Clinical and Molecular Hepatology

"Ji Hyun An"

Original Articles

Hepatic neoplasm

Assessment of the postoperative prognosis in patients with hepatocellular carcinoma using vibration-controlled transient elastography: A systemic review and meta-analysis: Jung Hwan Yu, Ji Won Han, Young Ju Suh, Young Eun Chon, Hee Yeon Kim, Ji Hyun An, Young-Joo Jin, Miyoung Choi, Seung Up Kim, Dae Won Jun, Han Ah Lee, Mi Na Kim; Clin Mol Hepatol 2024;30(Suppl):S186-S198.
Published online August 21, 2024; DOI: https://doi.org/10.3350/cmh.2024.0366

Backgrounds/Aims
This meta-analysis examined whether preoperative vibration-controlled transient elastography (VCTE) can predict postoperative complications and recurrence in patients undergoing hepatic resection for hepatocellular carcinoma (HCC).
Methods
A systematic literature search was conducted using Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases. Out of 431 individual studies, thirteen published between 2008 and 2022 were included. Five studies focused on HCC recurrence, while eight examined postoperative complications.
Results
The meta-analysis of five studies on HCC recurrence showed that the high-risk group with a high VCTE score had a significantly increased recurrence rate after hepatic resection (hazard ratio 2.14). The cutoff value of VCTE in the high-risk group of HCC recurrence was 7.4–13.4 kPa, the sensitivity was 0.60 (95% confidence interval [CI] 0.47–0.72), and the specificity was 0.60 (95% CI 0.46–0.72). The area under the receiver operating characteristic curve (AUC) of the liver stiffness measured by VCTE to predict the HCC recurrence was 0.63 (95% CI 0.59–0.67). The meta-analysis on the postoperative complications revealed a significantly increased risk of postoperative complications in the high-risk group (12–25.6 kPa) with a high VCTE value (odds ratio [OR], 8.32). The AUC of the liver stiffness measured by VCTE to predict the postoperative complications was 0.87 (95% CI 0.84–0.90), the sensitivity was 0.76 (95% CI 0.55–0.89) and the specificity was 0.85 (95% CI 0.73–0.92).
Conclusions
This meta-analysis suggests that preoperative VCTE in patients undergoing hepatic resection for HCC is useful in identifying individuals at a high risk of postoperative complications and HCC recurrence.

Citations

Citations to this article as recorded by

Comparison of HCC patients with and without MASLD after surgical resection
Chia-Jung Ho, Hao-Jan Lei, Chun-Ting Ho, Gar-Yang Chau, Shu-Cheng Chou, Elise Chia-Hui Tan, Pei-Chang Lee, Yi-Hsiang Huang, Ying-Ying Yang, Teh-Ia Huo, Ming-Chih Hou, Jaw-Ching Wu, Chien-Wei Su
JHEP Reports.2026; : 101768. CrossRef
Recent Trends in Noninvasive Tests for Assessing Hepatic Fibrosis in Patients with Chronic Liver Disease
Jung Hwan Yu
The Korean Journal of Medicine.2024; 99(5): 232. CrossRef

6,082 View
115 Download
2 Web of Science
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Steatotic liver disease

Diagnostic accuracy of the Fibrosis-4 index for advanced liver fibrosis in nonalcoholic fatty liver disease with type 2 diabetes: A systematic review and meta-analysis: Ji Won Han, Hee Yeon Kim, Jung Hwan Yu, Mi Na Kim, Young Eun Chon, Ji Hyun An, Young-Joo Jin, Miyoung Choi, Seung Up Kim, Han Ah Lee, Dae Won Jun; Clin Mol Hepatol 2024;30(Suppl):S147-S158.
Published online July 25, 2024; DOI: https://doi.org/10.3350/cmh.2024.0330

Background/Aims
The Fibrosis-4 index (FIB-4) is a noninvasive test widely used to rule out advanced liver fibrosis (AF) in patients with nonalcoholic fatty liver disease (NAFLD). However, its diagnostic accuracy in NAFLD patients with type 2 diabetes mellitus (T2DM) is controversial due to the high prevalence of AF in this population.
Methods
Research focusing on the diagnostic accuracy of FIB-4 for liver fibrosis as validated by liver histology in NAFLD patients with T2DM was included, and 12 studies (n=5,624) were finally included in the meta-analysis. Sensitivity, specificity, hierarchical summary receiver operating characteristic (HSROC), positive predictive values (PPVs), and negative predictive values (NPVs) at low cutoffs (1.3–1.67) and high cutoffs (2.67–3.25) for ruling in and out AF were calculated.
Results
At low cutoffs, the meta-analysis revealed a sensitivity of 0.74, specificity of 0.62, and HSROC of 0.75. At high cutoffs, the analysis showed a sensitivity of 0.33, specificity of 0.92, and HSROC of 0.85, suggesting FIB-4 as useful for identifying or excluding AF. In subgroup analyses, high mean age and F3 prevalence were associated with lower sensitivity. The calculated NPV and PPV were 0.82 and 0.49 at low cutoffs, whereas the NPV was 0.28 and the PPV was 0.70 at high cutoffs. There were insufficient estimated NPVs <0.90 at a hypothesized prevalence of AF >30% at an FIB-4 cutoff range of 1.3–1.67.
Conclusions
Collectively, FIB-4 has moderate diagnostic accuracy for identifying or excluding AF in NAFLD patients with T2DM, but more evidence must be accumulated due to the limited number of currently reported studies and their heterogeneity.

Citations

Citations to this article as recorded by

Two-step clinical care pathway to predict MASLD-related advanced fibrosis and long-term outcomes in type 2 diabetes
Yuping Chen, Bingtian Dong, Xinrui Jin, Chuan Liu, Ming-Hua Zheng, Xiao Liang, Yameng Sun, Hye Won Lee, Huapeng Lin, Emmanuel Tsochatzis, Salvatore Petta, Elisabetta Bugianesi, Masato Yoneda, Hannes Hagström, Jérôme Boursier, José Luis Calleja, George Boo
Gut.2026; : gutjnl-2025-337506. CrossRef
Part 2: CAR Metabolic Dysfunction-Associated Steatotic Liver Disease Working Group Recommendations for Risk Stratifying Patients With MASLD
Mitchell P. Wilson, Gavin Low, Abdel-Aziz Shaheen, Andreu F. Costa, An Tang, Emily Pang, Silvia Chang, Alexandra Medellin, Jérémy Dana, Noam Millo, Ania Kielar, Li Xin Zhang, Toni Whitaker, Mark Swain, Victoria Leung, Daisy Fung, Casey Hurrell, Christophe
Canadian Association of Radiologists Journal.2026; 77(1): 73. CrossRef
Prognostic value of the FIB-4 index in patients with myocardial infarction with non-obstructive coronary arteries
Wei Zhang, Yuqi Chen, Liu Zhu, Siliang Peng, Mengchao Jin, Jiayu Yin
International Journal of Cardiology.2026; 445: 134045. CrossRef
Reply to: “A machine learning model to predict liver-related outcomes after the functional cure of chronic hepatitis B: Is cirrhosis driving the performance?”
Moon Haeng Hur, Jeong-Hoon Lee
Journal of Hepatology.2025; 82(3): e143. CrossRef
The fibrosis-4 index for advanced liver fibrosis in NAFLD with T2DM: Half a loaf is better than no bread
Zeyu Wang, Dong Wan, Meidong Xu, Yong Jiang
Clinical and Molecular Hepatology.2025; 31(1): e25. CrossRef
Non-Invasive Liver Fibrosis Test Using Shear Wave Elastography
Ji Won Han
The Korean Journal of Medicine.2025; 100(1): 26. CrossRef
Age serves as the silent architect of FIB-4’s precision in unveiling advanced hepatic fibrosis in MASLD with T2DM: Correspondence to letter to the editor on “Diagnostic accuracy of the fibrosis-4 index for advanced liver fibrosis in nonalcoholic fatty liv
Ji Won Han, Dae Won Jun
Clinical and Molecular Hepatology.2025; 31(2): e152. CrossRef
Targeting endoplasmic reticulum proteostasis in liver fibrosis: From signaling mechanisms to therapeutic opportunities
Yawei Kong, Zhengyang Chen, Zhentian Nie, Wei Chen
Pharmacological Research.2025; 217: 107823. CrossRef
Comparison of FIB-4, APRI and AST/ALT ratio with FibroScan in patients with NAFLD and type 2 diabetes: a single-center study from Bangladesh
Muhammad Shah Alam, Syeda Tanzina Kalam, Monirul Islam Khan, Jabed Ahmed, Rahul Saha, A. B. M. Kamrul-Hasan
Egyptian Liver Journal.2025;[Epub] CrossRef
Impact of a high dietary fiber cereal meal intervention on the progression of liver fibrosis in T2DM with MASLD
Xi-Shuang Chen, Hui-Zhen Liu, Fang Huang, Jian Meng, Jing-Xian Fang, Yu Han, Hui-Ming Zou, Qing Gu, Xue Hu, Qian-Wen Ma, Yue-Xia Han, Sui-Jun Wang
Frontiers in Endocrinology.2025;[Epub] CrossRef
Association between fibrosis-4 index and coronary heart disease: a population-based study
Pan Jia, Mamajan Annamyradova, Genhao Fan, Qizhen Zhang, Yankun Song, Qiaozhi Li, Minghao Liu, Zuoying Xing, Yongxia Wang
BMC Cardiovascular Disorders.2025;[Epub] CrossRef
Forns index and fatty liver index, but not FIB-4, are associated with indices of glycaemia, pre-diabetes and type 2 diabetes: analysis of The Maastricht Study
Leen Heyens, Hanna Kenjic, Pieter Dagnelie, Casper Schalkwijk, Coen Stehouwer, Steven Meex, Jeroen Kooman, Otto Bekers, Marleen van Greevenbroek, Hans Savelberg, Geert Robaeys, Bastiaan de Galan, Annemarie Koster, Martien van Dongen, Simone Eussen, Ger Ko
BMJ Open Gastroenterology.2024; 11(1): e001466. CrossRef

7,096 View
184 Download
12 Web of Science
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Case Report

Benign liver tumors and cystic disease of liver

A case of primary hepatic actinomycosis: an enigmatic inflammatory lesion of the liver: Yeon Jung Ha, Ji Hyun An, Ju Hyun Shim, Eun Sil Yu, Jong Jae Kim, Tae Yong Ha, Han Chu Lee; Clin Mol Hepatol 2015;21(1):80-84.
Published online March 25, 2015; DOI: https://doi.org/10.3350/cmh.2015.21.1.80

Abstract
PDF

Primary hepatic actinomycosis is one of the chronic abscess-forming infections of the liver. Accurate diagnosis is frequently delayed due to its indolent course and nonspecific clinical and radiological manifestations. We report a case of a 57-year-old man presenting with asymptomatic multiple hepatic masses on follow-up abdominal computed tomography performed 1 year after stomach cancer surgery. Although a percutaneous liver biopsy procedure was conducted twice in order to obtain confirmative pathology, only a nonspecific organizing abscess with plasma cell infiltration was revealed, without identification of any organism in the tissue cultures. Ultimately, actinomycosis was diagnosed following the detection of sulfur granules on open surgical biopsied tissue. This case suggests that primary hepatic actinomycosis should be considered as one of the possible causes for enigmatic inflammatory lesions of the liver.

Citations

Citations to this article as recorded by

Hepatic Actinomycosis: A Diagnostic Challenge
Prithiviraj Nabi, Muthukumarassamy Rajakannu, Mukul Vij, Mohamed Rela
Journal of Clinical and Experimental Hepatology.2026; 16(2): 103442. CrossRef
An overview of case reports and case series of pulmonary actinomycosis mimicking lung cancer: a scoping review
Amin Khoshbayan, Nour Amirmozafari, Shiva Mirkalantari
Frontiers in Medicine.2024;[Epub] CrossRef
Abdominal actinomycosis presented as acute abdomen with intra-abdominal multiple tumors: A case report
Mohammad Reza Maghsoudi, Mohammad Azizmanesh, Javad Karimi Rozveh, Pouria Chaghamirzayi
International Journal of Surgery Case Reports.2024; 122: 110113. CrossRef
Primary Hepatic Actinomycosis Mimicking Hepatic Malignancy
Yong-Kyu Chung, Bo-Hyun Jung, Hee-Jung Wang
The Korean Journal of Gastroenterology.2022; 79(1): 45. CrossRef
Abdominopelvic Actinomycosis—The Diagnostic and Therapeutic Challenge of the Most Misdiagnosed Disease
Alin Mihai Vasilescu, Eugen Târcoveanu, Cristian Lupascu, Mihaela Blaj, Corina Lupascu Ursulescu, Costel Bradea
Life.2022; 12(3): 447. CrossRef
Primary liver actinomycosis in a pediatric patient: A case report and literature review
Zi-Jian Liang, Jian-Kun Liang, Yun-Pei Chen, Zhen Chen, Yong Wang
World Journal of Clinical Cases.2021; 9(20): 5717. CrossRef
A systematic review of case reports of hepatic actinomycosis
Zahra Chegini, Mojtaba Didehdar, Seidamir Pasha Tabaeian, Amin Khoshbayan, Aref Shariati
Orphanet Journal of Rare Diseases.2021;[Epub] CrossRef
Primary hepatic actinomycosis mimicking liver tumour
Qi‐Qiang Zeng, Xiang‐Wu Zheng, Qun‐Ji Wang, Zheng‐Ping Yu, Qi‐Yu Zhang
ANZ Journal of Surgery.2018;[Epub] CrossRef
Hepatic actinomycosis with immunoglobulin G4-related liver disease
Joo Hyung Lee, Hyung Sun Kim, Ji Sub Kim, Dong Ki Lee, Jin Hong Lim
Medicine.2018; 97(24): e11146. CrossRef
A Rare Thermophilic Bug in Complicated Diverticular Abscess
Kyawzaw Lin, Sithu Lin, Aung Naing Lin, Thinzar Lin, Zin Mar Htun, Madhavi Reddy
Case Reports in Gastroenterology.2017; 11(3): 569. CrossRef