- 现金
- 62111 元
- 精华
- 26
- 帖子
- 30437
- 注册时间
- 2009-10-5
- 最后登录
- 2022-12-28
|
J Hepatol. 2020 Jan 22. pii: S0168-8278(20)30022-2. doi: 10.1016/j.jhep.2020.01.007. [Epub ahead of print]
Hepatocellular carcinoma prediction beyond year 5 of oral therapy in a large cohort of Caucasian patients with chronic hepatitis B.
Papatheodoridis GV1, Sypsa V2, Dalekos GN3, Yurdaydin C4, Van Boemmel F5, Buti M6, Calleja JL7, Chi H8, Goulis J9, Manolakopoulos S10, Loglio A11, Voulgaris T12, Gatselis N3, Keskin O4, Veelken R5, Lopez-Gomez M7, Hansen BE13, Savvidou S9, Kourikou A14, Vlachogiannakos J12, Galanis K3, Idilman R4, Esteban R6, Janssen H15, Berg T5, Lampertico P11.
Author information
Abstract
BACKGROUND & AIMS:
Hepatocellular carcinoma (HCC) may develop in chronic hepatitis (CHB) patients even after 5 years of oral therapy and cannot be easily predicted. We assessed predictors and need for HCC surveillance in this setting.
METHODS:
Of 1951 adult Caucasians with CHB included in the PAGE-B cohort, 1427 (73%) have completed follow-up >5 years under therapy without HCC until year 5. Median follow-up has been 8.4 years from treatment onset. Points-based risk scores were developed to predict HCC risk after year 5.
RESULTS:
In years 5-12, HCC has been diagnosed in 33/1427 (2.3%) patients with cumulative incidence 2.4%, 3.2% and 3.8% at 8, 10 and 12 years, respectively. Older age or age >50 years, baseline cirrhosis and liver stiffness (LSM) ≥12 kPa at year 5 were independently associated with increased HCC risk. The HCC incidence was lower in non-cirrhotics than those with baseline cirrhosis and year-5 LSM <12 kPa than those with baseline cirrhosis and year-5 LSM ≥12 kPa. CAGE-B score was based on age at year 5 and baseline cirrhosis in relation to LSM at year 5 and SAGE-B score was based only on age and LSM at year 5 (c-index=0.809-0.814, 0.805-0.806 after bootstrap validation). Both scores offered 100% negative predictive values for HCC development in their low risk groups.
CONCLUSIONS:
In Caucasians with CHB, the HCC risk after the first 5 years of antiviral therapy depends on age, baseline cirrhosis status and LSM at year 5. CAGE-B and particularly SAGE-B represent simple and reliable risk scores for HCC prediction and surveillance beyond year 5 of therapy.
Copyright © 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
KEYWORDS:
cirrhosis; entecavir; liver stiffness; tenofovir
PMID:
31981727
DOI:
10.1016/j.jhep.2020.01.007
|
|