预测接受抗病毒治疗的慢性乙型肝炎患者发生肝细胞癌的风

StephenW

预测接受抗病毒治疗的慢性乙型肝炎患者发生肝细胞癌的风险：在中国验证 CAMD 和 AASL 评分

王帅1、刘炳伟2、范雪梅1、高杨1、洪明奇1、徐艳1
1 吉林大学中日协和医院消化内科,长春
2 浙江大学医学院附属杭州市第一人民医院重症医学科，杭州，中国

通讯地址：
徐艳博士
吉林大学中日联合医院消化内科，吉林长春 - 130 033
中国
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DOI: 10.4103/sjg.sjg_527_21
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背景：我们旨在验证肝硬化、年龄、男性和糖尿病（CAMD）评分和年龄、白蛋白、性别和肝硬化（AASL）评分对接受核仁治疗的慢性乙型肝炎（CHB）患者的预测价值中国东北地区的（t）ide类似物（NUC）。方法：纳入2009年1月至2020年6月在吉林大学中日协和医院接受NUC治疗的945例慢性乙型肝炎患者。回顾性分析综合病历，评估CAMD评分和AASL评分对肝细胞癌（HCC）的预测价值。结果：共有58名患者（5.94%）被诊断为HCC。多变量分析显示，年龄 [优势比 (OR) = 1.041, 95% 置信区间 (CI) 1.009–1.073, P < 0.011] 和肝硬化 (OR = 3.297, 95% CI 1.383–7.861, P < 0.007) 是独立预测因子肝癌。与非HCC组相比，HCC组的CAMD或AASL评分显着更高。 CAMD 和 AASL 的受试者工作特征 (ROC) 曲线 (AUC) 下面积分别为 0.721 (95% CI 0.663–0.780) 和 0.718 (95% CI 0.662–0.774)。使用 CAMD 或 AASL 进行的风险分层显示，低、中、高风险组之间 HCC 的 1 年、3 年和 5 年累积发病率存在显着差异（均 P < 0.001，对数秩检验）。结论：CAMD和AASL评分均对东北地区慢性乙型肝炎患者的HCC风险具有预测价值。未来，最佳监测频率和方法应个性化。

StephenW

Predicting the risk of hepatocellular carcinoma in chronic hepatitis B patients receiving antiviral therapy: Validating the CAMD and AASL scores in China

Shuai Wang1, Bingwei Liu2, Xuemei Fan1, Yang Gao1, Mingqi Hong1, Yan Xu1
1 Department of Gastroenterology, China-Japan Union Hospital of Jilin University, Changchun, China
2 Department of Critical Care Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China

Correspondence Address:
Dr. Yan Xu
Department of Gastroenterology, China-Japan Union Hospital of Jilin University, Changchun, Jilin - 130 033
China
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DOI: 10.4103/sjg.sjg_527_21
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Background: We aimed to validate the predictive value of the cirrhosis, age, male sex, and diabetes (CAMD) score and age, albumin, sex, and liver cirrhosis (AASL) score for chronic hepatitis B (CHB) patients, treated with nucleos(t)ide analogues (NUCs) in Northeast China. Methods: From January 2009 to June 2020, 945 patients diagnosed with CHB who received NUC therapy at China-Japan Union Hospital of Jilin University were included. Comprehensive medical records were retrospectively analyzed, and the predictive values of the CAMD score and AASL score for hepatocellular carcinoma (HCC) were evaluated. Results: A total of 58 patients (5.94%) were diagnosed with HCC. Multivariate analysis revealed that age [odds ratio (OR) = 1.041, 95% confidence interval (CI) 1.009–1.073, P < 0.011] and cirrhosis (OR = 3.297, 95% CI 1.383–7.861, P < 0.007) were independent predictors of HCC. Either the CAMD or AASL score was significantly higher in the HCC group compared to the non-HCC group. The area under the receiver operating characteristic (ROC) curve (AUC) of CAMD and AASL was 0.721 (95% CI 0.663–0.780) and 0.718 (95% CI 0.662–0.774), respectively. Risk stratification using either CAMD or AASL revealed significant differences in the one-, three-, and five-year cumulative incidence rates of HCC between the low-, intermediate-, and high-risk groups (all P < 0.001, log-rank test). Conclusions: Both CAMD and AASL scores have predictive value for HCC risk of CHB patients in Northeast China. In future, the optimal monitoring frequency and methods should be personalized.

StephenW

https://doi.org/10.4103/sjg.sjg_527_21