EASL2019 THU-223 开发优化风险预测模型 肝细胞癌合并慢性乙型

StephenW

THU-223
Development of an optimized risk prediction model for
hepatocellular carcinoma in chronic hepatitis B patients with
well-controlled viremia by antivirals
Hye Won LEE1, Beom Kyung Kim1, Seung Up Kim1, Jun Yong Park1,
Do Young Kim1, Sang Hoon Ahn1, Kwang-Hyub Han1. 1Yonsei
University College of Medicine, Department of Internal Medicine, Seoul,
Korea, Rep. of South
Email: [email protected]
Background and aims: The risk of hepatocellular carcinoma (HCC) in
patients with chronic hepatitis B has been substantially decreased inthe era of antiviral therapy. We aimed to develop an optimized risk
prediction model for HCC in patients with well-controlled viremia by
nucelos (t)ide analogues (NUCs).
Method: This study included patients who achieved virological
response (VR; serum HBV-DNA < 2, 000 IU/ml on two consecutive
assessments) by NUCs. Liver stiffness (LS) was assessed by transient
elastography at the time of confirmed VR in all patients. Patients with
decompensated liver cirrhosis or HCC at baseline were excluded.
Multivariate Cox-proportional hazards model were used to determine
potential factors for a risk prediction model.
Results: Among a total of 1511 patients,143 (9.5%) patients developed
HCC during follow-up. Age (adjusted hazard ratio [aHR] 1.04, 95% CI
1.02-1.06), LS ≥ 11 kPa (aHR 6.09, 95% CI 3.89-9.55), cirrhosis on
ultrasonography (aHR 2.47, 95% CI 1.35-4.53), male gender (aHR 1.9,
95% CI 1.2-2.8), albumin <4.5 g/dL (aHR 1.77, 95% CI 1.21-2.59) and
platelet < 135, 000/uL (aHR 1.57, 95% CI 1.07-2.32) were potential
variables to make a risk prediction model for HCC development (all
p < 0.05). These 6 parameters were weighted to develop a novel
nomogram ranging from 0 to 271 points; a total point of 180 means
the probability of 10% and 30% for HCC development at 5- and 10-
years, respectively. The overall c-index was 0.876 (95% CI 0.845-
0.902).
Conclusion: A novel nomogram enabled the more accurate prediction
of HCC development among patients with well-controlled
viremia by NUCs.

StephenW

THU-223
开发优化风险预测模型
肝细胞癌合并慢性乙型肝炎患者
抗病毒药物控制良好的病毒血症
Hye Won LEE1，Beom Kyung Kim1，Seung Up Kim1，Jun Yong Park1，
Do Young Kim1，Sang Hoon Ahn1，Kwang-Hyub Han1。 1Yonsei
首尔大学医学院内科，
韩国，南方众议院
电子邮件：[email protected]
背景与目的：肝细胞癌（HCC）的风险
在抗病毒治疗的时代，慢性乙型肝炎患者已经大大减少。我们的目标是开发出优化的风险
- 控制良好的病毒血症患者HCC的预测模型
nucelos（t）ide类似物（NUC）。
方法：本研究包括病毒学患者
反应（VR;连续两次血清HBV-DNA <2,000 IU / ml）
NUCs评估）。通过短暂评估肝硬度（LS）
在所有患者中确认VR时的弹性成像。患者
排除基线时失代偿性肝硬化或HCC。
多变量Cox比例风险模型用于确定
风险预测模型的潜在因素。
结果：共有1511名患者，其中143名（9.5％）患者发生
HCC在随访期间。年龄（校正风险比[aHR] 1.04,95％CI
1.02-1.06），LS≥11kPa（aHR 6.09,95％CI 3.89-9.55），肝硬化
超声检查（aHR 2.47,95％CI 1.35-4.53），男性（aHR 1.9，
95％CI 1.2-2.8），白蛋白<4.5 g / dL（aHR 1.77,95％CI 1.21-2.59）和
血小板<135,000 / uL（aHR 1.57,95％CI 1.07-2.32）是潜在的
为HCC发展制定风险预测模型的变量（全部
p <0.05）。这6个参数被加权以开发新颖的
列线图从0到271点不等;总计180意味着
5和10-的HCC发展概率分别为10％和30％
年，分别。整体c指数为0.876（95％CI 0.845-
0.902）。
结论：一种新颖的列线图可以更准确地预测
控制良好的患者HCC发展状况
NUCs的病毒血症。