Non-Invasive Liver Fibrosis Scores can Predict Hepatic Metastasis in Colorectal Cancers

Abstract

It was aimed to investigate the relationship between liver fibrosis and liver metastasis by using AST to Platelet Ratio Index (APRI) and Fibrosis4 (FIB4) non-invasive hepatic fibrosis scorings at the time of diagnosis in patients with nonmetastatic colorectal cancers (CRC) at diagnosis. A total of 1452 patients with colorectal cancer who were followed up between 2015-2020 were retrospectively reviewed. Seven hundred and fifty eight patients were included in the study. Fifty four patients who devoloped liver metastatis were compared with 704 patients who did not develop metastasis, the mean APRI score and mean FIB4 score at the time of diagnosis was determined to be significantly higher in the group with liver metastasis. The area under the curve (AUC) for the APRI score was 0.735 and the optimum sensitivity for detecting liver metastasis was 75.9%, while the optimal specificity was 65.1% and for the FIB4 score, AUC was 0.738, the optimum sensitivity for detecting liver metastasis was 74.1% and the specificity was 67.4%. When multivariate logistic regression analysis was conducted, FIB4 score, APRI score, Tstage, and Nstage were found as independent predictive factors in predicting liver metastasis It has been demonstrated that the group that may develop liver metastasis among patients with non-metastatic CRC at the time of diagnosis could be predicted by using the noninvasive liver fibrosis markers FIB4 and APRI scores. Moreover, it has been shown that these two scorings are also independent predictive markers. Based on this, shorter surveillance intervals may be an option in the group with higher FIB4 and APRI scores at the time of diagnosis.