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Development of Risk Prediction Model for Hepatocellular Carcinoma Progression of Indeterminate Nodules in Hepatitis B Virus-Related Cirrhotic Liver

Cho, HJ  | Kim, B  | Lee, JD | Kang, DR  | Kim, JK  | Lee, JH  | Shin, SJ  | Lee, KM  | Yoo, BM  | Lee, KJ  | Kim, SS  | Cheong, JY  | Cho, SW
The American journal of gastroenterology, 112(3). : 460-470, 2017
Journal Title
The American journal of gastroenterology
OBJECTIVES: This study was performed to evaluate long-term outcome of indeterminate nodules detected on cirrhotic liver and to develop risk prediction model for hepatocellular carcinoma (HCC) progression of indeterminate nodules on hepatitis B virus (HBV)-related cirrhotic liver.
METHODS: Indeterminate nodules up to 2 cm with uncertain malignant potential detected on computed tomography of cirrhotic liver during HCC surveillance were analyzed retrospectively. HCC risk prediction model of indeterminate nodules in HBV-related cirrhotic liver was deduced based on result of Cox regression analysis.
RESULTS: A total of 494 indeterminate nodules were included. Independent risk factors of HCC progression were old age, arterial enhancement, large nodule size, low serum albumin level, high serum alpha-fetoprotein (AFP) level, and prior HCC history in all included subjects. In subjects with chronic hepatitis B, old age (year: hazard ratio (HR)=1.06: P<0.001), arterial enhancement (HR=2.62: P=0.005), large nodule size (>1 cm: HR=7.34: P<0.001), low serum albumin level (/=100 ng/ml: HR=6.04: P=0.006), prior HCC history (HR=4.24: P=0.001), and baseline hepatitis B e antigen positivity (HR=2.31: P=0.007) were associated with HCC progression. We developed a simple risk prediction model using these risk factors and identified patients at low, intermediate, and high risk for HCC: 5-year cumulative incidences were 1%, 14.5%, and 63.1%, respectively. The developed risk score model showed good performance with area under the curve at 0.886 at 3 years, and 0.920 at 5 years in leave-one-out cross-validation.
CONCLUSIONS: We developed a useful and accurate risk score model for predicting HCC progression of indeterminate nodules detected on HBV-related cirrhotic liver.

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Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Medical Humanities & Social Medicine
Ajou Authors
강, 대용  |  김, 보현  |  김, 순선  |  김, 재근  |  신, 성재  |  유, 병무  |  이, 광재  |  이, 기명  |  이, 제희  |  정, 재연  |  조, 성원  |  조, 효정
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