Τίτλος:
Predictive performance of newer Asian hepatocellular carcinoma risk scores in treated Caucasians with chronic hepatitis B
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background & Aims: Recently, several risk scores for prediction of hepatocellular carcinoma (HCC) were developed in cohorts of treated Asian patients with chronic hepatitis B (CHB), but they have not been assessed in non-Asian patients. We evaluated the predictability and comparative utility of our PAGE-B and recent Asian HCC risk scores in nucleos(t)ide analogue (NA)-treated adult Caucasian patients with CHB, with or without well-documented compensated cirrhosis but not previous diagnosis of HCC. Methods: We included 1,951 patients treated with entecavir/tenofovir and followed up for a median of 7.6 years. The c-statistic was used to estimate the predictability of PAGE-B, HCC-Rescue, CAMD, mPAGE-B, and AASL score for HCC development within 5 or 10 years. The low- and high-risk group cut-offs were used for estimation of negative (NPV) and positive predictive values (PPV), respectively. Results: HCC developed in 103/1,951 (5.3%) patients during the first 5 years and in another 39/1,428 (2.7%) patients between years 5 and 10. The 3-, 5-, and 10-year cumulative HCC rates were 3.3%, 5.9%, and 9.6%, respectively. All scores offered good 5- and 10-year HCC prediction (c-statistic: 0.78–0.82). NPVs were always >99% (99.3–100%), whereas PPV ranged between 13% and 24%. Conclusions: In NA-treated Caucasian patients with CHB including compensated cirrhosis, HCC risk scores developed in NA-treated Asian patients offer good 5- and 10-year HCC predictability, similar to that of PAGE-B. PAGE-B and mPAGE-B scores are simpler in clinical practice, as they do not require an accurate diagnosis of cirrhosis, but the addition of albumin in mPAGE-B score does not seem to offer an advantage in patients with well compensated liver disease. Lay summary: Several risk scores for prediction of hepatocellular carcinoma (HCC) were recently developed in cohorts of treated Asian patients with chronic hepatitis B (CHB). In Caucasian patients with CHB treated with oral antivirals, newer Asian HCC risk scores offer good 5- and 10-year HCC predictability, similar to that of PAGE-B. For clinical practice, PAGE-B and mPAGE-B scores are simpler, as they do not require an accurate diagnosis of cirrhosis. © 2021 The Authors
Συγγραφείς:
Papatheodoridis, G.V.
Dalekos, G.N.
Idilman, R.
Sypsa, V.
Van Boemmel, F.
Buti, M.
Calleja, J.L.
Goulis, J.
Manolakopoulos, S.
Loglio, A.
Papatheodoridi, M.
Gatselis, N.
Veelken, R.
Lopez-Gomez, M.
Hansen, B.E.
Savvidou, S.
Kourikou, A.
Vlachogiannakos, J.
Galanis, K.
Yurdaydin, C.
Esteban, R.
Janssen, H.L.A.
Berg, T.
Lampertico, P.
Λέξεις-κλειδιά:
albumin; entecavir; tenofovir disoproxil, adult; age; age albumin sex liver cirrhosis score; Article; Asian hepatocellular carcinoma risk score; cancer incidence; cancer risk; carcinogenesis; Caucasian; chronic hepatitis B; cirrhosis age male gender diabetes score; clinical practice; cohort analysis; compensated liver cirrhosis; female; follow up; gender; hepatocellular carcinoma risk estimating score in chronic hepatitis B under entecavir.; high risk patient; human; liver cell carcinoma; low risk patient; major clinical study; male; middle aged; modified platelets age gnder score; predictive value; predictor variable; scoring system; sensitivity and specificity; thrombocyte; treatment duration
DOI:
10.1016/j.jhepr.2021.100290
