Evaluation of Transient Elastography in Prediction Of De novo Recurrence of Hepatocellular Carcinoma after Radiofrequency Ablation

Abstract Background Hepatocellular carcinoma (HCC) is the sixth most common malignancy worldwide and it is also a common cause of death in patients with chronic liver disease. The curative treatment options for HCC that are currently available are surgical resection, liver transplantation and radiofrequency ablation .Despite progressive improvements in the efficacy of RFA, the survival of patients with HCC who undergo RFA remains disappointing, mainly due to frequent intrahepatic recurrence of HCC after RFA. Aim of the work To evaluate the role of transient elastography (as an indirect indicator to degree of liver fibrosis) in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation in hepatitis C related hepatocellular carcinoma .And to compare between transient elastography and other non invasive fibrosis indices in prediction of denovo recurrence of hepatocellular carcinoma after radiofrequency ablation hepatitis C related hepatocellular carcinoma Patients and methods This prospective cohrt study was conducted on hepatocellular carcinoma patient, who underwent radiofrequency ablation in Tropical Medicine Department in Eldemerdash and Ain Shams Specialized Hospital, HCC clinic Ain Shams University Hospitals, Cairo, Egypt between march, 2017 and May, 2019. Data of the patient, who underwent radiofrequency ablation during the study period, were reviewed and the patients who fulfilled the inclusion criteria were enrolled into this study. The patients who fulfilled the inclusion criteria and underwent radiofrequency ablation were followed up for 12 months. Results TE revealed 28 patients with F4 and only 2 patients with F3, the mean measurement of liver stiffness was (22.45 ± 10.36) KPa. There was a significant negative correlation between LS and denovo recurrence of HCC (mean of LS in patients with complete response was 17.19 ± 3.32 and the mean of LS in patient with denovo recurrence was 36,94 ± 5.93,with the The best cut off value ≥24.65 (p value < 0.001)). There was no significant correlation between CDC, FIB4, API scores and denovo recurrence of HCC. Also it was found that the LS was significantly associated with prediction of manifestation of hepatic decompensation after RFA (means of LS in patient without manifestation decompensation after RFA (p value <0.001) .Regarding prediction of mortality, LS at cut off value > 42 .75 (p value = 0,031) was significantly associated with prediction of mortality after one year of RFA. As regard serum non invasive fibrosis indices our results showed correlation between FIB4 score and hepatic decompensation after one year of intervention (the mean of FIB4 score in patients ascites and jaundice was 6.05 ± 4.71 (p value = 0.05) ).Therewas no statistically significant correlation between CDS and API with hepatic decompensation after RFA .As regard role of serum non invasive fibrosis indices in prediction of mortality after RFA, FIB4 score, CDS and API were statistically non significant. Conclusion Our data suggest that LS measurement is a useful predictor of HCC de novorecurrence overall survival and possibility of hepatic decompensation after RFA

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Role of transient elastography in the prediction of de novo recurrence of hepatocellular carcinoma after radiofrequency ablation: single-center Egyptian study

Egyptian Liver Journal ◽

10.1186/s43066-021-00099-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

N. A. Abdelkader ◽

M. H. Abdelaleem ◽

M. A. Abo El-maaty ◽

S. A. Sayed ◽

H. I. Aly

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

De Novo ◽

Transient Elastography ◽

Treatment Options ◽

Liver Stiffness ◽

Complete Response ◽

Significant Negative Correlation ◽

Hepatic Decompensation

Abstract Background Radiofrequency is one of the curative treatment options for hepatocellular carcinoma (HCC). Despite the progressive improvements in the efficacy of radiofrequency, the survival of patients with HCC who undergo radiofrequency remains disappointing, mainly due to frequent intrahepatic recurrence of HCC after radiofrequency. We aimed to evaluate the role of transient elastography (TE) in the prediction of de novo recurrence of HCC after radiofrequency and to compare between transient elastography and the serological fibrosis indices in the prediction of de novo recurrence of HCC. Results Thirty HCC patients underwent baseline transient elastography for preinterventional assessment of the degree of fibrosis. Also noninvasive serum fibrosis indices were calculated from baseline data, including age platelet index (API), cirrhosis discrimination score (CDS), and FIB-4 index. Patients achieving complete response after 1 month post radiofrequency ablation were followed for further 12 months by triphasic abdominal CT scan to detect de novo lesions according to modified RECIST criteria. Baseline means of CDS, FIB4, and API were 6.03 ± 1.5, 3.98 ± 2.58, and 1.24 ± 1.08, respectively. Transient elastography revealed 28 patients with F4 and only 2 patients with F3 (mean liver stiffness 22.45 ± 10.36 Kba). There was a significant negative correlation between liver stiffness (LS) and de novo recurrence of HCC (mean of LS in patients with a complete response was 17.19 ± 3.32 while in those with de novo recurrence was 36.94 ± 5.93, with the best cut off value ≥24.65 (p value < 0.001). There was no significant correlation between CDC, FIB4, API scores, and de novo recurrence of HCC. It was found that the liver stiffness was significantly associated with the prediction of hepatic decompensation (p value <0.001). Also, liver stiffness at the cutoff value > 42.75 (p value = 0.031) was significantly associated with the prediction of 1-year mortality after radiofrequency ablation. Conclusion Our data suggested that liver stiffness measurement in hepatocellular carcinoma patients was a useful predictor of de novo recurrence, overall survival, and possibility of hepatic decompensation after radiofrequency ablation.

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Role of Transient Elastography in Determining the Surgical Strategy in Patients with Resectable Hepatocellular Carcinoma

HPB ◽

10.1016/j.hpb.2020.11.365 ◽

2021 ◽

Vol 23 ◽

pp. S149

Author(s):

M. Rajakannu ◽

D. Cherqui ◽

A. Sa Cunha ◽

D. Castaing ◽

R. Adam ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Transient Elastography ◽

Surgical Strategy

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Role of circulating microRNAs to predict hepatocellular carcinoma recurrence in patients treated with radiofrequency ablation or surgery

HPB ◽

10.1016/j.hpb.2021.06.421 ◽

2021 ◽

Author(s):

Matteo Canale ◽

Francesco Giuseppe Foschi ◽

Pietro Andreone ◽

Giorgio Ercolani ◽

Giorgia Marisi ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Radiofrequency Ablation ◽

Circulating Micrornas ◽

Hepatocellular Carcinoma Recurrence

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The impact of direct-acting antivirals on liver fibrosis in Egyptian hepatitis C virus patients: a single center experience

QJM ◽

10.1093/qjmed/hcab107.007 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Nadia Abdelaaty Abdelkader ◽

Amira Mahmoud AlBalakosy ◽

Ahmed Fouad Helmy Sherief ◽

Mohamed Soliman Gado

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Liver Fibrosis ◽

Transient Elastography ◽

Liver Stiffness ◽

Treatment Unit ◽

Non Invasive ◽

One Year ◽

The Impact

Abstract Background Hepatitis C virus (HCV) infection affects approximately 170 million people worldwide, causing liver cirrhosis and hepatocellular carcinoma (HCC) and leading to liver transplantation and ultimately death. Accurate evaluation of liver fibrosis in patients with chronic liver diseases is crucial, as liver fibrosis is important in order to make therapeutic decisions, determine prognosis of liver disease and to follow-up disease progression. Multiple non-invasive methods have been used successfully in the prediction of fibrosis; however, early changes in noninvasive biomarkers of hepatic fibrosis under effective antiviral therapy are widely unknown. The aim of this study is to evaluate changes of transient elastography values as well as FIB-4 and AST to platelet ratio index (APRI) in patients treated with DAAs. Objectives The aim beyond this study is to evaluate the changes in liver stiffness in hepatitis C Egyptian patients before and at least one year after treatment with DAAs using transient elastography and non-invasive liver fibrosis indices as FIB-4 and APRI scores. Patients and methods The present study was conducted on 100 patients with chronic hepatitis C patients attended to Ain Shams University Hospitals, Viral hepatitis treatment unit between October 2017 and December 2018, who were followed-up during treatment and after treatment for at least one year (retrospective and prospective study). Total number of cases during the study period was 117 patients. 17 patients were excluded from the study due to missed follow-up. Eventually, 100 patients were enrolled in the study fulfilling the inclusion criteria. Results The mean age of our patients is 47.9 years with Male predominance (52 males and 48 females). There was a significant improvement of, platelets counts, ALT and AST levels, which in turn cause significant improvement in FIB-4 and APRI scores. There was a significant improvement of liver stiffness after end of treatment, regardless of the DAA regimen used, as evidenced by Fibroscan. Conclusion Fibrosis regression –assessed by non-invasive markers of fibrosis is achievable upon removal of the causative agent.

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Effects of branched-chain amino acid-enriched nutrient for patients with hepatocellular carcinoma following radiofrequency ablation: A one-year prospective trial

Journal of Gastroenterology and Hepatology ◽

10.1111/j.1440-1746.2010.06306.x ◽

2010 ◽

Vol 25 (9) ◽

pp. 1550-1555 ◽

Cited By ~ 29

Author(s):

Hidekatsu Kuroda ◽

Akira Ushio ◽

Yasuhiro Miyamoto ◽

Kei Sawara ◽

Kanta Oikawa ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Amino Acid ◽

Radiofrequency Ablation ◽

Prospective Trial ◽

Branched Chain Amino Acid ◽

Branched Chain ◽

One Year

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Role of Chemical Biomarkers in Prediction of Intra-Amniotic Infection in Cases with Preterm Premature Rupture of Membrane, Observational Study

Journal of Gynecology & Reproductive Medicine ◽

10.33140/jgrm.03.02.08 ◽

2019 ◽

Vol 3 (2) ◽

Keyword(s):

Interleukin 6 ◽

Mean Value ◽

Maternal Serum ◽

P Value ◽

Subclinical Infection ◽

Premature Rupture ◽

Cutoff Value ◽

The Mean ◽

Sensitivity Specificity

Introduction: Early recognition of subclinical intra-amniotic infection before development of clinical Chorioamnionitis dramatically improve neonatal outcome before affection of fetal neurological function. Objective: this study was conducted to evaluate the role of procalcitonin and interleukin-6 in early prediction of intrauterine infection in pregnant women with premature rupture of membranes. Methods: This observational prospective cohort study was conducted on 100 pregnant women with preterm premature rupture of membrane (PPROM), Patients were divided into 2 groups: Group I: with normal CRP and WBCs level. Group2: with subclinical infection which was detected by elevated WBCs count >15,000 c/mm3 and / or positive CRP. This group was divided into two groups (Group (II) and Group (III) according to development of Chorioamnionitis. follow up of these patients was done to detect the cutoff value of procalcitonin and interleukin-6 as a predictive indicator of clinical intra-amniotic infection in patients with premature rupture of membrane. Results: This study showed that the mean value of maternal serum PCT concentration was higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.0001 which is highly significant between the studied cases and with cutoff value was >0.67ng/ml, sensitivity, specificity, PPV, NPV was 88.7%, 42.9%, 79.7% and 60% respectively and the mean value of maternal serum IL-6 concentration was also higher in patients with clinical infection than its concentration in patients without infection or with subclinical infection with P-value 0.001which is highly significant between the studied cases and with cutoff value was >11.1pg/ ml, sensitivity, specificity, PPV, NPV was 67.9%, 61.9%, 81.8% and 43.3% respectively. Conclusion: maternal serum procalcitonin is a good predictor of clinical intra-amniotic infection with good sensitivity, specificity, PPV, NPV which is nearly good as CRP which is better than serum interleukin-6 regarding sensitivity

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Role of Tie2, CD14, Angiopoietin as Angiogenetic Markers in Hepatocellular Carcinoma Complicating Hepatitis C Virus Infection

Journal of Hematology and Oncology Research ◽

10.14302/issn.2372-6601.jhor-19-3084 ◽

2019 ◽

Vol 3 (2) ◽

pp. 23-34

Author(s):

El-Zahraa M. Meghezel ◽

Heba A. Ahmed ◽

Ashraf A Askar ◽

Emad Eldin Nabil ◽

Ashraf Elyamany

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatitis C ◽

High Risk Group ◽

P Value ◽

Group Iii ◽

Group I ◽

Angiopoietin 2 ◽

Chronic Hepatitis C Patients ◽

Potential Use

Background Identifying biomarkers for early detection of hepatocellular carcinoma (HCC) remains quite challenging. In this study we aimed to estimate the number of TIE2-expressing monocytes (TEMs) cells, which display pro-tumoral activities and are defined as CD14+, TIE2+, and angiopoietin-2; and its potential use as a possible diagnostic marker in HCC patients complicating HCV induced cirrhosis. Methods Current study was conducted on 112 patients. They were divided into two groups: Group I (78 patients) with HCC complicating HCV induced cirrhosis; and group II chronic hepatitis C patients (34 patients). Both groups were compared to (age and sex-matched) healthy persons as group III (38 persons). Result The number of the circulating TEMs: CD14+ and TIE2+ monocytes were significantly higher in the peripheral blood of HCC patients than HCV LC patients and healthy controls, sensitivity and specificity for HCC diagnosis were respectively: CD14 (89.7%, 83.3%), TIE 2 (76.9%, 83.3%), and Ang-2 (76.9%, 66.7%). Moreover, analysis of the P-value and the odd’s ratio showed that CD14 has the highest predictive value for HCC. Conclusion Our results suggest that TEMs and Ang-2can be used as diagnostic markers for HCC, especially among the high-risk group of patients.

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