Kyu Sik Jung1, Seung Up Kim1,2, Kijun Song3, Jun Yong Park1,2, Do Young Kim1,2, Sang Hoon Ahn1,2,4, Beom Kyung Kim1,2, Kwang-Hyub Han1,2,4. 1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 2. Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Department of Biostatistics, Yonsei University College of Medicine, Seoul, Republic of Korea. 4. Brain Korea 21 Project of Medical Science, Seoul, Republic of Korea.
Abstract
UNLABELLED: Several risk prediction models have been created to predict hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) occurrence, with promising results. However, their prognostic performances need to be validated in the era of antiviral therapy. From 2006 to 2011, patients with chronic HBV infection were recruited and those with a history of HCC or hepatic decompensation were excluded. At enrollment, liver stiffness (LS) was measured using transient elastography. We assessed the performances of conventional HCC prediction models (CU-HCC, GAG-HCC, REACH-B, and LSM-HCC scores) and the modified REACH-B (mREACH-B) score where LS values were incorporated into REACH-B score instead of serum HBV-DNA levels. Of 1,308 subjects analyzed, the median age was 50.0 years (883 men). During the follow-up (median, 75.3 months), HCC developed in 125 (9.6%) patients. mREACH-B score had the highest areas under the receiver operating characteristic curves (AUROCs) for the prediction of HCC development at 3/5 years (0.828/0.806), compared with LSM-HCC (0.777/0.759), GAG-HCC (0.751/0.757), REACH-B (0.717/0.699), and CU-HCC (0.698/0.700) scores, respectively, with statistical significances (all P values <0.05 vs. mREACH-B). When serum HBV-DNA levels were excluded from the formula for REACH-B score, AUROCs for HCC development at 3/5 years improved paradoxically (from 0.717/0.699 to 0.757/0.732, respectively). In patients with antiviral therapy (n = 848), mREACH-B score had the better prognostic performances for HCC development at 3/5 years, compared to other prediction models. However, in patients without antiviral therapy (n = 460), it had the prognostic performances comparable to those of other prediction models. CONCLUSIONS: Prognostic performances of mREACH-B score seemed better compared to conventional models. In the era of antiviral therapy, incorporation of serum HBV-DNA level should be applied cautiously and individual risks should be assessed effectively based on the fibrotic burden.
UNLABELLED: Several risk prediction models have been created to predict hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) occurrence, with promising results. However, their prognostic performances need to be validated in the era of antiviral therapy. From 2006 to 2011, patients with chronic HBV infection were recruited and those with a history of HCC or hepatic decompensation were excluded. At enrollment, liver stiffness (LS) was measured using transient elastography. We assessed the performances of conventional HCC prediction models (CU-HCC, GAG-HCC, REACH-B, and LSM-HCC scores) and the modified REACH-B (mREACH-B) score where LS values were incorporated into REACH-B score instead of serum HBV-DNA levels. Of 1,308 subjects analyzed, the median age was 50.0 years (883 men). During the follow-up (median, 75.3 months), HCC developed in 125 (9.6%) patients. mREACH-B score had the highest areas under the receiver operating characteristic curves (AUROCs) for the prediction of HCC development at 3/5 years (0.828/0.806), compared with LSM-HCC (0.777/0.759), GAG-HCC (0.751/0.757), REACH-B (0.717/0.699), and CU-HCC (0.698/0.700) scores, respectively, with statistical significances (all P values <0.05 vs. mREACH-B). When serum HBV-DNA levels were excluded from the formula for REACH-B score, AUROCs for HCC development at 3/5 years improved paradoxically (from 0.717/0.699 to 0.757/0.732, respectively). In patients with antiviral therapy (n = 848), mREACH-B score had the better prognostic performances for HCC development at 3/5 years, compared to other prediction models. However, in patients without antiviral therapy (n = 460), it had the prognostic performances comparable to those of other prediction models. CONCLUSIONS: Prognostic performances of mREACH-B score seemed better compared to conventional models. In the era of antiviral therapy, incorporation of serum HBV-DNA level should be applied cautiously and individual risks should be assessed effectively based on the fibrotic burden.
Authors: 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 Journal: Hepatol Int Date: 2017-02-21 Impact factor: 6.047
Authors: Young Eun Chon; Dong Joon Kim; Sang Gyune Kim; In Hee Kim; Si Hyun Bae; Seong Gyu Hwang; Jeong Heo; Jeong Won Jang; Byung Seok Lee; Hyung Joon Kim; Dae Won Jun; Kang Mo Kim; Woo Jin Chung; Moon Seok Choi; Jae Young Jang; Hyung Joon Yim; Won Young Tak; Ki Tae Yoon; Jun Yong Park; Kwang-Hyub Han; Ki Tae Suk; Hyun Woong Lee; Byoung Kuk Jang; Sang Hoon Ahn Journal: Medicine (Baltimore) Date: 2016-04 Impact factor: 1.889
Authors: Seung Up Kim; Beom Kyung Kim; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Kijun Song; Kwang-Hyub Han Journal: Medicine (Baltimore) Date: 2016-05 Impact factor: 1.889