A novel risk score for hepatocellular carcinoma in Asian cirrhotic patients: A multicentre prospective cohort study

Kung Hao Liang; Sang Hoon Ahn; Hye Wong Lee; Ya Hui Huang; Rong Nan Chien; Tsung Hui Hu; Kwang Huei Lin; Christopher Sung Huan Yeh; Chao Wei Hsu; Chih Lang Lin; Tai Long Pan; Po Yuan Ke; Ming Ling Chang; Chau Ting Yeh

doi:10.1038/s41598-018-26992-3

A novel risk score for hepatocellular carcinoma in Asian cirrhotic patients: A multicentre prospective cohort study

Kung Hao Liang, Sang Hoon Ahn, Hye Wong Lee, Ya Hui Huang, Rong Nan Chien, Tsung Hui Hu, Kwang Huei Lin, Christopher Sung Huan Yeh, Chao Wei Hsu, Chih Lang Lin, Tai Long Pan, Po Yuan Ke, Ming Ling Chang, Chau Ting Yeh

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

Abstract

Liver cirrhotic patients suffer from a seemingly unpredictable risk of hepatocellular carcinoma (HCC). Here, an HCC risk score R (0 ? R ? 1) was derived from commonly tested haematological and biochemical parameters. In the score-derivation Taiwanese cohort (144 cirrhosis versus 48 HCCremission patients), the score had an area-under-the-curve (AUC) of 0.70 (95% confidence interval [CI], 0.61-0.78, P < 0.001). When validated in a Korean cohort (78 cirrhosis versus 23 HCC-remission patients), the AUC was 0.68 (CI, 0.56-0.80, P = 0.009). In a multicentre prospective cohort (478 cirrhotic patients prospectively followed for HCC occurrence), the hazard ratio with respect to R was 2.344 (CI = 1.183-4.646, P = 0.015). The cumulative incidences of HCC at two years after patient enrolment were 9.6% and 1.7% for the high-risk (R ≥ 0.5) and low-risk (R < 0.5) groups, respectively (P < 0.001). At the end of the study, the incidences were 10.9% and 5.0%, respectively (P = 0.012). The majority of HCCs (23/26) in the high-risk group emerged within the first two years of follow-up. In conclusion, an HCC risk score was developed for cirrhotic patients that effectively predicted HCC in a prospective cohort study.

Original language	English
Article number	8608
Journal	Scientific reports
Volume	8
Issue number	1
DOIs	https://doi.org/10.1038/s41598-018-26992-3
Publication status	Published - 2018 Dec 1

Bibliographical note

Funding Information:
The authors would like to thank Jun-Jeng Fen for constructing the freely-downloadable HCC predicting Apps (QuickMed). We thank Yi-Ting Liao, Chung-Yin Wu, Fang-Yi He, Hui-Chin Chen, Ya-Ming Cheng, Yu-Jean Chen and Chien-Chih Wang of the liver research center for the excellent technical and administrative assistance. Information systems constructed by Su-Wei Chang and Yi-Chun Wang were gratefully appreciated. This work was supported by grants from the Ministry of Science and Technology, Taiwan (MOST-106-2314-B-075- 074-MY2), Ministry of Health and Welfare (MOHW107-TDU-B-212-114023) and Chang Gung Memorial Hospital Medical Research Program, Linkou (CIRPG3B0032, CRRPG3E0101 and CMRPG2B0453).

Funding Information:
The authors would like to thank Jun-Jeng Fen for constructing the freely-downloadable HCC predicting Apps (QuickMed). We thank Yi-Ting Liao, Chung-Yin Wu, Fang-Yi He, Hui-Chin Chen, Ya-Ming Cheng, Yu-Jean Chen and Chien-Chih Wang of the liver research center for the excellent technical and administrative assistance. Information systems constructed by Su-Wei Chang and Yi-Chun Wang were gratefully appreciated. This work was supported by grants from the Ministry of Science and Technology, Taiwan (MOST-106-2314-B-075-074-MY2), Ministry of Health and Welfare (MOHW107-TDU-B-212-114023) and Chang Gung Memorial Hospital Medical Research Program, Linkou (CIRPG3B0032, CRRPG3E0101 and CMRPG2B0453).

Publisher Copyright:
© The Author(s) 2018.

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10.1038/s41598-018-26992-3

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Liang, K. H., Ahn, S. H., Lee, H. W., Huang, Y. H., Chien, R. N., Hu, T. H., Lin, K. H., Yeh, C. S. H., Hsu, C. W., Lin, C. L., Pan, T. L., Ke, P. Y., Chang, M. L., & Yeh, C. T. (2018). A novel risk score for hepatocellular carcinoma in Asian cirrhotic patients: A multicentre prospective cohort study. Scientific reports, 8(1), [8608]. https://doi.org/10.1038/s41598-018-26992-3

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title = "A novel risk score for hepatocellular carcinoma in Asian cirrhotic patients: A multicentre prospective cohort study",

abstract = "Liver cirrhotic patients suffer from a seemingly unpredictable risk of hepatocellular carcinoma (HCC). Here, an HCC risk score R (0 ? R ? 1) was derived from commonly tested haematological and biochemical parameters. In the score-derivation Taiwanese cohort (144 cirrhosis versus 48 HCCremission patients), the score had an area-under-the-curve (AUC) of 0.70 (95% confidence interval [CI], 0.61-0.78, P < 0.001). When validated in a Korean cohort (78 cirrhosis versus 23 HCC-remission patients), the AUC was 0.68 (CI, 0.56-0.80, P = 0.009). In a multicentre prospective cohort (478 cirrhotic patients prospectively followed for HCC occurrence), the hazard ratio with respect to R was 2.344 (CI = 1.183-4.646, P = 0.015). The cumulative incidences of HCC at two years after patient enrolment were 9.6% and 1.7% for the high-risk (R ≥ 0.5) and low-risk (R < 0.5) groups, respectively (P < 0.001). At the end of the study, the incidences were 10.9% and 5.0%, respectively (P = 0.012). The majority of HCCs (23/26) in the high-risk group emerged within the first two years of follow-up. In conclusion, an HCC risk score was developed for cirrhotic patients that effectively predicted HCC in a prospective cohort study.",

author = "Liang, {Kung Hao} and Ahn, {Sang Hoon} and Lee, {Hye Wong} and Huang, {Ya Hui} and Chien, {Rong Nan} and Hu, {Tsung Hui} and Lin, {Kwang Huei} and Yeh, {Christopher Sung Huan} and Hsu, {Chao Wei} and Lin, {Chih Lang} and Pan, {Tai Long} and Ke, {Po Yuan} and Chang, {Ming Ling} and Yeh, {Chau Ting}",

note = "Funding Information: The authors would like to thank Jun-Jeng Fen for constructing the freely-downloadable HCC predicting Apps (QuickMed). We thank Yi-Ting Liao, Chung-Yin Wu, Fang-Yi He, Hui-Chin Chen, Ya-Ming Cheng, Yu-Jean Chen and Chien-Chih Wang of the liver research center for the excellent technical and administrative assistance. Information systems constructed by Su-Wei Chang and Yi-Chun Wang were gratefully appreciated. This work was supported by grants from the Ministry of Science and Technology, Taiwan (MOST-106-2314-B-075- 074-MY2), Ministry of Health and Welfare (MOHW107-TDU-B-212-114023) and Chang Gung Memorial Hospital Medical Research Program, Linkou (CIRPG3B0032, CRRPG3E0101 and CMRPG2B0453). Funding Information: The authors would like to thank Jun-Jeng Fen for constructing the freely-downloadable HCC predicting Apps (QuickMed). We thank Yi-Ting Liao, Chung-Yin Wu, Fang-Yi He, Hui-Chin Chen, Ya-Ming Cheng, Yu-Jean Chen and Chien-Chih Wang of the liver research center for the excellent technical and administrative assistance. Information systems constructed by Su-Wei Chang and Yi-Chun Wang were gratefully appreciated. This work was supported by grants from the Ministry of Science and Technology, Taiwan (MOST-106-2314-B-075-074-MY2), Ministry of Health and Welfare (MOHW107-TDU-B-212-114023) and Chang Gung Memorial Hospital Medical Research Program, Linkou (CIRPG3B0032, CRRPG3E0101 and CMRPG2B0453). Publisher Copyright: {\textcopyright} The Author(s) 2018.",

year = "2018",

month = dec,

day = "1",

doi = "10.1038/s41598-018-26992-3",

language = "English",

volume = "8",

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TY - JOUR

T1 - A novel risk score for hepatocellular carcinoma in Asian cirrhotic patients

T2 - A multicentre prospective cohort study

AU - Liang, Kung Hao

AU - Ahn, Sang Hoon

AU - Lee, Hye Wong

AU - Huang, Ya Hui

AU - Chien, Rong Nan

AU - Hu, Tsung Hui

AU - Lin, Kwang Huei

AU - Yeh, Christopher Sung Huan

AU - Hsu, Chao Wei

AU - Lin, Chih Lang

AU - Pan, Tai Long

AU - Ke, Po Yuan

AU - Chang, Ming Ling

AU - Yeh, Chau Ting

N1 - Funding Information: The authors would like to thank Jun-Jeng Fen for constructing the freely-downloadable HCC predicting Apps (QuickMed). We thank Yi-Ting Liao, Chung-Yin Wu, Fang-Yi He, Hui-Chin Chen, Ya-Ming Cheng, Yu-Jean Chen and Chien-Chih Wang of the liver research center for the excellent technical and administrative assistance. Information systems constructed by Su-Wei Chang and Yi-Chun Wang were gratefully appreciated. This work was supported by grants from the Ministry of Science and Technology, Taiwan (MOST-106-2314-B-075- 074-MY2), Ministry of Health and Welfare (MOHW107-TDU-B-212-114023) and Chang Gung Memorial Hospital Medical Research Program, Linkou (CIRPG3B0032, CRRPG3E0101 and CMRPG2B0453). Funding Information: The authors would like to thank Jun-Jeng Fen for constructing the freely-downloadable HCC predicting Apps (QuickMed). We thank Yi-Ting Liao, Chung-Yin Wu, Fang-Yi He, Hui-Chin Chen, Ya-Ming Cheng, Yu-Jean Chen and Chien-Chih Wang of the liver research center for the excellent technical and administrative assistance. Information systems constructed by Su-Wei Chang and Yi-Chun Wang were gratefully appreciated. This work was supported by grants from the Ministry of Science and Technology, Taiwan (MOST-106-2314-B-075-074-MY2), Ministry of Health and Welfare (MOHW107-TDU-B-212-114023) and Chang Gung Memorial Hospital Medical Research Program, Linkou (CIRPG3B0032, CRRPG3E0101 and CMRPG2B0453). Publisher Copyright: © The Author(s) 2018.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Liver cirrhotic patients suffer from a seemingly unpredictable risk of hepatocellular carcinoma (HCC). Here, an HCC risk score R (0 ? R ? 1) was derived from commonly tested haematological and biochemical parameters. In the score-derivation Taiwanese cohort (144 cirrhosis versus 48 HCCremission patients), the score had an area-under-the-curve (AUC) of 0.70 (95% confidence interval [CI], 0.61-0.78, P < 0.001). When validated in a Korean cohort (78 cirrhosis versus 23 HCC-remission patients), the AUC was 0.68 (CI, 0.56-0.80, P = 0.009). In a multicentre prospective cohort (478 cirrhotic patients prospectively followed for HCC occurrence), the hazard ratio with respect to R was 2.344 (CI = 1.183-4.646, P = 0.015). The cumulative incidences of HCC at two years after patient enrolment were 9.6% and 1.7% for the high-risk (R ≥ 0.5) and low-risk (R < 0.5) groups, respectively (P < 0.001). At the end of the study, the incidences were 10.9% and 5.0%, respectively (P = 0.012). The majority of HCCs (23/26) in the high-risk group emerged within the first two years of follow-up. In conclusion, an HCC risk score was developed for cirrhotic patients that effectively predicted HCC in a prospective cohort study.

AB - Liver cirrhotic patients suffer from a seemingly unpredictable risk of hepatocellular carcinoma (HCC). Here, an HCC risk score R (0 ? R ? 1) was derived from commonly tested haematological and biochemical parameters. In the score-derivation Taiwanese cohort (144 cirrhosis versus 48 HCCremission patients), the score had an area-under-the-curve (AUC) of 0.70 (95% confidence interval [CI], 0.61-0.78, P < 0.001). When validated in a Korean cohort (78 cirrhosis versus 23 HCC-remission patients), the AUC was 0.68 (CI, 0.56-0.80, P = 0.009). In a multicentre prospective cohort (478 cirrhotic patients prospectively followed for HCC occurrence), the hazard ratio with respect to R was 2.344 (CI = 1.183-4.646, P = 0.015). The cumulative incidences of HCC at two years after patient enrolment were 9.6% and 1.7% for the high-risk (R ≥ 0.5) and low-risk (R < 0.5) groups, respectively (P < 0.001). At the end of the study, the incidences were 10.9% and 5.0%, respectively (P = 0.012). The majority of HCCs (23/26) in the high-risk group emerged within the first two years of follow-up. In conclusion, an HCC risk score was developed for cirrhotic patients that effectively predicted HCC in a prospective cohort study.

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ER -

A novel risk score for hepatocellular carcinoma in Asian cirrhotic patients: A multicentre prospective cohort study

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