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Identification of high-risk group for diabetes-associated hepatocellular carcinoma using noninvasive test for liver fibrosis

  • 0Department of Gastroenterology, Okayama City Hospital, Okayama.
European Journal of Gastroenterology & Hepatology +

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June 27, 2025

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June 27, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

The new Fibrosis-3 (FIB-3) index effectively identifies patients at high risk for diabetes-associated hepatocellular carcinoma (DM-HCC) across all ages. Unlike the Fibrosis-4 (FIB-4) index, FIB-3 does not require age-adjusted cutoffs for accurate risk stratification.

Area Of Science

  • Hepatology
  • Oncology
  • Diabetology

Background

  • Rising incidence of diabetes-associated hepatocellular carcinoma (DM-HCC) necessitates improved screening.
  • The Fibrosis-4 (FIB-4) index, a common screening tool, shows limitations due to age-related false positives.
  • The Fibrosis-3 (FIB-3) index, excluding age, was developed to overcome FIB-4's limitations.

Purpose Of The Study

  • To evaluate the efficacy of the novel Fibrosis-3 (FIB-3) index in identifying high-risk individuals for DM-HCC.
  • To compare the predictive performance of FIB-3 against the established Fibrosis-4 (FIB-4) index across all age demographics.

Main Methods

  • Study cohort comprised 174 patients with DM-HCC and 74 diabetic controls.
  • Receiver operating characteristic (ROC) curves and multivariate logistic regression analyses were employed.
  • The predictive capabilities of both FIB-4 and FIB-3 indices for HCC risk were assessed.

Main Results

  • Both FIB-4 and FIB-3 demonstrated strong performance in identifying high-risk DM-HCC groups (AUCs: FIB-4=0.909, FIB-3=0.911).
  • FIB-3 maintained predictive accuracy with a single cutoff across all ages, unlike FIB-4 which requires age-adjusted cutoffs.
  • Multivariate analysis confirmed FIB-3 as an independent predictor of HCC risk, even after adjusting for BMI, liver function, and tumor markers.

Conclusions

  • The FIB-3 index is a valuable tool for DM-HCC risk stratification, offering consistent performance across age groups.
  • FIB-3's age-independent nature addresses key limitations of the FIB-4 index.
  • This novel index may facilitate earlier diagnosis and improve patient prognosis for DM-HCC.

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