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A male-ABCD algorithm for hepatocellular carcinoma risk prediction in hbs ag carriers

Chinese Journal of Cancer Research 2021年第3期33卷 352-363页

作者： Yuting Wang Minjie Wang He Li Kun Chen Hongmei Zeng Xinyu Bi Zheng Zhu Yuchen Jiao Yong Wang Jian Zhu Hui Zhao Xiang Liu Chunyun Dai Chunsun Fan Can Zhao Deyin Guo Hong Zhao Jianguo Zhou Dongmei Wang Zhiyuan Wu Xinming Zhao Wei Cui Xuehong Zhang Jianqiang Cai Wanqing Chen Chunfeng Qu State Key Lab of Molecular Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Clinical Laboratory National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China National Central Cancer Registry National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Hepatobiliary Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Diagnostic Radiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Ultrasonography National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Qidong Liver Cancer Institute&Qidong People’s Hospital Qidong 226200China Lingbi Center for Disease Control and Prevention Suzhou 234200China Mengcheng Center for Disease Control and Prevention Bozhou 233500China Sheyang Center for Disease Control and Prevention Yancheng 224300China Shenqiu County Center for Disease Control and Prevention Zhoukou 411624China Dancheng Center for Disease Control and Prevention Zhoukou 477150China Channing Division of Network Medicine Department of MedicineBrigham and Womens Hospital and Harvard Medical SchoolBostonMA 02115USA Department of Nutrition T

Objective: Hepatocellular carcinoma(HCC) development among hepatitis B surface antigen(hbs ag) carriers shows gender disparity, influenced by underlying liver diseases that display variations in laboratory tests. We aimed to construct a risk-stratified HCC prediction model for hbs ag-positive male ***: hbs ag-positive males of 35-69 years old(N=6,153) were included from a multi-center populationbased liver cancer screening study. Randomly, three centers were set as training, the other three centers as validation. Within 2 years since initiation, we administrated at least two rounds of HCC screening using Bultrasonography and α-fetoprotein(AFP). We used logistic regression models to determine potential risk factors,built and examined the operating characteristics of a point-based algorithm for HCC risk ***: With 2 years of follow-up, 302 HCC cases were diagnosed. A male-ABCD algorithm was constructed including participant's age, blood levels of GGT(γ-glutamyl-transpeptidase), counts of platelets, white cells,concentration of DCP(des-γ-carboxy-prothrombin) and AFP, with scores ranging from 0 to 18.3. The area under receiver operating characteristic was 0.91(0.90-0.93), larger than existing models. At 1.5 points of risk score,26.10% of the participants in training cohort and 14.94% in validation cohort were recognized at low risk, with sensitivity of identifying HCC remained 100%. At 2.5 points, 46.51% of the participants in training cohort and 33.68% in validation cohort were recognized at low risk with 99.06% and 97.78% of sensitivity, respectively. At 4.5 points, only 20.86% of participants in training cohort and 23.73% in validation cohort were recognized at high risk,with positive prediction value of 22.85% and 12.35%, ***: Male-ABCD algorithm identified individual's risk for HCC occurrence within short term for their HCC precision surveillance.

关键词： Hepatocellular carcinoma asymptotic hbs ag carriers risk prediction model screening laboratory tests

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