Serum fibrosis index-based risk score predicts hepatocellular carcinoma in untreated patients with chronic hepatitis B
Open Access
- 1 July 2021
- journal article
- research article
- Published by The Korean Association for the Study of the Liver in Clinical and Molecular Hepatology
- Vol. 27 (3), 499-509
- https://doi.org/10.3350/cmh.2020.0333
Abstract
Background/Aims: Serum fibrosis scores comprised of common laboratory tests have high utility to assess severity of liver fibrosis. We aimed to derive and validate a hepatocellular carcinoma (HCC) risk score based on serum fibrosis scores to predict HCC in treatment-naive chronic hepatitis B (CHB) patients. Methods: Fifteen thousand one hundred eighty-seven treatment-naive adult CHB patients were identified to form the training cohort in this retrospective study. Individual fibrosis score was included to construct a new HCC prediction score. The score was externally validated in an independent treatment-naive Korean CHB cohort. Results: 180/15,187 patients (1.2%) in training cohort and 47/4,286 patients (1.1%) in validation cohort developed HCC during a mean follow-up of 52 and 50 months, respectively. The newly developed HCC risk score, Liang score, is composed of gender, age, hepatitis B virus DNA, fibrosis-4 (FIB-4) index, and ranges from 0 to 22. Area under the time-dependent receiver operating characteristic curve of Liang score was 0.79 (95% confidence interval, 0.70-0.89). A cutoff value of nine provided an extremely high negative predictive value of 99.9% and high sensitivity of 90.0% at 5 years in the validation cohort. Patients with Liang score <= 9 had HCC incidence <0.2% per year in both training and validation cohorts, in whom HCC surveillance might be exempted. Conclusion: A novel HCC risk score, Liang score, based on FIB-4 index, is applicable and accurate to identify treatment-naive CHB patients with very low risk of HCC to be exempted from HCC surveillance.Keywords
Funding Information
- Health and Medical Research Fund (15160551)
This publication has 33 references indexed in Scilit:
- Liver stiffness-based optimization of hepatocellular carcinoma risk score in patients with chronic hepatitis BJournal of Hepatology, 2014
- Entecavir treatment reduces hepatic events and deaths in chronic hepatitis B patients With liver cirrhosisJournal of Hepatology, 2013
- Meta‐analysis: the association of hepatitis B virus genotypes and hepatocellular carcinomaAlimentary Pharmacology & Therapeutics, 2013
- Development of a non‐invasive algorithm with transient elastography (Fibroscan) and serum test formula for advanced liver fibrosis in chronic hepatitis BAlimentary Pharmacology & Therapeutics, 2010
- Clinical Scoring System to Predict Hepatocellular Carcinoma in Chronic Hepatitis B CarriersJournal of Clinical Oncology, 2010
- Surrogate End Points and Long-Term Outcome in Patients With Chronic Hepatitis BClinical Gastroenterology and Hepatology, 2009
- Independent risk factors and predictive score for the development of hepatocellular carcinoma in chronic hepatitis BJournal of Hepatology, 2008
- Surveillance programme for hepatocellular carcinoma improves the survival of patients with chronic viral hepatitisLiver International, 2007
- FIB-4: An inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotestJournal of Hepatology, 2007
- Genotype C hepatitis B virus infection is associated with an increased risk of hepatocellular carcinomaGut, 2004