Predictive validation of qualitative fibrosis staging in patients with chronic hepatitis B on antiviral therapy

Hye Won Lee, Kiyong Na, Seung Up Kim, Beom Kyung Kim, Jun Yong Park, Ji Hae Nahm, Jung Il Lee, Do Young Kim, Sang Hoon Ahn, Kwang Hyub Han, Young Nyun Park

Research output: Contribution to journalArticle

Abstract

The fibrosis in chronic hepatitis shows dynamic changes during antiviral therapy (AVT). We investigated whether P-I-R (progressive vs. indeterminate vs. regressive) staging is predictive of hepatocellular carcinoma (HCC) recurrence in patients with chronic hepatitis B (CHB) taking AVT who underwent resection. Patients with CHB-related HCC who underwent curative resection between 2004 and 2017 and had received ≥2 years AVT at the time of resection were eligible. Two pathologists performed P-I-R staging. In total, 104 patients with CHB-related HCC were enrolled. The mean age of the study population was 56.3 years. The mean duration of AVT at the time of resection was 62.6 months. During the follow-up period (mean, 45.5 months), 20 (19.2%) and 14 (13.5%) patients developed early and late recurrence of HCC, respectively. The cumulative incidence of late recurrence was significantly lower in patients with regressive patterns than in those with indeterminate and progressive patterns according to P-I-R staging (P = 0.015, log-rank test), although the cumulative incidence of overall recurrence according to P-I-R staging was similar. Hepatitis B virus DNA levels (hazard ratio [HR] = 3.200, P = 0.020) and the regressive P-I-R staging pattern (HR = 0.127, P = 0.047) independently predicted the risk of late recurrence. One-time assessment of the P-I-R staging at the time of curative resection in patients with CHB-related HCC receiving AVT independently predicted late HCC recurrence. Therefore, qualitative fibrosis assessment by P-I-R staging might be useful in predicting the outcomes of patients with CHB undergoing AVT.

Original languageEnglish
Article number15628
JournalScientific reports
Volume9
Issue number1
DOIs
Publication statusPublished - 2019 Dec 1

Fingerprint

Chronic Hepatitis B
Antiviral Agents
Fibrosis
Hepatocellular Carcinoma
Recurrence
Therapeutics
Incidence
Chronic Hepatitis
Hepatitis B virus
DNA
Population

All Science Journal Classification (ASJC) codes

  • General

Cite this

Lee, Hye Won ; Na, Kiyong ; Kim, Seung Up ; Kim, Beom Kyung ; Park, Jun Yong ; Nahm, Ji Hae ; Lee, Jung Il ; Kim, Do Young ; Ahn, Sang Hoon ; Han, Kwang Hyub ; Park, Young Nyun. / Predictive validation of qualitative fibrosis staging in patients with chronic hepatitis B on antiviral therapy. In: Scientific reports. 2019 ; Vol. 9, No. 1.
@article{d0a2621f63fa4a9e823e2697ce814f91,
title = "Predictive validation of qualitative fibrosis staging in patients with chronic hepatitis B on antiviral therapy",
abstract = "The fibrosis in chronic hepatitis shows dynamic changes during antiviral therapy (AVT). We investigated whether P-I-R (progressive vs. indeterminate vs. regressive) staging is predictive of hepatocellular carcinoma (HCC) recurrence in patients with chronic hepatitis B (CHB) taking AVT who underwent resection. Patients with CHB-related HCC who underwent curative resection between 2004 and 2017 and had received ≥2 years AVT at the time of resection were eligible. Two pathologists performed P-I-R staging. In total, 104 patients with CHB-related HCC were enrolled. The mean age of the study population was 56.3 years. The mean duration of AVT at the time of resection was 62.6 months. During the follow-up period (mean, 45.5 months), 20 (19.2{\%}) and 14 (13.5{\%}) patients developed early and late recurrence of HCC, respectively. The cumulative incidence of late recurrence was significantly lower in patients with regressive patterns than in those with indeterminate and progressive patterns according to P-I-R staging (P = 0.015, log-rank test), although the cumulative incidence of overall recurrence according to P-I-R staging was similar. Hepatitis B virus DNA levels (hazard ratio [HR] = 3.200, P = 0.020) and the regressive P-I-R staging pattern (HR = 0.127, P = 0.047) independently predicted the risk of late recurrence. One-time assessment of the P-I-R staging at the time of curative resection in patients with CHB-related HCC receiving AVT independently predicted late HCC recurrence. Therefore, qualitative fibrosis assessment by P-I-R staging might be useful in predicting the outcomes of patients with CHB undergoing AVT.",
author = "Lee, {Hye Won} and Kiyong Na and Kim, {Seung Up} and Kim, {Beom Kyung} and Park, {Jun Yong} and Nahm, {Ji Hae} and Lee, {Jung Il} and Kim, {Do Young} and Ahn, {Sang Hoon} and Han, {Kwang Hyub} and Park, {Young Nyun}",
year = "2019",
month = "12",
day = "1",
doi = "10.1038/s41598-019-51638-3",
language = "English",
volume = "9",
journal = "Scientific Reports",
issn = "2045-2322",
publisher = "Nature Publishing Group",
number = "1",

}

Predictive validation of qualitative fibrosis staging in patients with chronic hepatitis B on antiviral therapy. / Lee, Hye Won; Na, Kiyong; Kim, Seung Up; Kim, Beom Kyung; Park, Jun Yong; Nahm, Ji Hae; Lee, Jung Il; Kim, Do Young; Ahn, Sang Hoon; Han, Kwang Hyub; Park, Young Nyun.

In: Scientific reports, Vol. 9, No. 1, 15628, 01.12.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Predictive validation of qualitative fibrosis staging in patients with chronic hepatitis B on antiviral therapy

AU - Lee, Hye Won

AU - Na, Kiyong

AU - Kim, Seung Up

AU - Kim, Beom Kyung

AU - Park, Jun Yong

AU - Nahm, Ji Hae

AU - Lee, Jung Il

AU - Kim, Do Young

AU - Ahn, Sang Hoon

AU - Han, Kwang Hyub

AU - Park, Young Nyun

PY - 2019/12/1

Y1 - 2019/12/1

N2 - The fibrosis in chronic hepatitis shows dynamic changes during antiviral therapy (AVT). We investigated whether P-I-R (progressive vs. indeterminate vs. regressive) staging is predictive of hepatocellular carcinoma (HCC) recurrence in patients with chronic hepatitis B (CHB) taking AVT who underwent resection. Patients with CHB-related HCC who underwent curative resection between 2004 and 2017 and had received ≥2 years AVT at the time of resection were eligible. Two pathologists performed P-I-R staging. In total, 104 patients with CHB-related HCC were enrolled. The mean age of the study population was 56.3 years. The mean duration of AVT at the time of resection was 62.6 months. During the follow-up period (mean, 45.5 months), 20 (19.2%) and 14 (13.5%) patients developed early and late recurrence of HCC, respectively. The cumulative incidence of late recurrence was significantly lower in patients with regressive patterns than in those with indeterminate and progressive patterns according to P-I-R staging (P = 0.015, log-rank test), although the cumulative incidence of overall recurrence according to P-I-R staging was similar. Hepatitis B virus DNA levels (hazard ratio [HR] = 3.200, P = 0.020) and the regressive P-I-R staging pattern (HR = 0.127, P = 0.047) independently predicted the risk of late recurrence. One-time assessment of the P-I-R staging at the time of curative resection in patients with CHB-related HCC receiving AVT independently predicted late HCC recurrence. Therefore, qualitative fibrosis assessment by P-I-R staging might be useful in predicting the outcomes of patients with CHB undergoing AVT.

AB - The fibrosis in chronic hepatitis shows dynamic changes during antiviral therapy (AVT). We investigated whether P-I-R (progressive vs. indeterminate vs. regressive) staging is predictive of hepatocellular carcinoma (HCC) recurrence in patients with chronic hepatitis B (CHB) taking AVT who underwent resection. Patients with CHB-related HCC who underwent curative resection between 2004 and 2017 and had received ≥2 years AVT at the time of resection were eligible. Two pathologists performed P-I-R staging. In total, 104 patients with CHB-related HCC were enrolled. The mean age of the study population was 56.3 years. The mean duration of AVT at the time of resection was 62.6 months. During the follow-up period (mean, 45.5 months), 20 (19.2%) and 14 (13.5%) patients developed early and late recurrence of HCC, respectively. The cumulative incidence of late recurrence was significantly lower in patients with regressive patterns than in those with indeterminate and progressive patterns according to P-I-R staging (P = 0.015, log-rank test), although the cumulative incidence of overall recurrence according to P-I-R staging was similar. Hepatitis B virus DNA levels (hazard ratio [HR] = 3.200, P = 0.020) and the regressive P-I-R staging pattern (HR = 0.127, P = 0.047) independently predicted the risk of late recurrence. One-time assessment of the P-I-R staging at the time of curative resection in patients with CHB-related HCC receiving AVT independently predicted late HCC recurrence. Therefore, qualitative fibrosis assessment by P-I-R staging might be useful in predicting the outcomes of patients with CHB undergoing AVT.

UR - http://www.scopus.com/inward/record.url?scp=85074233050&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074233050&partnerID=8YFLogxK

U2 - 10.1038/s41598-019-51638-3

DO - 10.1038/s41598-019-51638-3

M3 - Article

C2 - 31666552

AN - SCOPUS:85074233050

VL - 9

JO - Scientific Reports

JF - Scientific Reports

SN - 2045-2322

IS - 1

M1 - 15628

ER -