Yuen et al reported scores for predicting the risk of hepatocellular carcinoma in a patient with chronic hepatitis B. One score utilizes core promoter mutation testing, which may not be readily available. The authors are from the University of Hong Kong, Nagoya City University and Queen Mary Hospital in Hong Kong.
GAG-HCC is deived from Guide (G) with Age (A), Gender (G), HBV DNA (H), Core promoter mutations (C) and Cirrhosis (C).
Patient selection: chronic hepatitis B
Parameters:
(1) sex
(2) age in years
(3) LOG10(HBV copies per mL in blood)
(4) core promoter mutation (A1762T/G1764A)
(5) cirrhosis
Parameter
Finding
Points
sex
male
16
female
0
age in years
(age)
HBV DNA levels
3 * LOG10(copies)
core promoter mutation
no (wild type)
0
yes
19
cirrhosis
no
0
yes
30
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: around 186 (depends on age and DNA levels)
• A score > 101 is associated with an increasing risk for hepatocellular carcinoma at 5 and 10 years.
Performance:
• The area under the ROC curve is 0.88 for the 5-year risk prediction.
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