Predictive factors of risk of hepatocellular carcinoma in chronic hepatitis C.
Eur J Intern Med
; 24(8): 846-51, 2013 Dec.
Article
en En
| MEDLINE
| ID: mdl-23849588
ABSTRACT
OBJECTIVE:
To identify risk factors associated with the development of HCC and develop a score to identify high risk subgroups.METHODS:
We conducted a follow-up study, with biannual ultrasound and alpha-fetoprotein screening, in an unselected cohort of patients with chronic hepatitis C referred for evaluation from the primary care.RESULTS:
863 patients with chronic hepatitis C were followed for an average of 82 months. 58 patients have developed HCC (7%). 34 (4%) patients were excluded from analysis due to detection of liver cancer at first evaluation. The demographic and clinical variables collected during the first 6 months of evaluation were analyzed retrospectively. Cox proportional multivariate regression analysis identified four independent factors related with HCC risk; age, alpha-fetoprotein level, gammaglobulin level and platelet count below 150,000/ml. A risk score formula (HCC-4) was constructed which lets us identify patients with low (annual incidence of 0.05%), intermediate (annual incidence of 0.6%) and high (annual incidence 2.6%) risk of HCC development with an area under the curve of 0.802.CONCLUSION:
The application of the score to the cohort let us identify a high-risk subgroup of patients with an annual HCC incidence of 2.6%, in which the screening would be cost-effective.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Alfa-Fetoproteínas
/
Biomarcadores de Tumor
/
Carcinoma Hepatocelular
/
Hepatitis C Crónica
/
Hígado
/
Cirrosis Hepática
/
Neoplasias Hepáticas
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Año:
2013
Tipo del documento:
Article