Simple Scoring System Can Help Identify Patients with Cirrhosis at Low or High Risk for Hepatocellular Carcinoma
Simple Scoring System Can Help Identify Patients with Cirrhosis at Low or High
Risk for Hepatocellular Carcinoma
Increased knowledge of the risk factors associated with the appearance of
hepatocellular carcinoma (HCC) could improve the efficacy of surveillance
programs. In the March issue of Hepatology, R F Velázquez and colleagues
describe the development of a simple scoring system that can help detect early
signs of HCC.
A total of 463 patients aged 40 to 65 years with liver cirrhosis in Child-Pugh
class A or B were included in a program of early diagnosis. The predictive value
of different risk factors was evaluated using the Kaplan-Meier method and Cox
regression model.
Thirty-eight patients developed HCC. In the multivariate analysis, 4 variables
showed an independent predictive value for the development of HCC: age 55 years
or older, antibody to hepatitis C virus (anti-HCV) positivity, prothrombin
activity 75% or less, and platelet count less than 75 × 103/mm3.
According to the contribution of each of these factors to the final model, a
score ranging between 0 and 4.71 points was constructed to allow the division of
patients into 2 different risk groups.
The low-risk group included those with a score of 2.33 points or less (n = 270;
4 with HCC; cumulative incidence of HCC at 4 years, 2.3%), and the high-risk
group included those with a score greater than 2.33 (n = 193; 34 with HCC;
cumulative incidence of HCC at 4 years, 30.1%).
In conclusion, a simple score made up of 4 clinical and biological variables
allowed the investigators to distinguish 2 groups of cirrhotic patients at high
and low risk for the development of HCC. They believe this score can be useful
in establishing a subset of cirrhotic patients in whom a surveillance program
for early detection of HCC could be unjustified.
04/14/03
Reference
R F Velázquez and others. Prospective analysis of risk factors for
hepatocellular carcinoma in patients with liver cirrhosis. Hepatology 37:3;
520-527. March 2003.
http://www.hivandhepatitis.com/hep_c/news/041403a.html
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