RISS 검색 - 국내학술지논문 상세보기

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다국어 초록 (Multilingual Abstract)

Aims: Hepatocellular carcinoma (HCC) can develop after hepatitis B surface antigen (HBsAg) seroclearance. However, whether HCC risk differs between antiviral therapy (AVT)-induced or spontaneous seroclearance cases, and ways to identify atrisk populations remain unclear. We compared the HCC risk between AVT-induced and spontaneous cases and tested whether several HCC risk prediction models could be applied to HBsAg seroclearance patients.
Methods: A retrospective cohort of 1,200 patients (median age: 56 years; 824 males; 165 with cirrhosis; 216 AVT-induced cases) who achieved HBsAg seroclearance were analyzed for the development of HCC after HBsAg seroclearance. The performance of five HCC prediction models, CU-HCC, GAG-HCC, REACH-B, PAGE-B, and modified PAGE-B, was assessed.
Results: During a median of 4.8 years of follow-up (range: 0.5 - 17.8 years), HCC developed in 23 patients (1.9%). The HCC incidence rate was higher in the AVT-induced cases than in the spontaneous cases (3.9% vs. 0.9% at five years). AVT and cirrhosis were independent factors associated with HCC, with HCC incidence rates of 0.5%, 1.2%, 4.0%, and 10.5% at five years for spontaneous/no-cirrhosis, AVT-induced/no-cirrhosis, spontaneous/cirrhosis, and AVT-induced/cirrhosis patients, respectively. The area under the receiver operating curve (AUROC) for HCC development at five years was highest for CU-HCC scores (0.82). The HCC incidence was high for high CU-HCC scores (14.3% at five years) and high GAG-HCC scores (7.9% at five years), and was very low for low PAGE-B scores (0% at five years) or low modified PAGE-B scores (0% at five years).
Conclusions: AVT-induced HBsAg seroclearance was associated with higher HCC risk, especially for patients with cirrhosis, indicating that they need careful monitoring for HCC risk. The HCC risk models were able to stratify the HCC risk in patients with HBsAg seroclearance.