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KMID : 1040620170230020170
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Clinical and Molecular Hepatology
2017 Volume.23 No. 2 p.170 ~ p.178
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Risk score model for the development of hepatocellular carcinoma in treatment-naive patients receiving oral antiviral treatment for chronic hepatitis B
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Sohn Won
Cho Ju-Yeon
Kim Ji-Hoon
Lee Jung-Il
Kim Hyung-Joon
Woo Min-Ah
Jung Sin-Ho
Paik Yong-Han
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Abstract
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Background/Aims: This study aimed to develop and validate a risk prediction model for the development of hepatocellular carcinoma (HCC) in treatment-naive patients receiving oral antiviral treatment for chronic hepatitis B (CHB).
Methods: We investigated 2,061 Korean treatment-naive patients with CHB treated with entecavir as an initial therapy. A risk score model for HCC development was developed based on multivariable Cox regression model in a single center (n=990) and was validated using the time-dependent area under the receiver operating characteristic curve (AUROC) in three other centers (n=1,071). The difference of HCC development among risk groups (low, intermediate, and high) categorized by risk score was also investigated.
Results: The cumulative incidence rates of HCC at 5 years were 11.2% and 8.9% in the testing and validation cohorts, respectively. HCC-Risk Estimating Score in CHB patients Under Entecavir (HCC-RESCUE) is formulated as (age+15×gender [female=0 / male=1]+23×cirrhosis [absence=0 / presence=1]). The AUROCs at 1 year, 3 years, and 5 years were 0.82, 0.81, and 0.81, respectively, in the validation cohort. A significant difference of HCC development in each risk group was determined by the 5-year HCC risk score in the validation cohort (low risk group, 2.1%; intermediate risk group, 9.3%; high risk group, 41.2%, p<0.001).
Conclusions: The study presents a new risk score model with a good ability to predict HCC development and determine high risk patients for HCC development consisting of readily available clinical factors in treatment-naive CHB patients receiving entecavir.
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KEYWORD
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Chronic hepatitis B, Hepatocellular carcinoma, Assessment, Risk, Antiviral drugs
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