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Feasibility of dynamic risk prediction for hepatocellular carcinoma development in patients with chronic hepatitis B
Author(s) -
Jeon Mi Young,
Lee Hye Won,
Kim Seung Up,
Kim Beom Kyung,
Park Jun Yong,
Kim Do Young,
Han KwangHyub,
Ahn Sang Hoon
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13583
Subject(s) - hepatocellular carcinoma , medicine , transient elastography , chronic hepatitis , hazard ratio , subgroup analysis , gastroenterology , hepatitis b virus , hepatitis b , population , oncology , cirrhosis , confidence interval , liver fibrosis , immunology , virus , environmental health
Background & Aims Several risk prediction models for hepatocellular carcinoma ( HCC ) development are available. We explored whether the use of risk prediction models can dynamically predict HCC development at different time points in chronic hepatitis B ( CHB ) patients. Methods Between 2006 and 2014, 1397 CHB patients were recruited. All patients underwent serial transient elastography at intervals of >6 months. Results The median age of this study population (931 males and 466 females) was 49.0 years. The median CU ‐ HCC , REACH ‐B, LSM ‐ HCC and mREACH ‐B score at enrolment were 4.0, 9.0, 10.0 and 8.0 respectively. During the follow‐up period (median, 68.0 months), 87 (6.2%) patients developed HCC . All risk prediction models were successful in predicting HCC development at both the first liver stiffness ( LS ) measurement (hazard ratio [ HR ] = 1.067‐1.467 in the subgroup without antiviral therapy [ AVT ] and 1.096‐1.458 in the subgroup with AVT ) and second LS measurement ( HR = 1.125‐1.448 in the subgroup without AVT and 1.087‐1.249 in the subgroup with AVT ). In contrast, neither the absolute nor percentage change in the scores from the risk prediction models predicted HCC development (all P > .05). The mREACH ‐B score performed similarly or significantly better than did the other scores ( AUROC s at 5 years, 0.694‐0.862 vs 0.537‐0.875). Conclusions Dynamic prediction of HCC development at different time points was achieved using four risk prediction models, but not using the changes in the absolute and percentage values between two time points. The mREACH ‐B score was the most appropriate prediction model of HCC development among four prediction models.