The Accuracy of Noninvasive Methods in Predicting the Development of Hepatocellular Carcinoma and Hepatic Decompensation in Patients With Chronic Hepatitis B
Journal of Clinical Gastroenterology, 06/21/2012
Chon YE et al. – The results suggest that Liver stiffness measurement (LSM) or LSM–spleen diameter–to–platelet ratio index (LSPI) may be useful predictors of the development of hepatocellular carcinoma (HCC) and hepatic decompensation in patients with chronic hepatitis B (CHB).Methods
- A total of 1126 patients with CHB who underwent LSMs and attended regular follow-ups to detect the development of HCC and hepatic decompensations (variceal bleeding, ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, or hepatorenal syndrome) were enrolled.
- Noninvasive liver fibrosis prediction methods included, age-spleen-to-platelet ratio index, LSM, LSM-spleen diameter-to-platelet ratio index (LSPI), P2/MS, and FIB-4.
- During follow-up (median, 30.7 mo), HCC and hepatic decompensation developed in 63 and 68 patients, respectively.
- The accuracy of LSM and LSPI in predicting the development of HCC or hepatic decompensation was higher than that of aspartate aminotransferase-to-platelet ratio index, age–spleen-to-platelet ratio index, P2/MS, or FIB-4 (areas under the receiver operating characteristic curve=0.789 and 0.788 vs. 0.729, 0.756, 0.696, and 0.744 for HCC development; areas under the receiver operating characteristic curve=0.820 and 0.848 vs. 0.787, 0.799, 0.812, and 0.784 for hepatic decompensation).
- On multivariate analyses, LSM and LSPI were identified as independent predictors of the development of HCC [hazard ratio (HR), 1.040 (LSM); HR, 1.001 (LSPI)] and hepatic decompensation [HR, 1.033 (LSM); HR, 1.002 (LSPI)].