Individualized HCC surveillance using risk stratification scores in advanced fibrosis and cirrhotic HCV patients who achieved SVR: Prospective study.

IF 6.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Alimentary Pharmacology & Therapeutics Pub Date : 2025-01-01 Epub Date: 2024-09-23 DOI:10.1111/apt.18291
Gamal Shiha, Ayman Hassan, Nasser Mousa, Nada El-Domiaty, Nabiel Mikhail, Reham Gameaa, Abdelrahman Kobtan, Hanan El Bassat, Mohamed Sharaf-Eldin, Imam Waked, Mohamed Eslam, Riham Soliman
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Abstract

Background: Several HCC risk stratification scores were developed; however, none has been prospectively validated. The primary aim is to validate the clinical utility of six HCC risk scores in large prospective study of F3-4 patients achieving SVR following DAAs according to EASL guidelines. The secondary aim is to explore whether individualized risk stratification improves detection of HCC at early stages amenable to curative treatment.

Methods: This prospective study included two cohorts: Egyptian Liver Research Institute and Hospital (ELRIAH) cohort of 463 chronic HCV patients with advanced liver disease (F3 and F4) achieved SVR with a follow-up every 6 months according to EASL guidelines using 6 simple HCC risk scores and Tanta cohort of 492 comparable patients where individualized surveillance intervals were tailored based on HCC risk assessments using GES score as follows: low-risk patients were followed yearly, intermediate-risk every 6 months and high-risk every 2-3 months.

Results: All scores, except Watanabe post, successfully stratified patients into low-, intermediate- and high-risk groups, with log-rank p-value of 0.001 and Harrell's C ranging from 0.669 to 0.728. Clinical utility of these scores revealed that the highest percentage of patients classified as low risk was 42.5% using the GES, while the lowest was 8.9% using the aMAP. ELRIAH cohort, 25 patients developed HCC with 52% diagnosed at BCLC 0 and A. Tanta cohort, 35 patients developed HCC, with 80% diagnosed at BCLC 0 and A.

Conclusion: Individualized risk stratification using HCC risk scores was associated with improved early-stage detection and receipt of curative treatment.

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利用风险分层评分对获得 SVR 的晚期纤维化和肝硬化 HCV 患者进行个体化 HCC 监测:前瞻性研究。
背景:目前已开发出多种 HCC 风险分层评分,但还没有一种评分经过前瞻性验证。本研究的主要目的是在根据 EASL 指南对服用 DAAs 后获得 SVR 的 F3-4 级患者进行的大型前瞻性研究中验证六种 HCC 风险评分的临床实用性。次要目的是探讨个体化风险分层是否能提高在早期阶段检测出适合治疗的 HCC:这项前瞻性研究包括两个队列:埃及肝脏研究所和医院(ELRIAH)队列中的463名晚期肝病(F3和F4)慢性HCV患者已获得SVR,根据EASL指南,采用6种简单的HCC风险评分,每6个月随访一次;坦塔队列中的492名可比患者,根据GES评分进行HCC风险评估,定制个体化监测间隔:低风险患者每年随访一次,中风险患者每6个月随访一次,高风险患者每2-3个月随访一次:结果:除 Watanabe post 外,所有评分都成功地将患者分为低、中、高风险组,对数秩 P 值为 0.001,Harrell's C 为 0.669 至 0.728。这些评分的临床实用性显示,使用 GES 被归类为低风险的患者比例最高,为 42.5%,而使用 aMAP 被归类为低风险的患者比例最低,为 8.9%。在 ELRIAH 队列中,25 名患者发展为 HCC,其中 52% 诊断为 BCLC 0 和 A。在 Tanta 队列中,35 名患者发展为 HCC,其中 80% 诊断为 BCLC 0 和 A:结论:使用 HCC 风险评分进行个体化风险分层有助于提高早期发现率和治愈率。
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来源期刊
CiteScore
15.60
自引率
7.90%
发文量
527
审稿时长
3-6 weeks
期刊介绍: Alimentary Pharmacology & Therapeutics is a global pharmacology journal focused on the impact of drugs on the human gastrointestinal and hepato-biliary systems. It covers a diverse range of topics, often with immediate clinical relevance to its readership.
期刊最新文献
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