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  • Kim, Seung Up  (3)
  • Lee, Hye Won  (3)
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  • 1
    Online Resource
    Online Resource
    Novel Liver Stiffness-Based Nomogram for Predicting Hepatocellular Carcinoma Risk in Patients with Chronic Hepatitis B Virus Infection Initiating Antiviral Therapy
    MDPI AG ; 2021
    In:  Cancers Vol. 13, No. 23 ( 2021-11-23), p. 5892-
    Details
    In: Cancers, MDPI AG, Vol. 13, No. 23 ( 2021-11-23), p. 5892-
    Abstract: Hepatocellular carcinoma (HCC) risk prediction is important to developing individualized surveillance approaches. We designed a novel HCC prediction model using liver stiffness on transient elastography for patients receiving antiviral therapy against hepatitis B virus (HBV) infection. We recruited 2037 patients receiving entecavir or tenofovir as first-line antivirals and used the Cox regression analysis to determine key variables for model construction. Within 58.1 months (median), HCC developed in 182 (8.9%) patients. Patients with HCC showed a higher prevalence of cirrhosis (90.7% vs. 45.9%) and higher liver stiffness values (median 13.9 vs. 7.2 kPa) than those without. A novel nomogram (score 0–304) was established using age, platelet count, cirrhosis development, and liver stiffness values, which were independently associated with increased HCC risk, along with hepatitis B e antigen positivity and serum albumin and total bilirubin levels. Cumulative HCC probabilities were 0.7%, 5.0%, and 22.7% in the low- (score ≤87), intermediate- (88–222), and high-risk (≥223) groups, respectively. The c-index value was 0.799 (internal validity: 0.805), higher than that of the PAGE-B (0.726), modified PAGE-B (0.756), and modified REACH-B (0.761) models (all p 〈 0.05). Our nomogram showed acceptable performance in predicting HCC in Asian HBV-infected patients receiving potent antiviral therapy.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    URL: Article
    DOI: 10.3390/cancers13235892
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2527080-1
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Risk assessment of hepatocellular carcinoma and liver‐related events using ultrasonography and transient elastography in patients with chronic hepatitis B
    Wiley ; 2021
    In:  Journal of Viral Hepatitis Vol. 28, No. 10 ( 2021-10), p. 1362-1372
    Details
    In: Journal of Viral Hepatitis, Wiley, Vol. 28, No. 10 ( 2021-10), p. 1362-1372
    Abstract: Cirrhosis has prognostic value. We investigated whether the combined use of ultrasonography (US) and transient elastography (TE) to diagnose cirrhosis is beneficial for the risk assessment of hepatocellular carcinoma (HCC) and liver‐related events in patients with chronic hepatitis B (CHB). A total of 9300 patients with CHB who underwent US and TE in two institutions between 2006 and 2018 were enrolled. TE value ≥13 kPa was set to indicate cirrhosis. Patients were divided into four groups: US(+)TE(+) (cirrhosis by US and TE), US(+)TE(−) (cirrhosis by US, but not by TE), US(−)TE(+) (cirrhosis by TE, but not by US) and US(−)TE(−) (non‐cirrhosis by US and TE).The patients were predominantly male ( n  = 5474, 58.9%) with a mean age of 47.5 years. The proportions of patients with cirrhosis diagnosed by US and TE were 17.2% ( n  = 1595) and 13.2% ( n  = 1225), respectively. The proportion of patients with discordant results in diagnosing cirrhosis by US and TE was 18.7% ( n  = 1740). During follow‐up (median: 60.0 months), HCC and liver‐related events developed in 481 (5.2%) and 759 (8.2%) patients, respectively. The cumulative incidence rates of HCC and liver‐related events were highest in the US(+)TE(+) group, intermediate‐high in the US(−)TE(+) group, intermediate‐low in the US(+)TE(−) group and lowest in the US(−)TE(−) group (overall p   〈  .001). Cirrhosis assessed using US and TE was a major predictor of HCC and liver‐related event development in patients with CHB. Cirrhosis assessed using TE seemed better in predicting HCC or liver‐related events than using US, when cirrhosis diagnosis was discordant by US and TE.
    Type of Medium: Online Resource
    ISSN: 1352-0504 , 1365-2893
    URL: Issue
    URL: Article
    DOI: 10.1111/jvh.v28.10
    DOI: 10.1111/jvh.13560
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2007924-2
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  • 3
    Online Resource
    Online Resource
    Suboptimal Performance of Hepatocellular Carcinoma Prediction Models in Patients with Hepatitis B Virus-Related Cirrhosis
    MDPI AG ; 2022
    In:  Diagnostics Vol. 13, No. 1 ( 2022-12-20), p. 3-
    Details
    In: Diagnostics, MDPI AG, Vol. 13, No. 1 ( 2022-12-20), p. 3-
    Abstract: This study aimed to evaluate the predictive performance of pre-existing well-validated hepatocellular carcinoma (HCC) prediction models, established in patients with HBV-related cirrhosis who started potent antiviral therapy (AVT). We retrospectively reviewed the cases of 1339 treatment-naïve patients with HBV-related cirrhosis who started AVT (median period, 56.8 months). The scores of the pre-existing HCC risk prediction models were calculated at the time of AVT initiation. HCC developed in 211 patients (15.1%), and the cumulative probability of HCC development at 5 years was 14.6%. Multivariate Cox regression analysis revealed that older age (adjusted hazard ratio [aHR], 1.023), lower platelet count (aHR, 0.997), lower serum albumin level (aHR, 0.578), and greater LS value (aHR, 1.012) were associated with HCC development. Harrell’s c-indices of the PAGE-B, modified PAGE-B, modified REACH-B, CAMD, aMAP, HCC-RESCUE, AASL-HCC, Toronto HCC Risk Index, PLAN-B, APA-B, CAGE-B, and SAGE-B models were suboptimal in patients with HBV-related cirrhosis, ranging from 0.565 to 0.667. Nevertheless, almost all patients were well stratified into low-, intermediate-, or high-risk groups according to each model (all log-rank p 〈 0.05), except for HCC-RESCUE (p = 0.080). Since all low-risk patients had cirrhosis at baseline, they had unneglectable cumulative incidence of HCC development (5-year incidence, 4.9–7.5%). Pre-existing risk prediction models for patients with chronic hepatitis B showed suboptimal predictive performances for the assessment of HCC development in patients with HBV-related cirrhosis.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics13010003
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662336-5
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