Yuen et al reported scores for predicting the risk of hepatocellular carcinoma in a patient with chronic hepatitis B. One score can be used when core promoter mutation testing is not 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) cirrhosis
Parameter
Finding
Points
sex
male
14
female
0
age in years
(age)
HBV DNA levels
3 * LOG10(copies)
cirrhosis
no
0
yes
33
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: around 186 (depends on age and DNA levels)
• A score > 100 is associated with an increasing risk for hepatocellular carcinoma at 5 years.
• A score > 82 is associated with an increasing risk for hepatocellular carcinoma at 10 years.
Performance:
• The area under the ROC curve is 0.87 for the 5-year risk prediction.
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