論文

査読有り 国際誌
2019年7月

Albumin-Bilirubin Score Differentiates Liver Fibrosis Stage and Hepatocellular Carcinoma Incidence in Chronic Hepatitis B Virus Infection: A Retrospective Cohort Study.

The American journal of tropical medicine and hygiene
  • Koji Fujita
  • ,
  • Takako Nomura
  • ,
  • Asahiro Morishita
  • ,
  • Kyoko Oura
  • ,
  • Hirohito Yoneyama
  • ,
  • Hideki Kobara
  • ,
  • Kunihiko Tsutsui
  • ,
  • Takashi Himoto
  • ,
  • Tsutomu Masaki

101
1
開始ページ
220
終了ページ
225
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.4269/ajtmh.19-0129

The albumin-bilirubin (ALBI) score was originally established to stratify prognosis in patients with cirrhosis. The diagnostic accuracy of ALBI score in liver fibrosis staging in patients with chronic hepatitis B remains to be investigated. The present retrospective study, therefore, aimed to evaluate the ability of this score to stage liver fibrosis in these patients. Briefly, consecutive patients with hepatitis B virus (HBV) infection who underwent liver biopsy examinations in Kagawa University Hospital were enrolled. Liver fibrosis stage was assessed using a modified Meta-Analysis of Histological Data in Viral Hepatitis score. Albumin-bilirubin scores were calculated according to the following equation: (log10 total bilirubin [T-Bil] × 0.66) + (albumin [Alb] × -0.085). A total of 91 patients were enrolled in this study. Albumin-bilirubin score was able to differentiate stage 4 from stage 3 fibrosis (P < 0.05). When an ALBI score of -2.190 was adopted as the cutoff value for differentiating stage 4 from stages 1-3, the sensitivity, specificity, and positive likelihood ratio were 85.7%, 74.0%, and 3.300, respectively. Kaplan-Meier analysis showed that baseline ALBI scores < -2.190 correlated with better hepatocellular carcinoma (HCC)-free survival (P < 0.05). In conclusion, ALBI score can be used for liver fibrosis staging in Japanese chronic hepatitis B patients and can help distinguish cirrhotic from non-cirrhotic status. Furthermore, ALBI score was useful as a prognosis biomarker in our patients, with smaller ALBI scores predicting better HCC-free survival. Because calculating ALBI score is easy using serum T-Bil and Alb alone, ALBI score will help clinicians with decision-making in management of HBV-infected patients.

リンク情報
DOI
https://doi.org/10.4269/ajtmh.19-0129
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31115300
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609180

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