Validation of D2AS model for prediction of early hepatitis B virus-related hepatocellular carcinoma

Objective To validate the predictive value of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) risk score model D2AS in chronic HBV infection patients without antiviral therapy. Methods A total of 93 patients with chronic HBV infection were selected between January 2015 and July 2017 in the Third Affiliated Hospital of Hebei Medical University. Clinical data including age, gender, medical history, ultrasonography, hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), hepatitis B e antigen (HBeAg), hepatitis B e antibody (anti-HBe), hepatitis B core antibody (anti-HBc), HBV DNA and alanine aminotransferase levels were collected by information center. REACH-B score and D2AS score were used to predict the risk of HCC. Receiver operating characteristic curve (ROC) was used to evaluate the discrimination, and Hosmer-Lemeshow (H-L) goodness-of-fit test was used to evaluate the calibration of the model. Results REACH-B score and D2AS score for the 95 chronic HBV infection patients were 9 (8, 12) and 0.95 (0.57, 2.08), respectively. The area under the curve (AUC) for REACH-B score and D2AS score were 0.916 (95% confidence interval [CI] 0.834-0.998) and 0.784 (95%CI 0.587-0.981), respectively. The difference was not statistically significant (P=0.195). However, for HBeAg-negative patients with chronic HBV infection, the AUC for D2AS score and REACH-B score were 0.952 (95%CI 0.876-1.000) and 0.913 (95%CI 0.821-1.000), respectively (P=0.458). The H-L goodness-of-fit test was P>0.05. Conclusions The D2AS score can be used for HCC prediction among patients who do not meet antiviral criteria. The predictive value of the D2AS score for HCC is comparable to the REACH-B score in HBeAg-negative patients with chronic HBV infection. Key words: Carcinoma, hepatocellular; Hepatitis B; Prediction model