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.
Bibliographical noteFunding 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).
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