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首页> 外文期刊>Hepatology: Official Journal of the American Association for the Study of Liver Diseases >Prediction models of long-term Cirrhosis and hepatocellular carcinoma risk in chronic hepatitis B patients: Risk scores integrating host and virus profiles
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Prediction models of long-term Cirrhosis and hepatocellular carcinoma risk in chronic hepatitis B patients: Risk scores integrating host and virus profiles

机译：慢性乙型肝炎患者长期肝硬化和肝细胞癌风险的预测模型：整合宿主和病毒谱的风险评分

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Integrating host and HBV characteristics, this study aimed to develop models for predicting long-term cirrhosis and hepatocellular carcinoma (HCC) risk in chronic hepatitis B virus (HBV) patients. This analysis included hepatitis B surface antigen (HBsAg)-seropositive and anti-HCV-seronegative participants from the Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer in HBV (R.E.V.E.A.L.-HBV) cohort. Newly developed cirrhosis and HCC were ascertained through regular follow-up ultrasonography, computerized linkage with national health databases, and medical chart reviews. Two-thirds of the participants were allocated for risk model derivation and another one-third for model validation. The risk prediction model included age, gender, HBV e antigen (HBeAg) serostatus, serum levels of HBV DNA, and alanine aminotransferase (ALT), quantitative serum HBsAg levels, and HBV genotypes. Additionally, the family history was included in the prediction model for HCC. Cox's proportional hazards regression coefficients for cirrhosis and HCC predictors were converted into risk scores. The areas under receiver operating curve (AUROCs) were used to evaluate the performance of risk models. Elder age, male, HBeAg, genotype C, and increasing levels of ALT, HBV DNA, and HBsAg were all significantly associated with an increased risk of cirrhosis and HCC. The risk scores estimated from the derivation set could accurately categorize participants with low, medium, and high cirrhosis and HCC risk in the validation set (P<0.001). The AUROCs for predicting 3-year, 5-year, and 10-year cirrhosis risk ranged 0.83-0.86 and 0.79-0.82 for the derivation and validation sets, respectively. The AUROC for predicting 5-year, 10-year, 15-year risk of HCC ranged 0.86-0.89 and 0.84-0.87 in the derivation and validation sets, respectively. Conclusion: The risk prediction models of cirrhosis and HCC by integrating host and HBV profiles have excellent prediction accuracy and discriminatory ability. They may be used for clinical management of chronic hepatitis B patients.
机译：该研究综合了宿主和HBV的特征，旨在建立模型来预测慢性乙型肝炎病毒（HBV）患者的长期肝硬化和肝细胞癌（HCC）风险。该分析包括HBV（R.E.V.E.A.L.-HBV）队列中病毒载量升高和相关肝病/癌症的风险评估中的乙型肝炎表面抗原（HBsAg）血清反应阳性和抗HCV血清阴性参与者。通过定期的后续超声检查，与国家卫生数据库的计算机链接以及病历表检查，确定了新发的肝硬化和肝癌。三分之二的参与者被分配用于风险模型推导，另外三分之一用于模型验证。风险预测模型包括年龄，性别，HBV e抗原（HBeAg）血清状态，HBV DNA血清水平和丙氨酸转氨酶（ALT），血清HBsAg定量水平和HBV基因型。此外，家族史被纳入肝癌的预测模型。肝硬化的Cox比例风险回归系数和HCC预测因子被转换为风险评分。接收者工作曲线下的面积（AUROC）用于评估风险模型的性能。老年人，男性，HBeAg，C基因型以及ALT，HBV DNA和HBsAg水平升高均与肝硬化和HCC风险增加显着相关。从推导集估计的风险评分可以将低，中，高肝硬化和HCC风险的参与者准确地分类到验证集中（P <0.001）。推导和验证集预测的3年，5年和10年肝硬化风险的AUROC分别为0.83-0.86和0.79-0.82。在派生和验证集中，用于预测5年，10年，15年HCC风险的AUROC分别为0.86-0.89和0.84-0.87。结论：通过结合宿主和HBV谱对肝硬化和肝癌的风险预测模型具有出色的预测准确性和判别能力。它们可用于慢性乙型肝炎患者的临床管理。

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