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Improvement in enhanced liver fibrosis score and liver stiffness measurement reflects lower risk of hepatocellular carcinoma
Author(s) -
Liang Lilian Yan,
Wong Vincent WaiSun,
Tse YeeKit,
Yip Terry CheukFung,
Lui Grace ChungYan,
Chan Henry LikYuen,
Wong Grace LaiHung
Publication year - 2019
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15269
Subject(s) - medicine , transient elastography , hepatocellular carcinoma , gastroenterology , fibrosis , elastography , framingham risk score , cumulative incidence , carcinoma , liver fibrosis , ultrasound , radiology , cohort , disease
Summary 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.