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Addition of liver stiffness enhances the predictive accuracy of the PAGE-B model for hepatitis B-related hepatocellular carcinoma.
Chon, Hye Yeon; Lee, Han Ah; Suh, Sang Jun; Lee, Jung Il; Kim, Byung Seok; Kim, In Hee; Lee, Chang Hyeong; Jang, Byoung Kuk; Lee, Hyun Woong; Hwang, Jae Seok; Lee, Chang Hun; Lee, Jin-Woo; Yu, Jung Hwan; Seo, Yeon Seok; Yim, Hyung Joon; Kim, Seung Up.
Afiliación
  • Chon HY; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • Lee HA; Departments of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
  • Suh SJ; Departments of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
  • Lee JI; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • Kim BS; Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
  • Kim IH; Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
  • Lee CH; Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
  • Jang BK; Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
  • Lee HW; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • Hwang JS; Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
  • Lee CH; Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
  • Lee JW; Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
  • Yu JH; Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
  • Seo YS; Departments of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
  • Yim HJ; Departments of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
  • Kim SU; Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Aliment Pharmacol Ther ; 53(8): 919-927, 2021 04.
Article en En | MEDLINE | ID: mdl-33465253
BACKGROUND: The modified PAGE-B (mPAGE-B) and PAGE-B models reliably predict the risk of developing chronic hepatitis B (CHB)-related hepatocellular carcinoma (HCC). AIM(S): To investigate whether the addition of liver stiffness (LS) value, assessed using transient elastography, enhanced the predictive accuracies of these models METHODS: Patients with CHB who started anti-viral therapy (AVT) between 2007 and 2017 were enrolled. The training (Yonsei University Hospital) and validation (seven Korean referral institutes) cohorts contained 1211 and 973 patients, respectively. RESULTS: Based on multivariate analysis, older age (hazard ratio [HR] = 1.051, 95% confidence interval [CI] = 1.031-1.071), male sex (HR = 2.265, 95% CI = 1.463-3.506), lower platelet count (HR = 0.993, 95% CI = 0.989-0.997) and greater LS values (HR = 1.015, 95% CI = 1.002-1.028) were independently associated with an increased risk of HCC development (all P < 0.05). Thus, we developed a modified PAGELS -B model (maximum score 34) that included age, male sex, platelet count and LS value. The integrated area under the curve of the modified PAGELS model was greater than those of the PAGE-B and mPAGE-B models (0.760 vs 0.714 and 0.716, respectively) in the derivation dataset. The cumulative HCC incidence was significantly higher in the high-risk (modified PAGE-BLS score ≥ 24) group than in the intermediate-risk (modified PAGELS -B score 12-24) or low-risk (modified PAGELS -B score < 12) group (all P < 0.001). Similar results were observed in the validation cohort. CONCLUSIONS: The predictive accuracies of the PAGE-B and mPAGE-B models were validated in Korean patients with CHB receiving AVT. However, the modified PAGELS -B model featuring the addition of LS value showed higher predictability than the PAGE-B and mPAGE-B models.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma Hepatocelular / Hepatitis B Crónica / Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Male Idioma: En Revista: Aliment Pharmacol Ther Asunto de la revista: FARMACOLOGIA / GASTROENTEROLOGIA / TERAPIA POR MEDICAMENTOS Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Carcinoma Hepatocelular / Hepatitis B Crónica / Neoplasias Hepáticas Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans / Male Idioma: En Revista: Aliment Pharmacol Ther Asunto de la revista: FARMACOLOGIA / GASTROENTEROLOGIA / TERAPIA POR MEDICAMENTOS Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido