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Increased risk of hepatocellular carcinoma in chronic hepatitis B patients with transient elastography-defined subclinical cirrhosis

Authors
 Mi Na Kim  ;  Seung Up Kim  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Ki Jun Song  ;  Young Nyun Park  ;  Kwang-Hyub Han 
Citation
 HEPATOLOGY, Vol.61(6) : 1851-1859, 2015 
Journal Title
 HEPATOLOGY 
ISSN
 0270-9139 
Issue Date
2015
MeSH
Adult ; Alanine Transaminase/blood ; Antiviral Agents/therapeutic use ; Biopsy ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/virology* ; Elasticity Imaging Techniques* ; Female ; Hepatitis B, Chronic/blood ; Hepatitis B, Chronic/complications* ; Hepatitis B, Chronic/drug therapy ; Humans ; Incidence ; Liver/pathology ; Liver Cirrhosis/complications ; Liver Cirrhosis/diagnostic imaging* ; Liver Cirrhosis/pathology ; Liver Cirrhosis/virology ; Liver Neoplasms/epidemiology ; Liver Neoplasms/virology* ; Longitudinal Studies ; Male ; Middle Aged ; Propensity Score ; Prospective Studies ; Republic of Korea/epidemiology ; Risk Assessment
Abstract
Early detection of liver cirrhosis in its subclinical stage is of paramount importance to identify high-risk individuals for developing hepatocellular carcinoma (HCC). This study investigated whether transient elastography (TE) can identify patients with subclinical cirrhosis (SCC) who are at increased risk of developing HCC among chronic hepatitis B (CHB) patients without clinical evidence of cirrhosis. A total of 2,876 CHB patients without clinical cirrhosis who received TE examinations between April 2006 and December 2012 were enrolled in this prospective study. SCC was defined as a nonclinical cirrhosis, but with a liver stiffness (LS) value ≥13 kilopascals (kPa). Mean age of the study population was 46.1 years, and male gender was predominant (n = 1,775; 61.7%). Mean LS value was 7.9 kPa, and SCC was identified in 285 (9.9%) patients. During the median follow-up period of 48.9 months (range, 6.6-96.2), HCC developed in 16 patients (13.3 per 1,000 person-years) in the SCC group and 36 (3.4 per 1,000 person-years) in the non-SCC group. Cumulative incidence rate of HCC in the SCC group was significantly higher than that in the non-SCC group (P < 0.001, log-rank test). On multivariate analysis, SCC was independently associated with a risk of developing HCC, regardless of antiviral therapy (without antiviral therapy: hazard ratio [HR]: 4.680; 95% confidence interval [CI]: 1.187-18.441; P = 0.027; with antiviral therapy: HR, 3.344; 95% CI: 1.526-7.328; P = 0.003). CONCLUSION: TE can identify CHB patients with SCC who are at increased risk of developing HCC, even when cirrhosis is not clinically apparent.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/hep.27735/abstract
DOI
10.1002/hep.27735
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Mi Na(김미나)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Song, Ki Jun(송기준) ORCID logo https://orcid.org/0000-0003-2505-4112
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140388
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