Clinical utility of hepatocellular carcinoma risk scores in chronic hepatitis B
Thodoris Voulgaris
Margarita Papatheodoridi
Pietro Lampertico
George V. Papatheodoridis
First published: 29 December 2019 https://doi.org/10.1111/liv.14334
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/liv.14334
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Abstract
Background
Several risk scores have been recently developed to predict hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients We systematically assessed the performance of the available HCC risk scores.
Methods
Literature search was performed to identify all published studies reporting development or external validation of HCC risk scores in CHB patients.
Results
Until March 2019, 12 scores were developed in untreated Asian and 7 scores in treated Asian (n=6) or Caucasian (n=1) patients. All scores provided significant predictions for HCC development in the derivation and validation cohorts of their original studies (c‐statistic:0.76‐0.95) and usually classified patients into low, medium and high HCC risk groups. Eleven independent studies and three studies developing their own scores have validated externally some scores in Asian (GAG‐HCC:5, CU‐HCC:6, REACH‐B:6, REACH‐Bm:4, LSM‐HCC:3, PAGE‐B:5) or Caucasian/mixed origin patients (GAG‐HCC:4, CU‐HCC:4, REACH‐B:4, PAGE‐B:2). All scores offered acceptable predictability in almost all independent Asian cohorts (c‐statistic:0.70‐0.86), but only PAGE‐B and recently mPAGE‐B offered good predictability in all independent Caucasian and/or Asian cohorts. Negative predictive values for 5‐year HCC prediction were ≤99% (95%‐99%) in most independent cohorts assessing Asian risk scores and 99%‐100% in all independent cohorts (Caucasian/mixed origin:2; Asian:3) assessing PAGE‐B and/or recently mPAGE‐B.
Conclusions
Direct comparison of the newest HCC risk scores in independent patient cohorts of different origin remains intriguing, although statistical associations may not be directly transferable to clinical practice. PAGE‐B and recently mPAGE‐B score seem to offer persistently high predictability for Caucasian and/or Asian treated patients with low HCC risk who require no surveillance. 作者: StephenW 时间: 2020-1-3 14:29
慢性乙型肝炎肝细胞癌危险评分的临床应用
Thodoris寻常
玛格丽塔（Margarita Papatheodoridi）
Pietro Lampertico
乔治五世·帕帕特奥多里迪斯
首次发布：2019年12月29日 https://doi.org/10.1111/liv.14334