Simple Scoring System for Esophagogastric Varices Prediction in Hepatocellular Carcinoma Patients without Liver Stiffness Evaluation.

IF 2.5 3区医学 Q3 ONCOLOGY Oncology Pub Date : 2024-01-01 Epub Date: 2023-10-11 DOI:10.1159/000533672

Atsushi Hiraoka, Fujimasa Tada, Hideko Ohama, Mai Fukumoto, Kana Matsuoka, Takuya Matsuda, Kosuke Nakatani, Emi Yanagihara, Hironobu Saneto, Hirofumi Izumoto, Taisei Murakami, Kei Onishi, Shogo Kitahata, Kozue Kanemitsu-Okada, Tomoe Kawamura, Taira Kuroda, Hideki Miyata, Eiji Tsubouchi, Masashi Hirooka, Masanori Abe, Bunzo Matsuura, Tomoyuki Ninomiya, Yoichi Hiasa

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Abstract

Introduction: For predicting esophagogastric varices (EGVs), the Virtual Baveno VII Consensus Workshop has proposed a combination of liver stiffness determination and platelet count measurement using a FibroScan®. However, FibroScan® is not available at all institutions. The present study aimed to develop a simple method to predict development of EGV using only general blood examination results.

Materials and methods: A total of 1,090 hepatocellular carcinoma patients were enrolled, after excluding 956 with major portal vein tumor thrombus (Vp3/Vp4) or without upper gastrointestinal endoscopy examination results available. Those with EGV (≥ grade F2) or a history of treatment for the condition were defined as positive for significant EGV, and then clinical factors were retrospectively evaluated to determine indicators of occurrence.

Results: Logistic multivariate analysis showed platelet count (≤12 × 104/μL) (odds ratio [OR] 3.79, p < 0.001), mALBI grade 2a (OR 1.52, p = 0.036), and mALBI 2b or 3 (OR 3.46, p < 0.001) as significant predictive factors. Based on the OR values, platelet count (≤12 × 104/μL) and mALBI grade 2b/3 were each assigned 2 points and mALBI 2a was given 1 point, with the result termed recommendation for EGV screening (REGS) score. Significant EGV occurrence was noted in 2.9% (9/311) of the patients with a REGS score 0, 11.0% (13/118) with a score 1, 19.3% (53/274) with a score 2, 29.5% (39/132) with a score 3, and 38.0% (97/255) with a score 4 (p < 0.001).

Conclusion: The findings indicate that REGS score can provide useful predictive information for development of significant EGV without the need for special equipment such as a FibroScan®.

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无肝硬度评估的肝细胞癌患者食管胃底静脉曲张预测的简单评分系统。

背景/目的：为了预测食管胃底静脉曲张（EGV），虚拟Baveno VII共识研讨会提出了使用FibroScan®将肝硬度测定和血小板计数测量相结合。然而，并非所有机构都能做到这一点。本研究旨在开发一种简单的方法，仅使用一般血液检查结果来预测EGV的发展。材料/方法：共纳入1090名肝细胞癌（HCC）患者，排除956名患有严重门静脉瘤栓（Vp3/Vp4）或没有上消化道内窥镜检查结果的患者。那些患有EGV（≥F2级）或有该疾病治疗史的患者被定义为显著EGV阳性，然后回顾性评估临床因素以确定发生指标。结果：Logistic多变量分析显示血小板计数（≤12 x104/μL）[比值比（OR）3.79，P结论：研究结果表明，REGS评分可以在不需要FibroScan®等特殊设备的情况下为显著EGV的发展提供有用的预测信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncology 医学-肿瘤学

CiteScore

6.00

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.