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The accuracy of noninvasive methods in predicting the development of hepatocellular carcinoma and hepatic decompensation in patients with chronic hepatitis B

Authors
 Chon, Young Eun  ;  Jung, Eun Suk  ;  Park, Jun Yong  ;  Kim, Do Young  ;  Ahn, Sang Hoon  ;  Han, Kwang-Hyub  ;  Chon, Chae Yoon  ;  Jung, Kyu Sik  ;  Kim, Seung Up 
Citation
 JOURNAL OF CLINICAL GASTROENTEROLOGY, Vol.46(6) : 518-525, 2012 
Journal Title
JOURNAL OF CLINICAL GASTROENTEROLOGY
ISSN
 0192-0790 
Issue Date
2012
MeSH
Adult ; Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/etiology* ; Carcinoma, Hepatocellular/pathology ; Elasticity Imaging Techniques ; Esophageal and Gastric Varices/etiology ; Esophageal and Gastric Varices/pathology ; Female ; Follow-Up Studies ; Hepatitis B, Chronic/complications* ; Humans ; Liver Cirrhosis/complications* ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/pathology ; Liver Neoplasms/diagnosis ; Liver Neoplasms/etiology* ; Liver Neoplasms/pathology ; Longitudinal Studies ; Male ; Middle Aged ; Multivariate Analysis ; Organ Size ; Prospective Studies ; Risk ; Spleen
Keywords
chronic hepatitis B ; decompensation ; hepatocellular carcinoma ; prediction ; fibroscan
Abstract
BACKGROUND: Liver stiffness measurement (LSM) using transient elastography (FibroScan) can accurately assess the degree of liver fibrosis and predict the development of hepatocellular carcinoma (HCC) and variceal bleeding in patients with chronic hepatitis B (CHB).

AIMS: We compared the accuracy of noninvasive liver fibrosis prediction methods in predicting the development of HCC or hepatic decompensation in patients with CHB.

METHODS: A total of 1126 patients with CHB who underwent LSMs and attended regular follow-ups to detect the development of HCC and hepatic decompensations (variceal bleeding, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, or hepatorenal syndrome) were enrolled. Noninvasive liver fibrosis prediction methods included, age-spleen-to-platelet ratio index, LSM, LSM-spleen diameter-to-platelet ratio index (LSPI), P2/MS, and FIB-4.

RESULTS: During follow-up (median, 30.7 mo), HCC and hepatic decompensation developed in 63 and 68 patients, respectively. The accuracy of LSM and LSPI in predicting the development of HCC or hepatic decompensation was higher than that of aspartate aminotransferase-to-platelet ratio index, age-spleen-to-platelet ratio index, P2/MS, or FIB-4 (areas under the receiver operating characteristic curve=0.789 and 0.788 vs. 0.729, 0.756, 0.696, and 0.744 for HCC development; areas under the receiver operating characteristic curve=0.820 and 0.848 vs. 0.787, 0.799, 0.812, and 0.784 for hepatic decompensation). On multivariate analyses, LSM and LSPI were identified as independent predictors of the development of HCC [hazard ratio (HR), 1.040 (LSM); HR, 1.001 (LSPI)] and hepatic decompensation [HR, 1.033 (LSM); HR, 1.002 (LSPI)].

CONCLUSIONS: Our results suggest that LSM or LSPI may be useful predictors of the development of HCC and hepatic decompensation in patients with CHB.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00004836-201207000-00016&LSLINK=80&D=ovft
DOI
22688146
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
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
Chon, Young Eun(전영은)
Chon, Chae Yoon(전재윤)
Jung, Kyu Sik(정규식)
Jung, Eun Suk(정은석)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90685
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