肝脏硬度为基础的模型，用于慢性乙型肝炎病毒感染肝细胞

StephenW

Liver stiffness-based model for prediction of hepatocellular carcinoma in chronic hepatitis B virus infection: comparison with histological fibrosis

    Seung Hwan Shin1,
    Seung Up Kim1,2,3,4,
    Jun Yong Park1,2,3,4,
    Do Young Kim1,2,3,4,
    Sang Hoon Ahn1,2,3,4,5,
    Kwang-Hyub Han1,2,3,4,5 and
    Beom Kyung Kim1,2,3,4,*

Article first published online: 8 JUL 2014

DOI: 10.1111/liv.12621

© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

   



Abstract
Background & Aims

Liver stiffness (LS) value using transient elastography is a reliable, non-invasive tool for assessing liver fibrosis. LS-based prediction model, LSPS (=LS value × spleen diameter/platelet count) is well correlated with the risk of developing portal hypertension-related cirrhotic complications. Here, we assessed the prognostic performance of LSPS in predicting the development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB).
Methods

Between 2006 and 2010, we recruited 227 patients with CHB who underwent liver biopsy and LS measurement. The major end point was HCC development.
Results

Median age was 45 years and 156 (68.7%) patients were male. During the follow-up period (median, 61 months), HCC developed in 18 patients. Patient with HCC had a higher LS value, a longer spleen, and lower platelet counts (all P < 0.05) than those without HCC. On multivariate analysis, LSPS was identified as an independent predictor of HCC development [hazard ratio (HR) 1.541, P < 0.001] after adjusting for age, serum albumin level and histological fibrosis stage. When patients were stratified into three groups (LSPS <1.1, 1.1–2.5 and >2.5), the 5-year cumulative risk of HCC increased significantly in association with a higher LSPS value (4.0, 13.8, 36.2%, respectively, P < 0.001). Patients with LSPS 1.1–2.5 (HR 2.0, P = 0.032) and LSPS > 2.5 (HR 8.7, P = 0.002) had a higher risk of developing HCC than those with LSPS < 1.1.
Conclusions

LS value-spleen diameter to platelet ratio score is useful for assessing the risk of HCC development and careful surveillance strategies are required in an individual manner.

StephenW

肝脏硬度为基础的模型，用于慢性乙型肝炎病毒感染肝细胞肝癌的预测：与组织纤维化比较

    承焕Shin1，
    升向上Kim1,2,3,4，
    君永Park1,2,3,4，
    做年轻Kim1,2,3,4，
    桑勋Ahn1,2,3,4,5，
    刘广Hyub Han1,2,3,4,5和
    范庆Kim1,2,3,4，*

文章首次在网上公布：2014年7月8日

DOI：10.1111/ liv.12621

©2014年约翰·威利父子A / S。发布时间由John Wiley＆Sons出版有限公司

   



抽象
背景与目的

肝脏硬度（LS）值使用瞬时弹性成像是一种可靠的，非侵入性的工具，以评估肝纤维化。 LS-基于预测模型，LSPS（= LS值×脾脏直径/血小板计数）是很好的相关性与显影门脉高压相关的肝硬化的并发症的风险。在这里，我们评估LSP的预后表现在慢性乙型肝炎（CHB）预测肝细胞癌（HCC）的发展。
方法：

2006年至2010年，我们招募了227例CHB谁接受肝活检和LS测量。主要终点是肝癌的发展。
结果

平均年龄为45岁和156（68.7％）的患者是男性。在随访期间（中位数，61个月），肝癌开发18例。患者患有HCC有较高的LS值，较长的脾，并降低血小板计数（所有P <0.05）比那些没有肝癌。多因素分析，LSPS被认定为HCC的发展[危险比（HR）1.541，P <0.001]的独立预测因子校正年龄，血清白蛋白水平和组织纤维化阶段之后。当患者分为三组（LSPS<1.1，1.1-2.5和>2.5），肝癌的5年累积风险显著的关联具有更高LSPS值（4.0，13.8，36.2％，分别为P <0.001上升）。患者LSPS1.1-2.5（HR2.0，P=0.032）和LSP>2.5（HR8.7，P = 0.002），有发展HCC比那些LSPS<1.1的风险较高。
结论

LS价值脾直径血小板比分数是评价肝癌发展和审慎监管策略下所需要的个人方式的风险非常有用。