Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma

Mona Nasef; Lobna Abo Ali; Mohammed Hablus; Hossam Eldeen Soliman; Nehad Hawash; Nadia Elwan

doi:doi:10.11648/j.ijmi.20200804.15

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Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma

Mona Nasef, Lobna Abo Ali, Mohammed Hablus, Hossam Eldeen Soliman, Nehad Hawash, Nadia Elwan

Published in International Journal of Medical Imaging (Volume 8, Issue 4)

Received: 20 October 2020 Accepted: 10 November 2020 Published: 24 November 2020

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Abstract

Background: Post-hepatectomy liver failure (PHLF) is the most leading cause of mortality in patients diagnosed with hepatocellular carcinoma (HCC) and undergoing resection of the affected part of the liver. Objectives: This research aimed to determine the value of the lymphocyte to monocyte ratio (LMR), fibrosis score 4 (FIB-4) and liver stiffness measurements (LSM) using Fibroscan as pre-operative predictors of PHLF in Egyptian patients with post- hepatitis C virus (HCV) liver cirrhosis and HCC. Methods: In this prospective cohort study definition of PHLF was done according to the “50-50 criteria”. Multivariate analysis was done to identify PHLF independent predictors. The predictive accuracy of the pre-operative LMR, FIB-4 and LSM with Fibroscan were evaluated by receiver operating characteristic (ROC) curve. Results: Enrollment of fifty Egyptian patients was done. 14 patients (28%) experienced PHLF. The presence of oesophageal varices, serum AST, serum albumin, LMR, FIB-4 score, and LSM (P<0.05) were independent pre-operative predictors for PHLF. According to ROC curve analysis, LMR yielded the best accuracy for predicting PHLF at cutoff <3.33 [AUC = 0.940; sensitivity = 93.65%; specificity = 94.44%; positive predictive value = 86.67%; negative predictive value = 97.14%]. FIB-4 score and LSM had lower AUC (0.886 and 0.875) respectively. Conclusion: The pre-operative LMR has a higher predictive ability for PHLF in patients with HCV-related HCC undergoing hepatectomy compared with FIB-4 score and LSM using Fibroscan.

Published in	International Journal of Medical Imaging (Volume 8, Issue 4)
DOI	10.11648/j.ijmi.20200804.15
Page(s)	93-101
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Hepatocellular Carcinoma, Resection, Post-hepatectomy Liver Failure, Lymphocyte to Monocyte Ratio, Fibroscan, Fibrosis Score 4

References

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APA Style

Mona Nasef, Lobna Abo Ali, Mohammed Hablus, Hossam Eldeen Soliman, Nehad Hawash, et al. (2020). Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma. International Journal of Medical Imaging, 8(4), 93-101. https://doi.org/10.11648/j.ijmi.20200804.15

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ACS Style

Mona Nasef; Lobna Abo Ali; Mohammed Hablus; Hossam Eldeen Soliman; Nehad Hawash, et al. Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma. Int. J. Med. Imaging 2020, 8(4), 93-101. doi: 10.11648/j.ijmi.20200804.15

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AMA Style

Mona Nasef, Lobna Abo Ali, Mohammed Hablus, Hossam Eldeen Soliman, Nehad Hawash, et al. Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma. Int J Med Imaging. 2020;8(4):93-101. doi: 10.11648/j.ijmi.20200804.15

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@article{10.11648/j.ijmi.20200804.15,
  author = {Mona Nasef and Lobna Abo Ali and Mohammed Hablus and Hossam Eldeen Soliman and Nehad Hawash and Nadia Elwan},
  title = {Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma},
  journal = {International Journal of Medical Imaging},
  volume = {8},
  number = {4},
  pages = {93-101},
  doi = {10.11648/j.ijmi.20200804.15},
  url = {https://doi.org/10.11648/j.ijmi.20200804.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20200804.15},
  abstract = {Background: Post-hepatectomy liver failure (PHLF) is the most leading cause of mortality in patients diagnosed with hepatocellular carcinoma (HCC) and undergoing resection of the affected part of the liver. Objectives: This research aimed to determine the value of the lymphocyte to monocyte ratio (LMR), fibrosis score 4 (FIB-4) and liver stiffness measurements (LSM) using Fibroscan as pre-operative predictors of PHLF in Egyptian patients with post- hepatitis C virus (HCV) liver cirrhosis and HCC. Methods: In this prospective cohort study definition of PHLF was done according to the “50-50 criteria”. Multivariate analysis was done to identify PHLF independent predictors. The predictive accuracy of the pre-operative LMR, FIB-4 and LSM with Fibroscan were evaluated by receiver operating characteristic (ROC) curve. Results: Enrollment of fifty Egyptian patients was done. 14 patients (28%) experienced PHLF. The presence of oesophageal varices, serum AST, serum albumin, LMR, FIB-4 score, and LSM (P<0.05) were independent pre-operative predictors for PHLF. According to ROC curve analysis, LMR yielded the best accuracy for predicting PHLF at cutoff <3.33 [AUC = 0.940; sensitivity = 93.65%; specificity = 94.44%; positive predictive value = 86.67%; negative predictive value = 97.14%]. FIB-4 score and LSM had lower AUC (0.886 and 0.875) respectively. Conclusion: The pre-operative LMR has a higher predictive ability for PHLF in patients with HCV-related HCC undergoing hepatectomy compared with FIB-4 score and LSM using Fibroscan.},
 year = {2020}
}

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TY  - JOUR
T1  - Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma
AU  - Mona Nasef
AU  - Lobna Abo Ali
AU  - Mohammed Hablus
AU  - Hossam Eldeen Soliman
AU  - Nehad Hawash
AU  - Nadia Elwan
Y1  - 2020/11/24
PY  - 2020
N1  - https://doi.org/10.11648/j.ijmi.20200804.15
DO  - 10.11648/j.ijmi.20200804.15
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 93
EP  - 101
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20200804.15
AB  - Background: Post-hepatectomy liver failure (PHLF) is the most leading cause of mortality in patients diagnosed with hepatocellular carcinoma (HCC) and undergoing resection of the affected part of the liver. Objectives: This research aimed to determine the value of the lymphocyte to monocyte ratio (LMR), fibrosis score 4 (FIB-4) and liver stiffness measurements (LSM) using Fibroscan as pre-operative predictors of PHLF in Egyptian patients with post- hepatitis C virus (HCV) liver cirrhosis and HCC. Methods: In this prospective cohort study definition of PHLF was done according to the “50-50 criteria”. Multivariate analysis was done to identify PHLF independent predictors. The predictive accuracy of the pre-operative LMR, FIB-4 and LSM with Fibroscan were evaluated by receiver operating characteristic (ROC) curve. Results: Enrollment of fifty Egyptian patients was done. 14 patients (28%) experienced PHLF. The presence of oesophageal varices, serum AST, serum albumin, LMR, FIB-4 score, and LSM (P<0.05) were independent pre-operative predictors for PHLF. According to ROC curve analysis, LMR yielded the best accuracy for predicting PHLF at cutoff <3.33 [AUC = 0.940; sensitivity = 93.65%; specificity = 94.44%; positive predictive value = 86.67%; negative predictive value = 97.14%]. FIB-4 score and LSM had lower AUC (0.886 and 0.875) respectively. Conclusion: The pre-operative LMR has a higher predictive ability for PHLF in patients with HCV-related HCC undergoing hepatectomy compared with FIB-4 score and LSM using Fibroscan.
VL  - 8
IS  - 4
ER  -

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Author Information

Mona Nasef

Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Lobna Abo Ali

Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Mohammed Hablus

Gastrointestinal, Liver and Laparoscopic Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Hossam Eldeen Soliman

HPB and Liver transplantation surgery Department, National Liver Institute, Menoufia University, Menoufia, Egypt
Nehad Hawash

Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
Nadia Elwan

Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt

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APA Style

Mona Nasef, Lobna Abo Ali, Mohammed Hablus, Hossam Eldeen Soliman, Nehad Hawash, et al. (2020). Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma. International Journal of Medical Imaging, 8(4), 93-101. https://doi.org/10.11648/j.ijmi.20200804.15

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ACS Style

Mona Nasef; Lobna Abo Ali; Mohammed Hablus; Hossam Eldeen Soliman; Nehad Hawash, et al. Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma. Int. J. Med. Imaging 2020, 8(4), 93-101. doi: 10.11648/j.ijmi.20200804.15

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AMA Style

Mona Nasef, Lobna Abo Ali, Mohammed Hablus, Hossam Eldeen Soliman, Nehad Hawash, et al. Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma. Int J Med Imaging. 2020;8(4):93-101. doi: 10.11648/j.ijmi.20200804.15

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@article{10.11648/j.ijmi.20200804.15,
  author = {Mona Nasef and Lobna Abo Ali and Mohammed Hablus and Hossam Eldeen Soliman and Nehad Hawash and Nadia Elwan},
  title = {Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma},
  journal = {International Journal of Medical Imaging},
  volume = {8},
  number = {4},
  pages = {93-101},
  doi = {10.11648/j.ijmi.20200804.15},
  url = {https://doi.org/10.11648/j.ijmi.20200804.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20200804.15},
  abstract = {Background: Post-hepatectomy liver failure (PHLF) is the most leading cause of mortality in patients diagnosed with hepatocellular carcinoma (HCC) and undergoing resection of the affected part of the liver. Objectives: This research aimed to determine the value of the lymphocyte to monocyte ratio (LMR), fibrosis score 4 (FIB-4) and liver stiffness measurements (LSM) using Fibroscan as pre-operative predictors of PHLF in Egyptian patients with post- hepatitis C virus (HCV) liver cirrhosis and HCC. Methods: In this prospective cohort study definition of PHLF was done according to the “50-50 criteria”. Multivariate analysis was done to identify PHLF independent predictors. The predictive accuracy of the pre-operative LMR, FIB-4 and LSM with Fibroscan were evaluated by receiver operating characteristic (ROC) curve. Results: Enrollment of fifty Egyptian patients was done. 14 patients (28%) experienced PHLF. The presence of oesophageal varices, serum AST, serum albumin, LMR, FIB-4 score, and LSM (P<0.05) were independent pre-operative predictors for PHLF. According to ROC curve analysis, LMR yielded the best accuracy for predicting PHLF at cutoff <3.33 [AUC = 0.940; sensitivity = 93.65%; specificity = 94.44%; positive predictive value = 86.67%; negative predictive value = 97.14%]. FIB-4 score and LSM had lower AUC (0.886 and 0.875) respectively. Conclusion: The pre-operative LMR has a higher predictive ability for PHLF in patients with HCV-related HCC undergoing hepatectomy compared with FIB-4 score and LSM using Fibroscan.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Fibroscan and FIB-4 Assessment Versus Lymphocyte / Monocyte Ratio as Predictors of Post-Hepatectomy Liver Failure in HCV Egyptian Patients with Hepatocellular Carcinoma
AU  - Mona Nasef
AU  - Lobna Abo Ali
AU  - Mohammed Hablus
AU  - Hossam Eldeen Soliman
AU  - Nehad Hawash
AU  - Nadia Elwan
Y1  - 2020/11/24
PY  - 2020
N1  - https://doi.org/10.11648/j.ijmi.20200804.15
DO  - 10.11648/j.ijmi.20200804.15
T2  - International Journal of Medical Imaging
JF  - International Journal of Medical Imaging
JO  - International Journal of Medical Imaging
SP  - 93
EP  - 101
PB  - Science Publishing Group
SN  - 2330-832X
UR  - https://doi.org/10.11648/j.ijmi.20200804.15
AB  - Background: Post-hepatectomy liver failure (PHLF) is the most leading cause of mortality in patients diagnosed with hepatocellular carcinoma (HCC) and undergoing resection of the affected part of the liver. Objectives: This research aimed to determine the value of the lymphocyte to monocyte ratio (LMR), fibrosis score 4 (FIB-4) and liver stiffness measurements (LSM) using Fibroscan as pre-operative predictors of PHLF in Egyptian patients with post- hepatitis C virus (HCV) liver cirrhosis and HCC. Methods: In this prospective cohort study definition of PHLF was done according to the “50-50 criteria”. Multivariate analysis was done to identify PHLF independent predictors. The predictive accuracy of the pre-operative LMR, FIB-4 and LSM with Fibroscan were evaluated by receiver operating characteristic (ROC) curve. Results: Enrollment of fifty Egyptian patients was done. 14 patients (28%) experienced PHLF. The presence of oesophageal varices, serum AST, serum albumin, LMR, FIB-4 score, and LSM (P<0.05) were independent pre-operative predictors for PHLF. According to ROC curve analysis, LMR yielded the best accuracy for predicting PHLF at cutoff <3.33 [AUC = 0.940; sensitivity = 93.65%; specificity = 94.44%; positive predictive value = 86.67%; negative predictive value = 97.14%]. FIB-4 score and LSM had lower AUC (0.886 and 0.875) respectively. Conclusion: The pre-operative LMR has a higher predictive ability for PHLF in patients with HCV-related HCC undergoing hepatectomy compared with FIB-4 score and LSM using Fibroscan.
VL  - 8
IS  - 4
ER  -

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