慢性乙型肝炎患者肝细胞癌发生动态风险预测的可行性

StephenW

Feasibility of dynamic risk prediction for hepatocellular carcinoma development in patients with chronic hepatitis B
Mi Young Jeon
Hye Won Lee
Seung Up Kim
Beom Kyung Kim
Jun Yong Park
Do Young Kim
Kwang‐Hyub Han
Sang Hoon Ahn
First published: 2 September 2017
https://doi.org/10.1111/liv.13583

Funding informationThis study was supported by the Basic Science Research Program throug ... More

Handling Editor: Chun‐Jen Liu

Mi Young Jeon and Hye Won Lee contributed equally to this work as joint first authors. Seung U ... More

Abstract
Background & Aims

Several risk prediction models for hepatocellular carcinoma (HCC) development are available. We explored whether the use of risk prediction models can dynamically predict HCC development at different time points in chronic hepatitis B (CHB) patients.
Methods

Between 2006 and 2014, 1397 CHB patients were recruited. All patients underwent serial transient elastography at intervals of >6 months.
Results

The median age of this study population (931 males and 466 females) was 49.0 years. The median CU‐HCC, REACH‐B, LSM‐HCC and mREACH‐B score at enrolment were 4.0, 9.0, 10.0 and 8.0 respectively. During the follow‐up period (median, 68.0 months), 87 (6.2%) patients developed HCC. All risk prediction models were successful in predicting HCC development at both the first liver stiffness (LS) measurement (hazard ratio [HR] = 1.067‐1.467 in the subgroup without antiviral therapy [AVT] and 1.096‐1.458 in the subgroup with AVT) and second LS measurement (HR = 1.125‐1.448 in the subgroup without AVT and 1.087‐1.249 in the subgroup with AVT). In contrast, neither the absolute nor percentage change in the scores from the risk prediction models predicted HCC development (all P > .05). The mREACH‐B score performed similarly or significantly better than did the other scores (AUROCs at 5 years, 0.694‐0.862 vs 0.537‐0.875).
Conclusions

Dynamic prediction of HCC development at different time points was achieved using four risk prediction models, but not using the changes in the absolute and percentage values between two time points. The mREACH‐B score was the most appropriate prediction model of HCC development among four prediction models.

StephenW

慢性乙型肝炎患者肝细胞癌发生动态风险预测的可行性
米Je全
惠元李
Seung Up Kim
Beom Kyung Kim
君勇公园
做年轻的金
Kwang-Hyub Han
桑勋安
首次发布：2017年9月2日
https://doi.org/10.1111/liv.13583

资金信息本研究得到了基础科学研究计划的支持...更多

处理编辑：刘春仁

Mi Young Jeon和Hye Won Lee作为第一作者共同为这项工作做出了贡献。 Seung U ...更多

抽象
背景和目的

几种用于肝细胞癌（HCC）发展的风险预测模型是可用的。我们探讨了使用风险预测模型是否可以动态预测慢性乙型肝炎（CHB）患者不同时间点的HCC发展。
方法

在2006年至2014年间，招募了1397名CHB患者。所有患者均进行连续瞬时弹性成像，间隔> 6个月。
结果

该研究人群的中位年龄（931名男性和466名女性）为49.0岁。入选时的CU-HCC中位数，REACH-B，LSM-HCC和mREACH-B分数分别为4.0,9.0,10.0和8.0。在随访期间（中位数68.0个月），87例（6.2％）患者发生HCC。所有风险预测模型在第一次肝硬度（LS）测量（无抗病毒治疗组[AVT]组为1.067-1.467，AVT组为1.096-1.458）预测HCC发展方面均成功;第二次LS测量（在没有AVT的亚组中HR = 1.125-1.448，在AVT亚组中为1.087-1.249）。相比之下，风险预测模型得分的绝对值和百分比变化都不能预测HCC的发展（所有P> 0.05）。 mREACH-B评分与其他评分（AUROCs 5年，0.694-0.862 vs 0.537-0.875）相似或显着更好。
结论

使用四种风险预测模型实现了不同时间点HCC发展的动态预测，但未使用两个时间点之间的绝对值和百分比值的变化。 mREACH-B评分是四种预测模型中最适合HCC发展的预测模型。