Magnetic resonance elastography for the prediction of hepatocellular carcinoma in chronic hepatitis B

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY

JGH Open Pub Date : 2024-04-25 DOI:10.1002/jgh3.13067

Nobuharu Tamaki, Mayu Higuchi, Taisei Keitoku, Yudai Yamazaki, Naoki Uchihara, Keito Suzuki, Yuki Tanaka, Haruka Miyamoto, Michiko Yamada, Risa Okada, Kenta Takaura, Shohei Tanaka, Chiaki Maeyashiki, Yutaka Yasui, Kaoru Tsuchiya, Hiroyuki Nakanishi, Tatsuya Kanto, Masayuki Kurosaki, Namiki Izumi

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Abstract

Background and Aim

Magnetic resonance elastography (MRE) is used for the evaluation of liver fibrosis; however, it remains unclear whether MRE-based liver stiffness is associated with hepatocellular carcinoma (HCC) development, particularly in patients with chronic hepatitis B.

Methods

A total of 504 patients with chronic hepatitis B receiving MRE were enrolled. The primary endpoint was the association between MRE-based liver stiffness and HCC.

Results

In a cross-sectional analysis at the time of MRE measurement, the median (interquartile range) liver stiffness values in patients with presence or history of HCC and those without HCC were 3.68 (2.89–4.96) and 2.60 (2.22–3.45) kPa, respectively, and liver stiffness was significantly higher in patients with presence or history of HCC than in those without HCC (P < 0.001). In a longitudinal analysis of patients without HCC, the 1-, 3-, and 5-year cumulative incidence of HCC in patients with liver stiffness ≥3.6 kPa and those with liver stiffness <3.6 kPa were 3.8%, 7.0%, and 22.9%, and 0%, 0.9%, and 1.5%, respectively (P < 0.001). In the multivariable analysis, MRE-based liver stiffness (per 1 kPa) or liver stiffness ≥3.6 kPa was an independent factor for HCC development with an adjusted hazard ratio (aHR) of 1.61 (95% confidence interval [CI], 1.3–2.0) or aHR of 8.22 (95% CI, 2.1–31).

Conclusion

MRE-based liver stiffness is associated with HCC risk in patients with chronic hepatitis B and may be used for the early prediction of HCC development and determination of indications for treatment.

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用于预测慢性乙型肝炎肝细胞癌的磁共振弹性成像技术

背景和目的磁共振弹性成像（MRE）用于评估肝纤维化；但是，基于 MRE 的肝脏硬度是否与肝细胞癌（HCC）的发展有关，尤其是在慢性乙型肝炎患者中，目前仍不清楚。方法共招募了 504 名接受 MRE 的慢性乙型肝炎患者。主要终点是基于 MRE 的肝脏硬度与 HCC 之间的关系。结果在 MRE 测量时的横断面分析中，存在或有 HCC 病史的患者和无 HCC 患者的肝脏僵硬度中值（四分位数间距）分别为 3.68（2.89-4.96）和 2.60（2.22-3.45）kPa，存在或有 HCC 病史的患者的肝脏僵硬度明显高于无 HCC 患者（P <0.001）。在对无 HCC 患者的纵向分析中，肝硬度≥3.6 kPa 和肝硬度 <3.6 kPa 患者的 HCC 1 年、3 年和 5 年累积发病率分别为 3.8%、7.0% 和 22.9%，以及 0%、0.9% 和 1.5%（P <0.001）。在多变量分析中，基于 MRE 的肝脏僵硬度（每 1 kPa）或肝脏僵硬度≥3.6 kPa 是 HCC 发生的独立因素，调整后危险比 (aHR) 为 1.61（95% 置信区间 [CI]，1.3-2.0）或 aHR 为 8.22（95% CI，2.1-31）。结论基于 MRE 的肝脏硬度与慢性乙型肝炎患者的 HCC 风险相关，可用于早期预测 HCC 的发展并确定治疗适应症。

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

JGH Open GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

3.40

自引率

0.00%

发文量

143

审稿时长

7 weeks