. Two-hundred and thirty-one (23.2%) were cirrhotic at baseline. With the exception of 2 (7.7%) cases of HCC, the rest were diagnosed in cirrhotic patients. Overall HCC cumulative incidence was 9.49 (95% CI 6.4–13.9) per 1000 person-years. The incidence rate for cirrhotic patients was 41.2 (95% CI 27.6–61.6) per 1000 person-years and 0.93 (95% CI 0.23–3.7) per 1000 person-years for patients without cirrhosis. Overall mortality was significantly higher amongst patients with HCC (4.4% vs. 30.8%, p < 0.001). In patients with available liver biopsy (n = 249, 25%), advanced fibrosis (F3–F4) was significantly associated with higher HCC incidence, but not steatosis, lobular inflammation, nor ballooning. In the overall cohort, FIB-4 1.3 (HR 8.46, 95% CI 1.06–67.4, p = 0.044) and older age (HR 1.06, 95% CI 1.01–1.11, p = 0.025) were associated with increasing risk of HCC over time, whereas in cirrhotic patients predictors of HCC included decreasing values of albumin (HR 0.34, 95% CI 0.13–0.87, p = 0.024), platelets (HR 0.98, 95% CI 0.98–0.99, p = 0.001), and increasing values of liver stiffness (HR 1.03, 95% CI 1.00–1.06, p = 0.016). Conclusions: In a Spanish cohort of NAFLD patients, HCC was rare in non-cirrhotic patients. NITs might play a relevant role at predicting HCC. Keywords: NAFLD; hepatocellular carcinoma; FIB-4; transient elastography Author: Mònica Pons, Jesús Rivera-Esteban, Ramiro Manzano, Juan Bañares, María Bermúdez, Víctor Vargas, Maria Teresa Salcedo-Allende, Lluís Castells, Salvador Augustin, Beatriz Mínguez and Juan M. Pericàs Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue May 10 16:12:46 2022 CEST ModDate: Tue May 10 16:16:11 2022 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1457065 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- RVDESI+VnURWPalladioL Type 1 Custom yes yes no 10 0 SWSKQI+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 DPMINC+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 EAJKMZ+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 ZZLTBA+CMSY10 Type 1 Builtin yes yes no 28 0 TVYTIG+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 50 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 53 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 81 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-05-18 03:25:12 CEST RepresentationInformation: pmc_9103029.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-05-18 02:37:28 CEST Size: 1457065 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 252 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Design and Setting Destination: subsection.2.1 Item: Title: Patients Destination: subsection.2.2 Item: Title: Collected Variables Destination: subsection.2.3 Item: Title: Outcomes Destination: subsection.2.4 Item: Title: Statistical Analysis Destination: subsection.2.5 Item: Title: Results Destination: section.3 Children: Item: Title: Sample Destination: subsection.3.1 Item: Title: Baseline and Clinical Characteristics Destination: subsection.3.2 Item: Title: Incidence and Characteristics of HCC Destination: subsection.3.3 Item: Title: Liver Events and Death Destination: subsection.3.4 Item: Title: Predictors of HCC Destination: subsection.3.5 Item: Title: Discussion Destination: section.4 Children: Item: Title: Major Findings Destination: subsection.4.1 Item: Title: Incidence of HCC Destination: subsection.4.2 Item: Title: Decompensations, Liver Transplant, and Mortality Destination: subsection.4.3 Item: Title: Predictors of HCC Destination: subsection.4.4 Item: Title: Limitations Destination: subsection.4.5 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Non-Invasive Tests of Liver Fibrosis Help in Predicting the Development of Hepatocellular Carcinoma among Patients with NAFLD Author: Mònica Pons, Jesús Rivera-Esteban, Ramiro Manzano, Juan Bañares, María Bermúdez, Víctor Vargas, Maria Teresa Salcedo-Allende, Lluís Castells, Salvador Augustin, Beatriz Mínguez and Juan M. Pericàs Subject: Background: The potential role of non-invasive tests (NITs) for liver fibrosis for hepatocellular carcinoma (HCC) prediction remains poorly known. Methods: Retrospective analysis of a NAFLD cohort from a single university hospital in Barcelona, Spain. Incidence rates and cumulative incidence for the overall cohort, as well as cirrhotic and non-cirrhotic patients were calculated. Logistic regression analyses were carried out to investigate risk factors of HCC. Results: From the entire cohort of 1040 patients, 996 patients (95.8%) were analyzed, in whom 35 cases of HCC were detected, of which 26 (72.4%) HCC incident cases were newly diagnosed during a median follow-up of 2.5 (1.9 3.6) years. Two-hundred and thirty-one (23.2%) were cirrhotic at baseline. With the exception of 2 (7.7%) cases of HCC, the rest were diagnosed in cirrhotic patients. Overall HCC cumulative incidence was 9.49 (95% CI 6.4 13.9) per 1000 person-years. The incidence rate for cirrhotic patients was 41.2 (95% CI 27.6 61.6) per 1000 person-years and 0.93 (95% CI 0.23 3.7) per 1000 person-years for patients without cirrhosis. Overall mortality was significantly higher amongst patients with HCC (4.4% vs. 30.8%, p < 0.001). In patients with available liver biopsy (n = 249, 25%), advanced fibrosis (F3 F4) was significantly associated with higher HCC incidence, but not steatosis, lobular inflammation, nor ballooning. In the overall cohort, FIB-4 1.3 (HR 8.46, 95% CI 1.06 67.4, p = 0.044) and older age (HR 1.06, 95% CI 1.01 1.11, p = 0.025) were associated with increasing risk of HCC over time, whereas in cirrhotic patients predictors of HCC included decreasing values of albumin (HR 0.34, 95% CI 0.13 0.87, p = 0.024), platelets (HR 0.98, 95% CI 0.98 0.99, p = 0.001), and increasing values of liver stiffness (HR 1.03, 95% CI 1.00 1.06, p = 0.016). Conclusions: In a Spanish cohort of NAFLD patients, HCC was rare in non-cirrhotic patients. NITs might play a relevant role at predicting HCC. Keywords: NAFLD; hepatocellular carcinoma; FIB-4; transient elastography Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue May 10 16:12:46 CEST 2022 ModDate: Tue May 10 16:16:11 CEST 2022 ID: 0xbb008374dc519e1f80695ef88393d46f, 0xbb008374dc519e1f80695ef88393d46f Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: TVYTIG+VnURWPalladioL-Bold FontSubset: true FirstChar: 160 LastChar: 243 FontDescriptor: FontName: TVYTIG+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: QLBIEB+URWPalladioL-BoldItal FontSubset: true FirstChar: 110 LastChar: 112 FontDescriptor: FontName: QLBIEB+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: DPMINC+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 250 FontDescriptor: FontName: DPMINC+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 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