[aMAP评分预测慢性乙型肝炎抗病毒治疗患者肝细胞癌发生的应用价值]。

Q3 Medicine
Y F Gao, Z Z Liu, L Y Ma, Y X Liu, C Y Zhao
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引用次数: 0

摘要

目的:评价aMAP评分对接受抗病毒治疗的慢性乙型肝炎(CHB)患者肝细胞癌(HCC)发生风险的预测价值。方法:回顾性分析2001年1月至2021年11月在河北医科大学第三医院和石家庄第五医院开始抗病毒治疗的508例慢性乙型肝炎患者的病历。根据aMAP、AASL-HCC、PAGE-B、PAGE-B和CAMD评分标准将患者分为低、中、高风险组。随访结束时根据是否发生HCC分为HCC组(33例)和非HCC组(475例)。采用单因素和多因素Cox回归分析肝癌发生的危险因素。不同时间点HCC的累积发病率采用Kaplan-Meier法估算,log-rank法比较。采用受试者工作特征(ROC)曲线评价aMAP评分对HCC的预测效果,并与其他评分进行比较。采用Mann-Whitney U检验或Fisher检验比较组间非正态分布的定量数据。组间计数资料比较采用χ2检验。结果:在中位随访8.7年(6.8-8.9年)期间,共有33例(6.5%)发生HCC。多因素分析显示,患者年龄在50 ~ 50岁之间(HR=2.804, 95%CI 1.332 ~ 5.902;P=0.007)和肝硬化(HR=11.808, 95%CI 4.360 ~ 31.976;3年HCC预测效果PPP>0.05;并且PAGE-B评分同样优越(AUC为0.732),在5年HCC预测性能方面,PP为0.05;但明显优于PAGE-B评分和PAGE-B评分(AUC分别为0.795和0.875),p < 0.05。结论:aMAP评分可以准确评估接受抗病毒治疗的CHB患者发生HCC的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Application value of an aMAP score in predicting the occurrence of hepatocellular carcinoma in patients with chronic hepatitis B receiving antiviral therapy].

Objective: To evaluate the predictive value of an aMAP score for the occurrence risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) receiving antiviral therapy. Methods: The medical records of 508 CHB patients who started receiving antiviral treatment in the Third Hospital of Hebei Medical University and the Fifth Hospital of Shijiazhuang from January 2001 to November 2021 were retrospectively analyzed. They were divided into low-, intermediate-, and high-risk groups according to the aMAP, AASL-HCC, PAGE-B, mPAGE-B, and CAMD scoring criteria. At the end of follow-up, they were divided into HCC (33 cases) and non-HCC group (475 cases) according to whether HCC occurred. The occurrence risk factors for HCC were analyzed by univariate and multivariate Cox regression analysis. The cumulative incidence of HCC at different time points was estimated by the Kaplan-Meier method and compared by the log-rank method. The HCC prediction performance of the aMAP score was evaluated by the receiver operating characteristic (ROC) curve and compared with other scores. The Mann-Whitney U test, or Fisher test, was used to compare the non-normally distributed quantitative data between groups. The χ2 test was used to compare the count data between groups. Results: A total of 33 cases (6.5%) developed HCC during the median follow-up period of 8.7 (6.8-8.9) years. Multivariate analysis showed that age>50 years (HR=2.804, 95%CI 1.332-5.902; P=0.007) and liver cirrhosis (HR=11.808, 95%CI 4.360-31.976; P<0.001) were independent risk factors for HCC occurrence. The cumulative incidence of HCC defined by the aMAP score at 3 and 5 years was significantly lower in the low-risk group (0, 0) than that in the intermediate-risk group (4.4%, 5.4%) and the high-risk group (10.8%, 18.5%), P<0.001. The aMAP score performed similarly to the AASL-HCC score, mPAGE-B score, and CAMD score [area under the ROC curve (AUC) was 0.863, 0.900, 0.851, and 0.886, respectively], with P>0.05 in terms of the 3-year HCC prediction performance; and was equally superior with the PAGE-B score (AUC was 0.732), with P<0.05. The aMAP score was not worse than the AASL-HCC score and CAMD score (AUC was 0.890, 0.894, and 0.882, respectively), with P>0.05 in terms of the 5-year HCC prediction performance; however, it was significantly superior to the PAGE-B score and mPAGE-B score (AUC was 0.795 and 0.875, respectively), with P<0.05. In addition, the AUC of the aMAP score for predicting HCC occurrence at baseline, 1 year, 2 years, and 3 years of antiviral treatment was>0.9. Conclusions: The aMAP score can accurately assess the risk of HCC in CHB patients receiving antiviral therapy.

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来源期刊
中华肝脏病杂志
中华肝脏病杂志 Medicine-Medicine (all)
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1.20
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7574
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