Liver stiffness-based optimization of hepatocellular carcinoma risk score in patients with chronic hepatitis B

Area of Science:

• Hepatology
• Oncology
• Viral Hepatitis Research

Background:

• Chronic hepatitis B (CHB) is a leading cause of hepatocellular carcinoma (HCC).
• Current prediction models like CU-HCC may have limitations due to inaccurate cirrhosis diagnosis via ultrasonography.
• Improved risk stratification is crucial for timely HCC detection in CHB patients.

Purpose of the Study:

• To evaluate the accuracy of a novel LSM-HCC score for predicting HCC in CHB patients.
• To refine the existing CU-HCC score by integrating liver stiffness measurement (LSM) data.
• To compare the predictive performance of the LSM-HCC score against the CU-HCC score.

Main Methods:

• A prospective cohort study involving 1555 CHB patients undergoing transient elastography.
• Patients were randomized into training (1035) and validation (520) cohorts.
• A multivariable Cox regression model incorporated LSM, age, serum albumin, and HBV DNA levels to develop the LSM-HCC score.

Main Results:

• The LSM-HCC score, ranging from 0 to 30, was developed using LSM, age, serum albumin, and HBV DNA.
• The LSM-HCC score demonstrated superior predictive accuracy compared to the CU-HCC score (AUC 0.83-0.89 vs. 0.75-0.81).
• A cutoff value of 11 for the LSM-HCC score achieved a high negative predictive value (99.4%-100%) for excluding HCC at 5 years.

Conclusions:

• The LSM-HCC score, incorporating LSM, age, serum albumin, and HBV DNA, is a highly accurate tool for predicting HCC in CHB patients.
• This refined score offers improved diagnostic precision over existing methods.
• The LSM-HCC score shows significant potential for clinical application in managing CHB patients at risk of HCC.