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Five‐year on‐treatment variables‐based PPACS model predicts subsequent hepatocellular carcinoma in entecavir/tenofovir‐treated patients

医学 恩替卡韦 肝细胞癌 肝硬化 内科学 胃肠病学 回顾性队列研究 肿瘤科 临床终点 置信区间 乙型肝炎 慢性肝炎 临床试验 免疫学 病毒 拉米夫定
作者
Yeonjung Ha,Ji Hyae Lim,Young Eun Chon,Mi Na Kim,Joo Ho Lee,Kang Mo Kim,Ju Hyun Shim,Danbi Lee,Seong Gyu Hwang,Seungbong Han,Han Chu Lee
出处
期刊:International Journal of Cancer [Wiley]
卷期号:153 (12): 2045-2054 被引量:2
标识
DOI:10.1002/ijc.34704
摘要

Abstract Considering the lower risk of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients receiving long‐term potent antiviral therapy, models predicting HCC after 5 years of therapy are needed. We conducted a multicenter retrospective cohort study to construct and validate a model predicting HCC after 5 years of entecavir (ETV) or tenofovir (TFV) therapy for CHB. The endpoint was HCC after 5 years of ETV/TFV therapy. Information on age, sex, liver cirrhosis (assessed by diagnosis code and confirmed by clinical findings) and type of antiviral agent was obtained at baseline (initiation of ETV/TFV). Laboratory values were collected at baseline and 5 years. Risk factors for HCC were identified in the training set and the final prediction model was validated using the test set. Among 7542 patients, 345 (4.6%) developed HCC after 5 years of ETV/TFV therapy. HCC risk after 5 years of ETV/TFV therapy was increased by 4‐fold in patients with liver cirrhosis than in those without cirrhosis at baseline. Furthermore, P latelet counts and P rothrombin time at 5 years, A ge at baseline and S ex were associated with risk of HCC and were incorporated into a prediction model, PPACS. PPACS showed a good performance with a time‐dependent area under the curve of 0.80 (95% confidence interval, 0.75‐0.85) at 8‐year of ETV/TFV therapy, a Brier score of 0.031 and an integrated Brier score of 0.006 in the test set. In conclusion, the PPACS model provides a reliable assessment of HCC risk after 5 years of ETV/TFV therapy ( https://ppacs.shinyapps.io/shiny_app_up/ ).
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