How to predict HCC development in patients with chronic B viral liver disease?

Hepatocellular carcinoma (HCC) is one of the major malignant diseases in Asia. Although no randomized controlled studies have demonstrated decreased mortalities, screening for HCC has become an accepted procedure in the high-risk population. Since the incidence of HCC is strikingly different according to geographical distribution of risk factors, especially chronic hepatitis B virus (HBV) infection, a surveillance strategy in high endemic areas should be established according to national conditions. Chronic necro-inflammation by persistent HBV infection per se can progress to cirrhosis and the occurrence of HCC. As in other chronic liver diseases, the more risk factors the chronic B viral patients have, the higher occurrence of HCC was shown. Based on the risk factors of 4,339 Korean patients, the individual prediction model (IPM) was made by the calculation of relative weighs of risk factors and a self-exploited screening program for HCC was established accordingly. US screening at 6-month intervals was beneficial for the early detection of HCC, especially in the high-risk group, and prolonged survival. The usefulness of a tailored screening program with IPM for HCC was prospectively confirmed. The effective screening system for diagnosis of HCC limited to patients with chronic hepatitis B might be necessitated in high endemic area.