增强的肝纤维化评分和肝硬度测量的改善反映了肝细胞癌的

StephenW

Aliment Pharmacol Ther. 2019 Apr 25. doi: 10.1111/apt.15269. [Epub ahead of print]
Improvement in enhanced liver fibrosis score and liver stiffness measurement reflects lower risk of hepatocellular carcinoma.
Liang LY1,2, Wong VW1,2,3, Tse YK1,2, Yip TC1,2, Lui GC2, Chan HL1,2,3, Wong GL1,2,3.
Author information

1
    Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong.
2
    Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong.
3
    State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong.

Abstract
BACKGROUND:

The Liver stiffness measurement hepatocellular carcinoma (LSM-HCC) score predicts HCC accurately in patients with chronic hepatitis B (CHB).
AIM:

To assess the ability of LSM-HCC combined with enhanced liver fibrosis (ELF) score to predict HCC in CHB patients who received anti-viral treatment.
METHODS:

CHB patients who had transient elastography examinations in 2006-2013 with intermediate and high risk of HCC by LSM-HCC score (ie 11 or above) were assessed by repeat transient elastography at least 3 years later. ELF score was assessed by retrieving the stored serum samples 4 weeks within transient elastography examination. The primary endpoint was the cumulative incidence of HCC.
RESULTS:

A total of 453 CHB patients (mean age 51.7 ± 10.3 years; male 74.4%) were recruited, 45 patients (9.9%) developed HCC during the mean follow-up of 56 months. Regarding LSM-HCC score, 71.4%, 24.3% and 4.3% of patients had LSM-HCC score improved, remained static and deteriorated respectively; whereas 36.9%, 57.8% and 5.3% of patients had ELF score improved, remained static and deteriorated respectively. The sensitivity (86.7%) and negative predictive value (NPV) (95.3%) of combined LSM-HCC and ELF score were higher than that of each score alone. Kaplan-Meier analysis showed that ELF score would help further differentiate the HCC risk in patients with intermediate risk by LSM-HCC score (P = 0.026), but not in patients with high risk by LSM-HCC score (P = 0.770).
CONCLUSIONS:

The two-step algorithm combining LSM-HCC score and ELF score could improve the accuracy of predicting HCC of CHB patients receiving anti-viral treatment.

© 2019 John Wiley & Sons Ltd.

PMID:
    31025388
DOI:
    10.1111/apt.15269

StephenW

Aliment Pharmacol Ther。 2019年4月25日.doi：10.1111 / apt.15269。 [印刷前的电子版]
增强的肝纤维化评分和肝硬度测量的改善反映了肝细胞癌的低风险。
Liang LY1,2，Wong VW1,2,3，Tse YK1,2，Yip TC1,2，Lui GC2，Chan HL1,2,3，Wong GL1,2,3。
作者信息

1
香港中文大学消化病研究所，香港特别行政区，香港。
2
香港中文大学医学与治疗学系，香港特别行政区，香港。
3
香港中文大学消化病国家重点实验室，香港特别行政区，香港。

抽象
背景：

肝硬度测量肝细胞癌（LSM-HCC）评分可准确预测慢性乙型肝炎（CHB）患者的HCC。
目标：

评估LSM-HCC联合增强肝纤维化（ELF）评分预测接受抗病毒治疗的CHB患者的HCC的能力。
方法：

通过LSM-HCC评分（即11或以上）进行HCC中度和高风险的短期弹性成像检查的CHB患者至少在3年后通过重复瞬时弹性成像进行评估。通过在瞬时弹性成像检查中检索储存的血清样品4周来评估ELF评分。主要终点是HCC的累积发病率。
结果：

招募了453名CHB患者（平均年龄51.7±10.3岁;男性74.4％），45名患者（9.9％）在56个月的平均随访期间发生HCC。关于LSM-HCC评分，71.4％，24.3％和4.3％的患者LSM-HCC评分改善，分别保持静止和恶化;而36.9％，57.8％和5.3％的患者ELF评分改善，分别保持静止和恶化。 LSM-HCC和ELF联合评分的敏感性（86.7％）和阴性预测值（NPV）（95.3％）均高于单独评分。 Kaplan-Meier分析显示，ELF评分有助于通过LSM-HCC评分进一步区分中度风险患者的HCC风险（P = 0.026），但LSM-HCC评分高风险患者则无此差异（P = 0.770）。
结论：

结合LSM-HCC评分和ELF评分的两步法可以提高预测接受抗病毒治疗的CHB患者HCC的准确性。

©2019 John Wiley＆Sons Ltd.

结论：
31025388
DOI：
10.1111 / apt.15269

StephenW

https://onlinelibrary.wiley.com/doi/pdf/10.1111/apt.15269

newchinabok

肝癌的比例很大