Tomoko Aoki1,2, Hiroko Iijima3,4, Toshifumi Tada5, Takashi Kumada5, Takashi Nishimura1,2, Chikage Nakano1,2, Kyohei Kishino1, Yoshihiro Shimono1, Kazunori Yoh1, Ryo Takata1, Akio Ishii1, Tomoyuki Takashima1, Yoshiyuki Sakai1, Nobuhiro Aizawa1, Hiroki Nishikawa1, Naoto Ikeda1, Yoshinori Iwata1, Hirayuki Enomoto1, Seiichi Hirota6, Jiro Fujimoto7, Shuhei Nishiguchi1. 1. Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. 2. Hyogo College of Medicine, Ultrasound Imaging Center, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. 3. Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. hiroko-i@hyo-med.ac.jp. 4. Hyogo College of Medicine, Ultrasound Imaging Center, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. hiroko-i@hyo-med.ac.jp. 5. Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan. 6. Department of Surgical Pathology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. 7. Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
Abstract
BACKGROUND: This study aimed to establish a new scoring system that combined several risk factors, including virtual touch quantification (VTQ) values and fasting plasma glucose (FPG) levels, for predicting the development of hepatocellular carcinoma (HCC) in patients with chronic liver disease. METHODS: A total of 1808 chronic liver disease patients who underwent VTQ measurement were analyzed. Risk factors for developing HCC were selected by multivariate Cox proportional hazards models. RESULTS: VTQ (>1.33 m/s), FPG (≥110 mg/dl), sex (male), age (≥55 years), and α-fetoprotein (AFP) level (≥5 ng/ml) were independently selected as risk factors for HCC development by multivariate analysis. Using these parameters, we established a new scoring system (0 to 5 points), based on VTQ, FPG, sex, age, and AFP level, named VFMAP. As compared with the low VFMAP score group (0 or 1 point), the hazard ratio for the incidence of HCC was 17.37 [95 % confidence interval (CI), 2.35-128.40] in the intermediate-score group (2 or 3 points) and 66.82 (95 % CI, 9.01-495.80) in the high-score group (4 or 5 points). The area under the receiver operating characteristic curve of the VFMAP score for predicting HCC development within 5 years was 0.82 (95 % CI, 0.76-0.87), indicating a moderate diagnostic value. A VFMAP cutoff value of 3 excluded HCC within 5 years with a high negative predictive value (98.2 %). CONCLUSION: The VFMAP score accurately predicted HCC in patients with chronic liver disease.
BACKGROUND: This study aimed to establish a new scoring system that combined several risk factors, including virtual touch quantification (VTQ) values and fasting plasma glucose (FPG) levels, for predicting the development of hepatocellular carcinoma (HCC) in patients with chronic liver disease. METHODS: A total of 1808 chronic liver diseasepatients who underwent VTQ measurement were analyzed. Risk factors for developing HCC were selected by multivariate Cox proportional hazards models. RESULTS:VTQ (>1.33 m/s), FPG (≥110 mg/dl), sex (male), age (≥55 years), and α-fetoprotein (AFP) level (≥5 ng/ml) were independently selected as risk factors for HCC development by multivariate analysis. Using these parameters, we established a new scoring system (0 to 5 points), based on VTQ, FPG, sex, age, and AFP level, named VFMAP. As compared with the low VFMAP score group (0 or 1 point), the hazard ratio for the incidence of HCC was 17.37 [95 % confidence interval (CI), 2.35-128.40] in the intermediate-score group (2 or 3 points) and 66.82 (95 % CI, 9.01-495.80) in the high-score group (4 or 5 points). The area under the receiver operating characteristic curve of the VFMAP score for predicting HCC development within 5 years was 0.82 (95 % CI, 0.76-0.87), indicating a moderate diagnostic value. A VFMAP cutoff value of 3 excluded HCC within 5 years with a high negative predictive value (98.2 %). CONCLUSION: The VFMAP score accurately predicted HCC in patients with chronic liver disease.
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