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Risk score model for the development of hepatocellular carcinoma in treatment-naïve patients receiving oral antiviral treatment for chronic hepatitis B

Authors
 Won Sohn  ;  Ju-Yeon Cho  ;  Ji Hoon Kim  ;  Jung Il Lee  ;  Hyung Joon Kim  ;  Min-Ah Woo  ;  Sin-Ho Jung  ;  Yong-Han Paik 
Citation
 CLINICAL AND MOLECULAR HEPATOLOGY, Vol.23(2) : 170-178, 2017-06 
Journal Title
CLINICAL AND MOLECULAR HEPATOLOGY
ISSN
 2287-2728 
Issue Date
2017-06
MeSH
Administration, Oral ; Adult ; Antiviral Agents / therapeutic use* ; Area Under Curve ; Carcinoma, Hepatocellular / diagnosis* ; Carcinoma, Hepatocellular / epidemiology ; Carcinoma, Hepatocellular / etiology ; DNA, Viral / blood ; DNA, Viral / genetics ; DNA, Viral / metabolism ; Female ; Guanine / analogs & derivatives* ; Guanine / therapeutic use ; Hepatitis B e Antigens / blood ; Hepatitis B virus / isolation & purification ; Hepatitis B, Chronic / complications ; Hepatitis B, Chronic / drug therapy* ; Hepatitis B, Chronic / virology ; Humans ; Incidence ; Liver Neoplasms / diagnosis* ; Liver Neoplasms / epidemiology ; Liver Neoplasms / etiology ; Male ; Middle Aged ; Proportional Hazards Models ; ROC Curve ; Retrospective Studies ; Risk Factors
Keywords
Antiviral drugs ; Assessment, Risk ; Chronic hepatitis B ; Hepatocellular carcinoma
Abstract
Background/aims: This study aimed to develop and validate a risk prediction model for the development of hepatocellular carcinoma (HCC) in treatment-naïve patients receiving oral antiviral treatment for chronic hepatitis B (CHB).

Methods: We investigated 2,061 Korean treatment-naïve patients with CHB treated with entecavir as an initial therapy. A risk score model for HCC development was developed based on multivariable Cox regression model in a single center (n=990) and was validated using the time-dependent area under the receiver operating characteristic curve (AUROC) in three other centers (n=1,071). The difference of HCC development among risk groups (low, intermediate, and high) categorized by risk score was also investigated.

Results: The cumulative incidence rates of HCC at 5 years were 11.2% and 8.9% in the testing and validation cohorts, respectively. HCC-Risk Estimating Score in CHB patients Under Entecavir (HCC-RESCUE) is formulated as (age+15×gender [female=0 / male=1]+23×cirrhosis [absence=0 / presence=1]). The AUROCs at 1 year, 3 years, and 5 years were 0.82, 0.81, and 0.81, respectively, in the validation cohort. A significant difference of HCC development in each risk group was determined by the 5-year HCC risk score in the validation cohort (low risk group, 2.1%; intermediate risk group, 9.3%; high risk group, 41.2%, p<0.001).

Conclusions: The study presents a new risk score model with a good ability to predict HCC development and determine high risk patients for HCC development consisting of readily available clinical factors in treatment-naïve CHB patients receiving entecavir.
Files in This Item:
T992017199.pdf Download
DOI
10.3350/cmh.2016.0086
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Jung Il(이정일) ORCID logo https://orcid.org/0000-0002-0142-1398
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/195660
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