Risk factors for hepatocellular carcinoma at baseline and 1 year after initiation of nucleos(t)ide analog therapy for chronic hepatitis B

被引：6

作者：

Kaneko, Shun ^{[1
,2
]}

Kurosaki, Masayuki ^{[1
]}

Mashiba, Toshie ^{[3
]}

Marusawa, Hiroyuki ^{[4
]}

Kondo, Masahiko ^{[5
]}

Kojima, Yuji ^{[6
]}

Uchida, Yasushi ^{[7
]}

Fujii, Hideki ^{[8
]}

Akahane, Takehiro ^{[9
]}

Yagisawa, Hitoshi ^{[10
]}

Kusakabe, Atsunori ^{[11
]}

Kobashi, Haruhiko ^{[12
]}

Abe, Takehiko ^{[13
]}

Yoshida, Hideo ^{[14
]}

Ogawa, Chikara ^{[15
]}

Furuta, Koichiro ^{[16
]}

Tamaki, Nobuharu ^{[1
]}

Tsuji, Keiji ^{[17
,18
]}

Matsushita, Tomomichi ^{[19
]}

Izumi, Namiki ^{[1
]}

机构：

[1] Musashino Red Cross Hosp, Dept Gastroenterol & Hepatol, 1-26-1 Kyonan Cho, Musashino, Tokyo 1808610, Japan

[2] Tokyo Med & Dent Univ, Dept Gastroenterol & Hepatol, Tokyo, Japan

[3] Matsuyama Red Cross Hosp, Ctr Liver Biliary Pancreat Dis, Matsuyama, Ehime, Japan

[4] Japanese Red Cross Osaka Hosp, Dept Gastroenterol, Osaka, Japan

[5] Japanese Red Cross Otsu Hosp, Dept Gastroenterol, Otsu, Shiga, Japan

[6] Japanese Red Cross Ise Hosp, Dept Gastroenterol, Ise, Mie, Japan

[7] Japanese Red Cross Matsue Hosp, Dept Gastroenterol, Matsue, Shimane, Japan

[8] Japanese Red Cross Kyoto Daiichi Hosp, Dept Gastroenterol, Kyoto, Japan

[9] Japanese Red Cross Ishinomaki Hosp, Dept Gastroenterol, Ishinomaki, Miyagi, Japan

[10] Japanese Red Cross Akita Hosp, Dept Gastroenterol, Akita, Japan

[11] Japanese Red Cross Nagoya Daini Hosp, Dept Gastroenterol, Nagoya, Aichi, Japan

[12] Japanese Red Cross Okayama Hosp, Dept Hepatol, Okayama, Japan

[13] Japanese Red Cross Maebashi Hosp, Dept Gastroenterol, Maebashi, Gumma, Japan

[14] Japanese Red Cross Med Ctr, Dept Gastroenterol, Tokyo, Japan

[15] Japanese Red Cross Takamatsu Hosp, Dept Gastroenterol, Takamatsu, Kagawa, Japan

[16] Japanese Red Cross Masuda Hosp, Dept Gastroenterol, Masuda, Shimane, Japan

[17] Hiroshima Red Cross Hosp, Dept Gastroenterol, Hiroshima, Japan

[18] Atom Bomb Survivors Hosp, Hiroshima, Japan

[19] Japanese Red Cross Gifu Hosp, Dept Gastroenterol, Gifu, Japan

来源：

JOURNAL OF MEDICAL VIROLOGY | 2023年 / 95卷 / 01期

关键词：

albumin-bilirubin score; hepatitis B virus; hepatocellular carcinoma; nucleos(t)ide analogs; PREDICTION MODELS; SCORING SYSTEM; ENTECAVIR; VALIDATION; SCORES;

D O I：

10.1002/jmv.28210

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

Nucleos(t)ide analogs (NAs) cannot completely suppress the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). This study aimed to identify the risk factors for HCC development in naive CHB patients treated with current NA. Patients receiving NA (n = 905) were recruited retrospectively from the 17 hospitals of the Japanese Red Cross Liver Study Group. All treatment-naive patients had been receiving current NA continuously for more than 1 year until the end of the follow-up. We analyzed the accuracy of predictive risk score using the area under receiver operating characteristic curve. The albumin-bilirubin (ALBI) score was significantly improved by NA therapy (-0.171 +/- 0.396; p < 0.001 at Week 48). A total of 72 (8.0%) patients developed HCC over a median follow-up of 6.2 (1.03-15.7) years. An independent predictive factor of HCC development was older age, cirrhosis, lower platelet counts at baseline and ALBI score, and alpha-fetoprotein (AFP) at 1 year after NA therapy according to multivariate analysis. The accuracy was assessed using the PAGE-B, mPAGE-B, aMAP, APA-B, and REAL-B scores that included these factors. Discrimination was generally acceptable for these models. aMAP and REAL-B demonstrated high discrimination with 0.866/0.862 and 0.833/0.859 for 3- and 5-year prediction from the status of 1 year after NA therapy, respectively. Baseline age and platelet count, as well as ALBI and AFP one year after NA, were useful for stratifying carcinogenesis risk. The aMAP and REAL-B scores were validated with high accuracy in Japanese CHB patients.

引用

页数：10

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