Liver Fibrosis Marker FIB-4 Is Associated With Hepatic and Extrahepatic Malignancy Risk in a Population-Based Cohort Study

IF 6 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Liver International Pub Date : 2025-05-13 DOI:10.1111/liv.70139

Shira Zelber-Sagi, Yochai Schonmann, Galit Weinstein, Hanny Yeshua

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引用次数: 0

Abstract

Background and Aims

An association between Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and the development of extrahepatic malignancies has been demonstrated. However, the association of fibrosis with extrahepatic cancer is unclear. Our study aimed to test the long-term association between liver fibrosis marker and the incidence of hepatic and extrahepatic malignancies.

Methods

A retrospective cohort study of a nationally representative sample, following 763 752 adult Clalit health services members without pre-existing liver-related diagnoses or malignancies for 14.67 years. The adjusted association between baseline liver Fibrosis-4 score (FIB-4; FIB-4 ≥ 2.67 indicated presumed advanced fibrosis), assessed from routine laboratory measurements, and incident cancer was assessed through multivariable Cox regression models.

Results

The study included 763 752 people (mean age 54.3 ± 8.2 years, 43.9% males). Presumed advanced fibrosis was associated with a 16% greater risk for malignancy compared to the risk of those with no fibrosis (hazard ratio (HR) = 1.16; 95% CI, 1.10–1.22), adjusting for age, sex, ethnicity, socioeconomic status, peripherality index, baseline smoking, and obesity. The association of advanced fibrosis with malignancy was stronger when the age-specific FIB-4 cutoff was applied (HR = 1.40; 1.34–1.46) and in a subsample of subjects with MASLD diagnosis at baseline (HR = 1.43; 1.12–1.83). The association remained robust across sex, age, and ethnic groups. Both inconclusive fibrosis and fibrosis were strongly associated with malignancy of the liver or bile ducts [(HR = 1.41; 1.21–1.66) and (HR = 5.66; 4.19–7.64), respectively].

Conclusions

Liver fibrosis score is independently associated with malignancy occurrence and certain types of malignancies, and may serve as an indicator of high-risk cancer in the general population.

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在一项基于人群的队列研究中，肝纤维化标志物FIB-4与肝脏和肝外恶性肿瘤风险相关

背景和目的代谢功能障碍相关脂肪变性肝病（MASLD）与肝外恶性肿瘤的发展之间的关联已被证实。然而，肝纤维化与肝外癌的关系尚不清楚。我们的研究旨在测试肝纤维化标志物与肝脏和肝外恶性肿瘤发生率之间的长期关联。方法对全国代表性样本进行回顾性队列研究，随访14.67年无肝脏相关诊断或恶性肿瘤的Clalit成年健康服务人员763 752人。基线肝纤维化-4评分(FIB-4；FIB-4≥2.67表示推定为晚期纤维化)，通过常规实验室测量评估，并通过多变量Cox回归模型评估癌症发生率。结果共纳入763 752人，平均年龄54.3±8.2岁，男性43.9%。与未发生纤维化的患者相比，推定的晚期纤维化患者发生恶性肿瘤的风险增加16%(风险比(HR) = 1.16；95% CI, 1.10-1.22)，调整了年龄、性别、种族、社会经济地位、外围性指数、基线吸烟和肥胖。当应用年龄特异性FIB-4切断时，晚期纤维化与恶性肿瘤的相关性更强(HR = 1.40；1.34-1.46)和基线诊断为MASLD的受试者亚样本(HR = 1.43；1.12 - -1.83)。这种联系在性别、年龄和种族群体中都很明显。非结论性纤维化和纤维化均与肝脏或胆管恶性肿瘤密切相关[(HR = 1.41；1.21-1.66)和(HR = 5.66；分别为4.19 - -7.64)]。结论肝纤维化评分与恶性肿瘤的发生及某些类型的恶性肿瘤独立相关，可作为普通人群中高危肿瘤的指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Liver International 医学-胃肠肝病学

CiteScore

13.90

自引率

4.50%

发文量

348

审稿时长

2 months

期刊介绍： Liver International promotes all aspects of the science of hepatology from basic research to applied clinical studies. Providing an international forum for the publication of high-quality original research in hepatology, it is an essential resource for everyone working on normal and abnormal structure and function in the liver and its constituent cells, including clinicians and basic scientists involved in the multi-disciplinary field of hepatology. The journal welcomes articles from all fields of hepatology, which may be published as original articles, brief definitive reports, reviews, mini-reviews, images in hepatology and letters to the Editor.