aMAP risk score predicts hepatocellular carcinoma development in patients with chronic hepatitis

作者：Rong Fan, George Papatheodoridis, Jian Sun, Hamish Innes, Hidenori Toyoda, Qing Xie, Shuyuan Mo, Vana Sypsa, Indra Neil Guha, Takashi Kumada, Junqi Niu, George Ν. Dalekos, Satoshi Yasuda, Eleanor Barnes, Jianqi Lian, Vithika Suri, Ramazan Idılman, Stephen T. Barclay, Xiaoguang Dou, Thomas Berg, Peter Hayes, John F. Flaherty, Yuanping Zhou, Zhengang Zhang, Marı́a Buti, Sharon Hutchinson, Yabing Guo, José Luís Calleja, Lanjia Lin, Longfeng Zhao, Yongpeng Chen, Harry L.A. Janssen, Chaonan Zhu, Lei Shi, Xiaoping Tang, Anuj Gaggar, Lai Wei, Jidong Jia, William L. Irving, Philip J. Johnson, Pietro Lampertico, Jinlin Hou · 发表于：Journal of Hepatology · 年份：2020 · DOI：10.1016/j.jhep.2020.07.025 · 被引用次数：367 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Hepatitis B Virus Studies、Hepatitis C virus research

BACKGROUND & AIMS: Hepatocellular carcinoma (HCC) is the leading cause of death in patients with chronic hepatitis. In this international collaboration, we sought to develop a global universal HCC risk score to predict the HCC development for patients with chronic hepatitis. METHODS: A total of 17,374 patients, comprising 10,578 treated Asian patients with chronic hepatitis B (CHB), 2,510 treated Caucasian patients with CHB, 3,566 treated patients with hepatitis C virus (including 2,489 patients with cirrhosis achieving a sustained virological response) and 720 patients with non-viral hepatitis (NVH) from 11 international prospective observational cohorts or randomised controlled trials, were divided into a training cohort (3,688 Asian patients with CHB) and 9 validation cohorts with different aetiologies and ethnicities (n = 13,686). RESULTS: We developed an HCC risk score, called the aMAP score (ranging from 0 to 100), that involves only age, male, albumin-bilirubin and platelets. This metric performed excellently in assessing HCC risk not only in patients with hepatitis of different aetiologies, but also in those with different ethnicities (C-index: 0.82-0.87). Cut-off values of 50 and 60 were best for discriminating HCC risk. The 3- or 5-year cumulative incidences of HCC were 0-0.8%, 1.5-4.8%, and 8.1-19.9% in the low- (n = 7,413, 43.6%), medium- (n = 6,529, 38.4%), and high-risk (n = 3,044, 17.9%) groups, respectively. The cut-off value of 50 was associated with a sensit...