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KMID : 1188320170110040528
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Gut and Liver
2017 Volume.11 No. 4 p.528 ~ p.534
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A Novel Model for Predicting Hepatocellular Carcinoma Development in Patients with Chronic Hepatitis B and Normal Alanine Aminotransferase Levels
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Sinn Dong-Hyun
Lee Jeong-Hoon
Kim Kyung-A
Ahn Joong-Hyun
Lee Ji-Hyeon
Kim Jung-Hee
Lee Dong-Hyeon
Yoon Jung-Hwan
Kang Won-Seok
Gwak Geum-Youn
Paik Yong-Han
Choi Moon-Seok
Lee Joon-Hyeok
Koh Kwang-Cheol
Paik Seung-Woon
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Abstract
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Background/Aims: Hepatocellular carcinoma (HCC) can develop in chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) levels. Therefore, methods that can stratify an individual’s HCC risk are needed.
Methods: A simple HCC risk score was developed from 971 patients with CHB who had elevated hepatitis B virus DNA levels (>2,000 IU/mL) with normal or mildly elevated ALT levels (<80 U/L). The score was validated from an independent cohort of 507 patients.
Results: A 4-point risk scale was developed, with HCC risk ranging from 0% to 17.8% at 5 years for the lowest and highest risk scores. The D2AS score had high area under the receiver operating curves (AUROCs) for predicting development of HCC at 3/5 years (0.895/0.884). The calculated AUROCs to predict the development of HCC at 3/5 years were 0.889/0.876 in the validation cohort, with 5-year HCC incidence rates ranging from 0% to 13.8% at 5 years for the lowest and highest risk scores.
Conclusions: The D2AS risk score can play a valuable role in risk stratification and may be useful for guiding clinical decisions for enhanced surveillance or treatment to reduce the HCC risk in CHB patients with normal or mildly elevated ALT levels.
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KEYWORD
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Carcinoma, hepatocellular, Hepatitis B, Liver function tests
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