Validation of risk prediction scores for hepatocellular carcinoma in patients with chronic hepatitis B treated with entecavir or tenofovir
- Authors
- Chang, Jin Won; Lee, Jae Seung; Lee, Hye Won; Kim, Beom Kyung; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Seo, Yeon Seok; Lee, Han Ah; Kim, Mi Na; Lee, Yu Rim; Hwang, Seong Gyu; Rim, Kyu Sung; Um, Soon Ho; Tak, Won Young; Kweon, Young Oh; Park, Soo Young; Kim, Seung Up
- Issue Date
- 1월-2021
- Publisher
- WILEY
- Keywords
- antiviral therapy; chronic hepatitis B; entecavir; hepatocellular carcinoma; risk prediction score; tenofovir disoproxil fumarate
- Citation
- JOURNAL OF VIRAL HEPATITIS, v.28, no.1, pp.95 - 104
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF VIRAL HEPATITIS
- Volume
- 28
- Number
- 1
- Start Page
- 95
- End Page
- 104
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/129466
- DOI
- 10.1111/jvh.13411
- ISSN
- 1352-0504
- Abstract
- Several prediction scores for the early detection of hepatocellular carcinoma (HCC) are available. We validated the predictive accuracy of age, albumin, sex, liver cirrhosis (AASL), RESCUE-B, PAGE-B and modified PAGE-B (mPAGE-B) scores in chronic hepatitis B (CHB) patients treated with entecavir (ETV) or tenofovir disoproxil fumarate (TDF). Between 2007 and 2014, 3171 patients were recruited (1645, ETV; 1517, TDF). The predictive accuracy of each prediction score was assessed. The mean age of the study population (1977 men; 1194 women) was 48.8 years. Liver cirrhosis was present in 1040 (32.8%) patients. During follow-up (median, 58.2 months), 280 (8.8%) patients developed HCC; these patients were significantly older; more likely to be male; had significantly higher proportions of liver cirrhosis, hypertension and diabetes; and had significantly higher values for the four risk scores than those who did not develop HCC (allP < .05). Older age (hazard ratio [HR] = 1.048), male sex (HR = 2.142), liver cirrhosis (HR = 3.144) and prolonged prothrombin time (HR = 2.589) were independently associated with an increased risk of HCC (allP < .05), whereas a higher platelet count (HR = 0.996) was independently associated with a decreased risk of HCC (P < .05). The predictive accuracy of AASL score was the highest for 3- and 5-year HCC predictions (areas under the curve [AUCs] = 0.818 and 0.816, respectively), followed by RESCUE-B, PAGE-B and mPAGE-B scores (AUC = 0.780-0.815 and 0.769-0.814, respectively). In conclusion, four HCC prediction scores were assessed in Korean CHB patients treated with ETV or TDF. The AASL score showed the highest predictive accuracy.
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