Validation of the PAGE-B score to predict hepatocellular carcinoma risk in caucasian chronic hepatitis B patients on treatment  

作　　者：Pinar Gokcen Fatih Guzelbulut Gupse Adali Ayca Gokce Degirmenci Salturk Oguzhan Ozturk Ozgur Bahadir Emine Kanatsiz Mevlut Kiyak Kamil Ozdil Hamdi Levent Doganay 

机构地区：[1]Department of Gastroenterology,Health Sciences University,Umraniye Teaching and Research Hospital,Istanbul 34764,Turkey [2]Department of Gastroenterology,Health Sciences University,Haydarpasa Numune Teaching and Research Hospital,Istanbul 34668,Turkey

出　　处：《World Journal of Gastroenterology》2022年第6期665-674,共10页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Several risk scores have been developed to predict hepatocellular carcinoma(HCC)risk in chronic hepatitis B(CHB)patients.The majority of risk scores are based on pretreatment variables that are no longer considered risk factors for HCC development due to the suppression of hepatitis B virus replication early in the course of potent antiviral treatment in most patients.The PAGE-B score,which is based on platelet levels,age and sex,has been shown to accurately predict HCC risk in CHB patients on antiviral treatment in various populations.AIM We aimed to evaluate the PAGE-B score in predicting HCC risk in Turkish CHB patients on antiviral treatment.METHODS In this study,we recruited 742 CHB patients who had been treated with tenofovir disoproxil fumarate or entecavir for≥1 year.Risk groups were determined according to the PAGE-B scores as follows:≤9,low;10-17,moderate and≥18,high.The cumulative HCC incidences in each risk group were computed using Kaplan-Meier analysis and were compared using the log-rank test.The accuracy of the PAGE-B score in predicting HCC risk was evaluated using a timedependent area under the receiver operating characteristic(AUROC)curve at all study time points.Univariate and multivariate logistic regression analyses were used to assess the risk factors for HCC development.RESULTS The mean follow-up time was 54.7±1.2 mo.HCC was diagnosed in 26 patients(3.5%).The cumulative HCC incidences at 1,3,5 and 10 years were 0%,0%,0%and 0.4%in the PAGE-B low-risk group;0%,1.2%,1.5%and 2.1%in the PAGE-B moderate-risk group;and 5%,11.7%,12.5%,and 15%in the PAGE-B high-risk group,respectively(log-rank P<0.001).The AUROCs of the PAGE-B score in the prediction of HCC development at 1,3,5 and 10 years were 0.977,0.903,0.903 and 0.865,respectively.In the multivariable analysis,older age,male sex,lower platelet levels,presence of cirrhosis,and absence of alanine aminotransferase normalization at month 6 were associated with HCC development(all P<0.05).CONCLUSION The PAGE-B score is a practical

关 键 词：Chronic hepatitis B Hepatocellular carcinoma PAGE-B score Surveillance 

分 类 号：R512.62[医药卫生—内科学] R735.7[医药卫生—临床医学]