TY - JOUR
T1 - aMAP risk score predicts hepatocellular carcinoma development in patients with chronic hepatitis
AU - Fan, Rong
AU - Papatheodoridis, George
AU - Sun, Jian
AU - Innes, Hamish
AU - Toyoda, Hidenori
AU - Xie, Qing
AU - Mo, Shuyuan
AU - Sypsa , Vana
AU - Guha, Indra Neil
AU - Kumada, Takashi
AU - Niu, Junqi
AU - Dalekos, George
AU - Yasuda, Satoshi
AU - Barnes, Eleanor
AU - Lian, Jianqi
AU - Suri, Vithika
AU - Idilman, Ramazan
AU - Barclay, Stephen T.
AU - Dou, Xiaoguang
AU - Berg, Thomas
AU - Hayes, Peter C.
AU - Flaherty, John F.
AU - Zhou, Yuanping
AU - Zhang, Zhengang
AU - Buti, Maria
AU - Hutchinson, Sharon J.
AU - Guo, Yabing
AU - Calleja, Jose Luis
AU - Lin, Lanjia
AU - Zhao, Longfeng
AU - Chen, Yongpeng
AU - Janssen, Harry LA.
AU - Zhu, Chaonan
AU - Shi, Lei
AU - Tang, Xiaoping
AU - Gaggar, Anuj
AU - Wei, Lai
AU - Jia, Jidong
AU - Irving, William L.
AU - Johnson, Philip J.
AU - Lampertico, Pietro
AU - Hou, Jinlin
N1 - *1-1-70*
Due to be published OA (from publisher website) but only early version available at time of checking 28/07/20 ST
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AAM: made open as open access status confirmed on publisher webpage. ET 2/9/20
Acceptance from webpage
VoR not yet available at 18/9/20 ET and 15/10/20. Also probably need to keep the AAM for compliance - VoR is published under CC-BY-NC-ND.
PY - 2020/7/20
Y1 - 2020/7/20
N2 - AbstractBackground & AimsHepatocellular carcinoma (HCC) is the leading cause of death in patients with chronic hepatitis. In this international collaboration, we sought to develop a global universal HCC risk score to predict the HCC development for chronic hepatitis patients.MethodsA total of 17,374 patients, comprising 10,578 treated Asian chronic hepatitis B (CHB) patients, 2510 treated Caucasian CHB patients, 3566 treated hepatitis C virus (HCV)-infected patients (including 2489 patients with cirrhosis achieving a sustained virologic response) and 720 non-viral hepatitis (NVH) patients from 11 international prospective observational cohorts or randomized controlled trials, were divided into a training cohort (3688 Asian CHB patients) and 9 validation cohorts with different aetiologies and ethnicities (N =13,686).ResultsWe developed an HCC risk score, called the aMAP score (ranging from 0 to 100), that involves only age, Male, Albumin-bilirubin and Platelets. This metric performed excellently in assessing HCC risk not only in patients with hepatitis of different aetiologies but also in those with different ethnicities (c-index: 0.82-0.87). Cut-off values of 50 and 60 were best for discriminating HCC risk. The 3- or 5-year cumulative incidences of HCC were 0-0.8%, 1.5-4.8%, and 8.1-19.9% in the low- (N=7413, 43.6%), medium- (N=6529, 38.4%), and high-risk (N =3044, 17.9%) groups, respectively. The cut-off value of 50 was associated with a sensitivity of 85.7-100% and a negative predictive value of 99.3-100%. The cut-off value of 60 resulted in a specificity of 56.6-95.8% and a positive predictive value of 6.6-15.7%.ConclusionsThis objective, simple, reliable risk score based on five common parameters accurately predicts HCC development, regardless of aetiology and ethnicity, which may help to establish a risk score-guided HCC surveillance strategy worldwide.
AB - AbstractBackground & AimsHepatocellular carcinoma (HCC) is the leading cause of death in patients with chronic hepatitis. In this international collaboration, we sought to develop a global universal HCC risk score to predict the HCC development for chronic hepatitis patients.MethodsA total of 17,374 patients, comprising 10,578 treated Asian chronic hepatitis B (CHB) patients, 2510 treated Caucasian CHB patients, 3566 treated hepatitis C virus (HCV)-infected patients (including 2489 patients with cirrhosis achieving a sustained virologic response) and 720 non-viral hepatitis (NVH) patients from 11 international prospective observational cohorts or randomized controlled trials, were divided into a training cohort (3688 Asian CHB patients) and 9 validation cohorts with different aetiologies and ethnicities (N =13,686).ResultsWe developed an HCC risk score, called the aMAP score (ranging from 0 to 100), that involves only age, Male, Albumin-bilirubin and Platelets. This metric performed excellently in assessing HCC risk not only in patients with hepatitis of different aetiologies but also in those with different ethnicities (c-index: 0.82-0.87). Cut-off values of 50 and 60 were best for discriminating HCC risk. The 3- or 5-year cumulative incidences of HCC were 0-0.8%, 1.5-4.8%, and 8.1-19.9% in the low- (N=7413, 43.6%), medium- (N=6529, 38.4%), and high-risk (N =3044, 17.9%) groups, respectively. The cut-off value of 50 was associated with a sensitivity of 85.7-100% and a negative predictive value of 99.3-100%. The cut-off value of 60 resulted in a specificity of 56.6-95.8% and a positive predictive value of 6.6-15.7%.ConclusionsThis objective, simple, reliable risk score based on five common parameters accurately predicts HCC development, regardless of aetiology and ethnicity, which may help to establish a risk score-guided HCC surveillance strategy worldwide.
KW - hepatocellular carcinoma; risk score; hepatitis B virus; hepatitis C virus; non-alcoholic fatty liver disease
U2 - 10.1016/j.jhep.2020.07.025
DO - 10.1016/j.jhep.2020.07.025
M3 - Article
JO - Journal of Hepatology
JF - Journal of Hepatology
SN - 0168-8278
ER -