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Risk Assessment of Hepatocellular Carcinoma Using Transient Elastography Vs. Liver Biopsy in Chronic Hepatitis B Patients Receiving Antiviral Therapy

Authors
 Yeon Seok Seo  ;  Mi Na Kim  ;  Seung Up Kim  ;  Sang Gyune Kim  ;  Soon Ho Um  ;  Kwang-Hyub Han  ;  Young Seok Kim 
Citation
 MEDICINE, Vol.95(12) : 2985, 2016 
Journal Title
MEDICINE
ISSN
 0025-7974 
Issue Date
2016
MeSH
Adult ; Antiviral Agents/therapeutic use* ; Biopsy* ; Carcinoma, Hepatocellular/diagnosis* ; Carcinoma, Hepatocellular/pathology* ; Early Detection of Cancer ; Elasticity Imaging Techniques* ; Female ; Hepatitis B, Chronic/drug therapy* ; Hepatitis B, Chronic/pathology* ; Humans ; Liver/pathology* ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/pathology ; Liver Neoplasms/diagnosis* ; Liver Neoplasms/pathology* ; Male ; Middle Aged ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Tertiary Care Centers
Abstract
Liver stiffness (LS) assessed using transient elastography (TE) can assess the risk of developing hepatocellular carcinoma (HCC). We evaluated whether TE, when compared with histological data as a reference standard, can predict the risk of HCC development in chronic hepatitis B (CHB) patients starting antiviral therapy.Observational cohort database of 381 patients with CHB who underwent liver biopsy (LB) and TE were reviewed. All patients underwent surveillance for HCC development using ultrasonography and alpha-fetoprotein.During the median follow-up period of 48.1 (interquartile range 30.3-69.3) months, HCC developed in 34 (8.9%) patients. In patients with HCC development, age, proportion of diabetes mellitus, histological fibrosis stage, and LS value were significantly higher than those in patients without (all P <0.05). The cumulative incidence rates of HCC increased significantly in association with elevated LS value in 3 stratified groups (LS value <8, 8-13, and >13 kPa; log-rank test, P <0.001), and with higher histological fibrosis stage in 3 stratified groups (F0-2, F3, and F4; log-rank test, P <0.001). On multivariate analysis, along with age, LS value was an independent predictor of HCC development (hazard ratio 1.041, P <0.001), whereas histological staging was not (P >0.05).TE predicted HCC development independently in patients with CHB starting antiviral therapy. However, further investigation is needed to determine whether the current surveillance strategy can be optimized based on the LS value at the time of starting antiviral therapy.
Files in This Item:
T201600888.pdf Download
DOI
10.1097/MD.0000000000002985
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146568
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