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World J Gastrointest Oncol. May 15, 2026; 18(5): 117512
Published online May 15, 2026. doi: 10.4251/wjgo.v18.i5.117512
Published online May 15, 2026. doi: 10.4251/wjgo.v18.i5.117512
Baseline and longitudinal biomarkers predict hepatocellular carcinoma in chronic hepatitis C: A cohort study
Yi-Lin Li, Hung-Da Tung, Tang-Wei Chuang, Chun-Ta Cheng, Mai-Gio Pang, Jyh-Jou Chen, Kun-Ming Zhong, Ting-Yi Huang, Pei-Lun Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Hospital, Liouying, Tainan 736402, Taiwan
Author contributions: Li YL, Tung HD, and Chen JJ contributed to the conceptualization and design of the study; Li YL, Tung HD, and Chuang TW conducted the literature analysis and drafted the initial manuscript; Li YL and Huang TY were responsible for data collection, database construction, and visualization (tables and figures); Cheng CT, Pang MG, Lee PL and Chen JJ contributed to data analysis and critical revision of the manuscript; Zhong KM assisted in drafting and revising the manuscript; Lee PL provided supervision, biostatistical analysis and final editing; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Chi Mei Hospital, Liouying (Approval No. 11412-L02).
Informed consent statement: Waiver of informed consent for this retrospective analysis.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The data are available from the corresponding author upon reasonable request.
Corresponding author: Pei-Lun Lee, Chief Physician, Lecturer, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Hospital, Liouying, No. 201 Taikang, Tainan 736402, Taiwan. peilun57@gmail.com
Received: December 9, 2025
Revised: January 16, 2026
Accepted: February 10, 2026
Published online: May 15, 2026
Processing time: 156 Days and 11.4 Hours
Revised: January 16, 2026
Accepted: February 10, 2026
Published online: May 15, 2026
Processing time: 156 Days and 11.4 Hours
Core Tip
Core Tip: This retrospective cohort study evaluated 271 treatment-naïve patients with chronic hepatitis C to determine whether baseline and 3-year trajectories of the fibrosis-4 (FIB-4) index and other biomarkers predict long-term hepatocellular carcinoma (HCC) risk. A baseline FIB-4 value > 3.25 strongly predicted HCC independently, while a 3-year ΔFIB-4 ≥ 1 helped risk stratification. Persistently low FIB-4 values identified a group with negligible HCC incidence. Periodic, low-cost monitoring of FIB-4 and alpha-fetoprotein may offer a practical approach to guide surveillance and treatment prioritization in resource-limited settings.