Wong et al reported a model for predicting hepatocellular carcinoma in a patient with chronic hepatitis B. This can identify a patient who may benefit from more aggressive management. The authors are from the Chinese University of Hong Kong, Hong Kong Cancer Institute and Prince of Wales Hospital in Hong Kong.
Patient selection: chronic hepatitis B (HBV)
Parameters:
(1) age in years
(2) serum albumin in g/L
(3) serum total bilirubin in µmol/L
(4) HBV DNA as LOG10(copies/mL)
(5) cirrhosis
Parameter
Finding
Points
age in years
<= 50 years
0
> 50 years
3
serum albumin
> 35 g/L
0
<= 35 g/L
20
serum total bilirubin
<= 18 µmol/L
0
> 18 µmol/L
1.5
LOG10(HBV copies/mL)
<= 4
0
4 to 6
1
> 6
4
cirrhosis
no
0
yes
15
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 43.5 (paper states 44.5)
• The higher the score the greater the risk of hepatocellular carcinoma.
Total Score
Risk Group
5-Year Risk of HCC
< 5
low
2.2%
5 to 19
intermediate
14.5%
>= 20
high
29.4%
Performance:
• The area under the ROC curve is 0.76.
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