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Individualized surveillance of chronic hepatitis B patients according to hepatocellular carcinoma risk based on PAGE-B scores

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Abstract
Background and aims Current guidelines for chronic hepatitis B (CHB) patients are to undergo surveillance for
hepatocellular carcinoma (HCC) with 6-month ultrasonography. We aimed to compare detection rates of very-early-stage
HCC in two groups: group A, undergoing 6-month ultrasonography versus group B, undergoing 6-month ultrasonography
alternating with dynamic computed tomography (CT).
Methods This retrospective study assessed 2151 CHB patients under entecavir/tenofovir therapy from 2007 to 2016.
Detection rates of very-early-stage HCC were compared between groups A/B at intermediate/high risk based on platelets,
age, gender-hepatitis B scores. The primary endpoint was the proportion of patients in each group with very-early-stage HCC.
Cox proportional hazards model was used to assess the effect of surveillance modalities to detect very-early-stage HCC.
Results Five-year cumulative HCC incidence rates in group A were 15.0% not significantly different from 18.2% in group B at
high risk (P= 0.17). Detection rates of very-early-stage HCC were significantly higher in group B than in group A (P< 0.001),
and surveillance using CT alternating with ultrasonography was significantly associated with detection of very-early-stage
HCC (hazard ratio 3.89, P < 0.001). Among intermediate-risk patients, difference between detection rates of very-early-stage
HCC in groups A and B was not significant (P = 0.30), and surveillance using CT alternating with ultrasonography was not
significantly associated with detection of very-early-stage HCC (hazard ratio 1.61, P= 0.23).
Conclusion In high-risk CHB patients, surveillance using CT alternating with ultrasonography led to higher detection rates of
very-early-stage HCC compared to surveillance using ultrasonography.
Author(s)
Kim JHKang SHLee MJChoi HSJun BGKim TSChoi DHSuk KTKim MY김영돈천갑진Baik SKKim DJ
Issued Date
2021
Type
Article
Keyword
surveillancehepatocellular carcinomaPAGE-B score
DOI
10.1097/MEG.0000000000001870
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7250
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2435185449&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Individualized%20surveillance%20of%20chronic%20hepatitis%20B%20patients%20according%20to%20hepatocellular%20carcinoma%20risk%20based%20on%20PAGE-B%20scores&amp;offset=0&amp;pcAvailability=true
Publisher
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
Location
영국
Language
영어
ISSN
0954-691X
Citation Volume
33
Citation Number
12
Citation Start Page
1564
Citation End Page
1572
Appears in Collections:
Medicine > Medicine
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