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      • Validation of the Risk Prediction Scores for Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Treated with Entecavir or Tenofovir

        ( Jin Won Chang ),( Jae Seung Lee ),( Hye Won Lee ),( Beom Kyung Kim ),( Jun Yong Park ),( Do Young Kim ),( Sang Hoon Ahn ),( Yeon Seok Seo ),( Han Ah Lee ),( Mi Na Kim ),( Yu Rim Lee ),( Seong Gyu Hw 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

        Aims: Several prediction scores are available for the early detection of hepatocellular carcinoma (HCC). We validated the predictive accuracy of the AASL, RESCUE-B, PAGE-B, and modified PAGE-B (mPAGE-B) scores in patients with chronic hepatitis B (CHB) treated with entecavir (ETV) or tenofovir disoproxil fumarate (TDF). Methods: Between 2007 and 2014, 3,171 patients were recruited (1,645 with ETV and 1,517 with TDF). The predictive accuracy of each prediction score was assessed. Results: The mean age of the study population (1,977 men and 1,194 women) was 48.8 years. Liver cirrhosis was noted in 1,040 (32.8%) patients. During follow-up (median, 58.2 months), 280 (8.8%) patients developed HCC and were significantly older; were more likely to be male; had significantly higher proportions of liver cirrhosis, hypertension, and diabetes; and had significantly higher values of the four risk scores than those who did not develop HCC (all P<0.05). Older age (hazard ratio [HR]=1.048), male sex (HR=2.142), liver cirrhosis (HR=3.144), and prolonged prothrombin time (HR=2.589) were independently associated with an increased risk of HCC development (all P<0.05), whereas a higher platelet count (HR=0.996) was independently associated with a decreased risk (P<0.05). The predictive accuracy of the AASL score was highest at 3 and 5 years HCC prediction (area under the curve [AUC]=0.818 and 0.816, respectively), followed by RESCUE-B, PAGE-B, and mPAGE-B scores (AUC=0.780-0.815 and 0.769-0.814, respectively). Conclusions: Four HCC prediction scores performed acceptably in Korean patients with CHB treated with ETV or TDF. Of these, the AASL score showed the highest predictive accuracy.

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