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Diagnosing the degree of hepatic fibrosis helps to determine the severity of the underlying liver disease and may influence therapeutic decisions in HCC patients. Non-invasive fibrosis scores can be used to estimate the degree of fibrosis in liver disease patients, but most of these scores were developed in patients with viral hepatitis and without HCC. This study explored the ability of the Fibrosis-4 Index (FIB-4), the AST\/Platelet Ratio Index (APRI), and the AST\/ALT ratio to diagnose or exclude advanced fibrosis (METAVIR F3\/4 versus F0-2) in patients with early-intermediate, potentially resectable HCC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We retrospectively reviewed 119 patients who underwent hepatic resection for HCC at a tertiary centre (2007\u20132019), 75 of whom had advanced fibrosis (prevalence 63%). Histological assessment of the surgical liver specimen was used as a reference standard for the degree of fibrosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall diagnostic performance was highest for the FIB-4 Index, with an area under the receiver operating characteristic curve (AUROC) of 0.82, compared with 0.78 for APRI, and 0.56 for the AST\/ALT ratio. Using established cut-off values, FIB-4 achieved a 90% positive predictive value at the higher cut-off (3.25) and a 90% negative predictive value at the lower cut-off (1.45).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The FIB-4 Index could reliably diagnose or exclude advanced fibrosis in patients with early-intermediate HCC, and may thus have a role in guiding therapeutic decisions in these patients.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00432-024-05708-3","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T11:02:00Z","timestamp":1712833320000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnostic performance of non-invasive liver fibrosis scores in patients with early-intermediate hepatocellular carcinoma"],"prefix":"10.1007","volume":"150","author":[{"given":"Christopher","family":"Schrecker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Falko","family":"Schulze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg","family":"Trojan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolf Otto","family":"Bechstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Zeuzem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Koch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,4,11]]},"reference":[{"issue":"6","key":"5708_CR1","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1097\/MEG.0000000000001343","volume":"31","author":"AO Abdelaziz","year":"2019","unstructured":"Abdelaziz AO, Abdelhalim H, Elsharkawy A, Shousha HI, Abdelmaksoud AH, Soliman ZA, Seif MI, Sayed DB, Farouk MH, Elbaz TM, Nabeel MM (2019) Liver stiffness measurement changes following hepatocellular carcinoma treatment with percutaneous microwave ablation or transarterial chemoembolization: a cohort study. 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Wolf Otto Bechstein reports consulting fees, speaker fees, or travel support from Astellas, Chiesi, Deutscher \u00c4rzteverlag, Else Kr\u00f6ner-Fresenius-Stiftung, ESOT, Falk Foundation, Gesundheit \u00d6sterreich GmbH, Gore Deutschland, Medac, MCI Deutschland, Novartis, Sanofi, Sanofi Genzyme, Sirtex, Springer, and Terumo. Stefan Zeuzem reports consulting fees or speaker fees from AbbVie, Gilead, Intercept, Janssen, Merck\/MSD, and Sobi. Christine Koch reports consulting fees, speaker fees, or travel support from Eisai, Elsevier, Ipsen, Medac, Merck\/MSD, Novartis, Roche, and Servier. The funders had no role in the design of the study; in the collection, analysis, or interpretation of data; in the writing of the manuscript; in the decision to publish the results.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was approved by the institutional review board of the University Hospital Frankfurt (reference number SGI-4-2019). The research was conducted in accordance with the World Medical Association Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Institutional review board statement"}},{"value":"Written informed consent was obtained from all patients involved in the study unless patients died before consent could be obtained, in which case the requirement for consent was waived by the institutional review board to avoid a selection bias.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"187"}}