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Liver Int. 2015 Mar;35(3):1054-62. doi: 10.1111/liv.12621. Epub 2014 Jul 8.

Liver stiffness-based model for prediction of hepatocellular carcinoma in chronic hepatitis B virus infection: comparison with histological fibrosis.

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  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND & AIMS:

Liver stiffness (LS) value using transient elastography is a reliable, non-invasive tool for assessing liver fibrosis. LS-based prediction model, LSPS (=LS value × spleen diameter/platelet count) is well correlated with the risk of developing portal hypertension-related cirrhotic complications. Here, we assessed the prognostic performance of LSPS in predicting the development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB).

METHODS:

Between 2006 and 2010, we recruited 227 patients with CHB who underwent liver biopsy and LS measurement. The major end point was HCC development.

RESULTS:

Median age was 45 years and 156 (68.7%) patients were male. During the follow-up period (median, 61 months), HCC developed in 18 patients. Patient with HCC had a higher LS value, a longer spleen, and lower platelet counts (all P < 0.05) than those without HCC. On multivariate analysis, LSPS was identified as an independent predictor of HCC development [hazard ratio (HR) 1.541, P < 0.001] after adjusting for age, serum albumin level and histological fibrosis stage. When patients were stratified into three groups (LSPS <1.1, 1.1-2.5 and >2.5), the 5-year cumulative risk of HCC increased significantly in association with a higher LSPS value (4.0, 13.8, 36.2%, respectively, P < 0.001). Patients with LSPS 1.1-2.5 (HR 2.0, P = 0.032) and LSPS > 2.5 (HR 8.7, P = 0.002) had a higher risk of developing HCC than those with LSPS < 1.1.

CONCLUSIONS:

LS value-spleen diameter to platelet ratio score is useful for assessing the risk of HCC development and careful surveillance strategies are required in an individual manner.

© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

KEYWORDS:

chronic hepatitis B; fibroscan; hepatitis B virus; hepatocellular carcinoma; liver stiffness; platelet count; prediction; prognosis; spleen size

[PubMed - indexed for MEDLINE]
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