接受抗病毒治疗的慢性乙型肝炎患者肝细胞癌的长期预测模

StephenW

接受抗病毒治疗的慢性乙型肝炎患者肝细胞癌的长期预测模型：基于韩国患者的数据
Ji Hun Lee 1、Seung Kak Shin 2、Seong Hee Kang 3 4、Tae Hyung Kim 1 5、Hyung Joon Yim 1 5、Sun Young Yim 1 5、Young-Sun Lee 1 5、Young Kul Jung 1 5、Ji Hoon Kim 1 5 , Yeon Seok Seo 1 5 , Jong Eun Yeon 1 5 , Oh Sang Kwon 2 , Soon Ho Um 1 5 , Kwan Soo Byun 1 5
隶属关系
隶属关系

    1个
    高丽大学医学院医学系，韩国首尔 02841。
    2个
    韩国仁川 21565 嘉泉大学医学院嘉泉大学吉尔医学中心内科。
    3个
    仁济大学医学院内科，首尔 01757，韩国。
    4个
    延世大学原州医学院内科，原州 26426，韩国。
    5个
    高丽大学医学院内科，首尔 02841，韩国。

    PMID：36431090 DOI：10.3390/jcm11226613

抽象的

预测肝细胞癌 (HCC) 的发展是慢性乙型肝炎 (CHB) 患者的关键临床问题。本研究的目的是开发一个长达 10 年的精确而简单的 HCC 风险评分。回顾性招募了总共 1895 名接受恩替卡韦或富马酸替诺福韦地索普西治疗的 CHB 患者，并随机分为推导队列（n = 1239）和验证队列（n = 656）。在推导队列中被证明是 HCC 独立危险因素的变量用于开发预测模型。 ACCESS-HCC 模型包括五个变量（年龄、肝硬化、乙醇消耗、肝脏硬度和血清丙氨酸转氨酶）。 3 年、5 年和 10 年 HCC 风险的曲线下面积分别为 0.798、0.762 和 0.883，高于其他预测模型。根据显着不同的 HCC 发病率对分数进行分类：0-4，低； 5-8，中级；和 9-14，高风险。年发病率分别为0.5%、3.2%和11.3%。该模型的性能在独立队列中得到验证。 ACCESS-HCC 模型显示了改进的长期预测，并为接受抗病毒治疗的 CHB 患者提供了三种不同的 HCC 风险类别。需要进一步研究使用更大的队列进行外部验证。

关键词：抗病毒剂；乙型肝炎病毒;肝细胞癌；肝硬化;风险因素。
拨款支持

    k2212101/高丽大学安山医院

StephenW

Long-Term Prediction Model for Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Receiving Antiviral Therapy: Based on Data from Korean Patients
Ji Hun Lee  1 , Seung Kak Shin  2 , Seong Hee Kang  3   4 , Tae Hyung Kim  1   5 , Hyung Joon Yim  1   5 , Sun Young Yim  1   5 , Young-Sun Lee  1   5 , Young Kul Jung  1   5 , Ji Hoon Kim  1   5 , Yeon Seok Seo  1   5 , Jong Eun Yeon  1   5 , Oh Sang Kwon  2 , Soon Ho Um  1   5 , Kwan Soo Byun  1   5
Affiliations
Affiliations

    1
    Department of Medicine, Korea University College of Medicine, Seoul 02841, Korea.
    2
    Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Korea.
    3
    Department of Internal Medicine, Inje University College of Medicine, Seoul 01757, Korea.
    4
    Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea.
    5
    Department of Internal Medicine, Korea University College of Medicine, Seoul 02841, Korea.

    PMID: 36431090 DOI: 10.3390/jcm11226613

Abstract

Predicting the development of hepatocellular carcinoma (HCC) is a key clinical issue in patients with chronic hepatitis B (CHB). The aim of this study was to develop a precise and simple HCC risk score for up to 10 years. A total of 1895 CHB patients treated with entecavir or tenofovir disoproxil fumarate were retrospectively recruited and randomized into derivation (n = 1239) and validation cohorts (n = 656). Variables proven to be independent risk factors for HCC in the derivation cohort were used to develop the prediction model. The ACCESS-HCC model included five variables (age, cirrhosis, consumption of ethanol, liver stiffness, and serum alanine aminotransferase). Areas under curves were 0.798, 0.762, and 0.883 for HCC risk at 3, 5, and 10 years, respectively, which were higher than those of other prediction models. The scores were categorized according to significantly different HCC incidences: 0-4, low; 5-8, intermediate; and 9-14, high-risk. The annual incidence rates were 0.5%, 3.2%, and 11.3%, respectively. The performance of this model was validated in an independent cohort. The ACCESS-HCC model shows improved long-term prediction and provides three distinct risk categories for HCC in CHB patients receiving antiviral therapy. Further research is needed for external validation using larger cohorts.

Keywords: antiviral agent; hepatitis B virus; hepatocellular carcinoma; liver cirrhosis; risk factors.
Grant support

    k2212101/Korea University Ansan Hospital

StephenW

https://www.mdpi.com/2077-0383/11/22/6613/pdf?version=1668582679