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Predictors of failure to detect early hepatocellular carcinoma in patients with chronic hepatitis B who received regular surveillance

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dc.contributor.author김도영-
dc.contributor.author김명진-
dc.contributor.author김범경-
dc.contributor.author김승업-
dc.contributor.author박준용-
dc.contributor.author안상훈-
dc.contributor.author안찬식-
dc.contributor.author최진영-
dc.contributor.author한광협-
dc.date.accessioned2018-08-28T17:01:32Z-
dc.date.available2018-08-28T17:01:32Z-
dc.date.issued2018-
dc.identifier.issn0269-2813-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/162177-
dc.description.abstractBACKGROUND: A proportion of chronic hepatitis B (CHB) patients are diagnosed with advanced hepatocellular carcinoma (HCC) despite regular surveillance. AIMS: To determine predictors for HCC detection failure in CHB patients who underwent regular surveillance. METHODS: CHB patients with well-preserved liver function, who underwent ultrasonography and alpha-foetoprotein (AFP) analysis every 6 months, were enrolled. Cox regression analysis was used to identify predictors for detection failure, defined as HCC initially diagnosed at Barcelona Clinic Liver Cancer (BCLC) stage B or C. RESULTS: Of the 4590 CHB patients (mean age, 52.1 years; men, 61.6%), 169 patients were diagnosed with HCC (3.68%) and 35 (20.7%) HCC patients were initially diagnosed with HCC BCLC stage B or C. The cumulative incidence of HCC detection failure was 0.2% at year 1 and 1.3% at year 5. Multivariate analyses indicated that cirrhosis (hazard ratio [HR], 3.078; 95% CI, 1.389-6.821; P = 0.006), AFP levels >/=9 ng/mL (HR, 5.235; 95% CI, 2.307-11.957; P = 0.010), and diabetes mellitus (HR, 3.336; 95% CI, 1.341-8.296; P = 0.010) were independent predictors of HCC detection failure. Another model that incorporated liver stiffness (LS) values identified LS values >/=11.7 kPa (HR, 11.045; 95% CI, 2.066-59.037; P = 0.005) and AFP levels >/=9 ng/mL (HR, 4.802; 95% CI, 1.613-14.297; P = 0.005) as predictors of detection failure. CONCLUSIONS: In CHB patients undergoing regular surveillance with ultrasonography and alpha-foetoprotein (AFP) analysis every 6 months, the HCC detection failure rate was not high (0.8% per person; 0.1% per test). However, careful attention should be paid in patients with advanced liver fibrosis (clinical cirrhosis or LS value >11.7 kPa), high AFP levels, or diabetes mellitus, who are prone to surveillance failure.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherWiley-Blackwell-
dc.relation.isPartOfALIMENTARY PHARMACOLOGY & THERAPEUTICS-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titlePredictors of failure to detect early hepatocellular carcinoma in patients with chronic hepatitis B who received regular surveillance-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Internal Medicine-
dc.contributor.googleauthorY E Chon-
dc.contributor.googleauthorK S Jung-
dc.contributor.googleauthorM-J Kim-
dc.contributor.googleauthorJ-Y Choi-
dc.contributor.googleauthorC An-
dc.contributor.googleauthorJ Y Park-
dc.contributor.googleauthorS H Ahn-
dc.contributor.googleauthorB K Kim-
dc.contributor.googleauthorS U Kim-
dc.contributor.googleauthorH Park-
dc.contributor.googleauthorS K Hwang-
dc.contributor.googleauthorK S Rim-
dc.contributor.googleauthorK-H Han-
dc.contributor.googleauthorD Y Kim-
dc.identifier.doi10.1111/apt.14578-
dc.contributor.localIdA00385-
dc.contributor.localIdA00426-
dc.contributor.localIdA00487-
dc.contributor.localIdA00654-
dc.contributor.localIdA01675-
dc.contributor.localIdA02226-
dc.contributor.localIdA02268-
dc.contributor.localIdA04200-
dc.contributor.localIdA04268-
dc.relation.journalcodeJ00061-
dc.identifier.eissn1365-2036-
dc.identifier.pmid29492988-
dc.identifier.urlhttps://onlinelibrary.wiley.com/doi/abs/10.1111/apt.14578-
dc.contributor.alternativeNameKim, Do Young-
dc.contributor.alternativeNameKim, Myeong Jin-
dc.contributor.alternativeNameKim, Beom Kyung-
dc.contributor.alternativeNameKim, Seung Up-
dc.contributor.alternativeNamePark, Jun Yong-
dc.contributor.alternativeNameAhn, Sang Hoon-
dc.contributor.alternativeNameAn, Chan Sik-
dc.contributor.alternativeNameChoi, Jin Young-
dc.contributor.alternativeNameHan, Kwang Hyup-
dc.contributor.affiliatedAuthorKim, Do Young-
dc.contributor.affiliatedAuthorKim, Myeong Jin-
dc.contributor.affiliatedAuthorKim, Beom Kyung-
dc.contributor.affiliatedAuthorKim, Seung Up-
dc.contributor.affiliatedAuthorPark, Jun Yong-
dc.contributor.affiliatedAuthorAhn, Sang Hoon-
dc.contributor.affiliatedAuthorAn, Chan Sik-
dc.contributor.affiliatedAuthorChoi, Jin Young-
dc.contributor.affiliatedAuthorHan, Kwang Hyup-
dc.citation.volume47-
dc.citation.number8-
dc.citation.startPage1201-
dc.citation.endPage1212-
dc.identifier.bibliographicCitationALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol.47(8) : 1201-1212, 2018-
dc.identifier.rimsid59764-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers

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