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Subcirrhotic liver stiffness by FibroScan correlates with lower risk of hepatocellular carcinoma in patients with HBV-related cirrhosis

 Mi Young Jeon  ;  Hye Won Lee  ;  Seung Up Kim  ;  Ja Yoon Heo  ;  Sojung Han  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kwang-Hyub Han 
 HEPATOLOGY INTERNATIONAL, Vol.11(3) : 268-276, 2017 
Journal Title
Issue Date
Antiviral Agents/therapeutic use ; Carcinoma, Hepatocellular/complications* ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/pathology ; Elasticity Imaging Techniques/methods* ; Female ; Follow-Up Studies ; Hepatitis B virus/drug effects ; Hepatitis B virus/genetics ; Hepatitis B, Chronic/complications* ; Hepatitis B, Chronic/drug therapy ; Hepatitis B, Chronic/epidemiology ; Hepatitis B, Chronic/pathology ; Humans ; Incidence ; Liver/diagnostic imaging* ; Liver/pathology ; Liver Cirrhosis/diagnostic imaging* ; Liver Cirrhosis/pathology ; Liver Neoplasms/complications* ; Liver Neoplasms/epidemiology ; Liver Neoplasms/pathology ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk
Chronic hepatitis B ; Hepatocellular carcinoma ; Liver cirrhosis ; Liver stiffness ; Transient elastography
BACKGROUND AND AIMS: The risk of developing hepatocellular carcinoma (HCC) varies, even in the context of cirrhosis. We investigated the relationship between liver stiffness (LS) in subcirrhotic range, assessed via transient elastography (TE), and risk of HCC development in patients with chronic hepatitis B (CHB)-related cirrhosis. METHODS: Data on 540 patients presenting with clinically evident CHB-related cirrhosis between April 2006 and December 2014 were reviewed retrospectively. Subcirrhotic range of LS was defined by TE values ≤13 kPa. RESULTS: Of the study population, 214 (39.6%) had LS values in the subcirrhotic range. During follow-up (median 54.1 months), 81 patients (15.0%) developed HCC. In conjunction with age, male gender, and diabetes mellitus, subcirrhotic LS value (hazard ratio = 0.462) was an independent predictor of HCC development on multivariate analysis (all p < 0.05). Cumulative HCC incidence was significantly lower for patients in subcirrhotic (versus cirrhotic) LS range (log-rank test, p < 0.05). In our cohort, the modified REACH-B score performed better than other prediction models, namely REACH-B, CU-HCC, and LSM-HCC scoring systems (area under receiver operating characteristic curve: 0.717 versus 0.669, 0.578, and 0.624, respectively, for 7-year HCC risk). CONCLUSIONS: A significant association between subcirrhotic range of LS value and lower risk of HCC development was identified in patients with clinically evident CHB-related cirrhosis. Thus, different TE-based HCC surveillance strategies may be required even in patients with identical liver cirrhosis disease category.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
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, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
Jeon, Mi Young(전미영) ORCID logo https://orcid.org/0000-0002-3980-4503
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
Han, Sojung(한소정)
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