Yang et al developed a number of nomograms for predicting the risk of hepatocellular carcinoma (HCC) occurring in a patient with chronic viral hepatitis B. These can help to identify a patient who may benefit from closer monitoring over time. The authors are from National Taiwan University, Chang Gung University, Toronto General Hospital and Bristol Myers Squibb.
Patient selection: adults from 30 to 65 years of age with chronic HBV from Taiwan
Parameters:
(1) age
(2) gender
(3) family history of hepatocellular carcinoma
(4) alcohol intake (drinking alcohol at least 4 times per week for at least 1 year)
(5) serum ALT in IU/L (reference range and method not specified)
(6) HBeAg
|
Parameter |
Finding |
Points |
|
age |
30 to 34 years |
0 |
|
|
35 to 39 years |
1 |
|
|
40 to 44 years |
2 |
|
|
45 to 49 years |
3 |
|
|
50 to 54 years |
4 |
|
|
55 to 59 years |
5 |
|
|
60 to 65 years |
6 |
|
gender |
female |
0 |
|
|
male |
2 |
|
family history of HCC |
no |
0 |
|
|
yes |
2 |
|
regular alcohol intake |
no |
0 |
|
|
yes |
1 |
|
serum ALT |
< 15 IU/L |
0 |
|
|
15 to 44 IU/L |
1 |
|
|
>= 45 IU/L |
3 |
|
HBeAg |
absent |
0 |
|
|
present |
3 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 17
• The higher the score the greater the risk of the patient developing hepatocellular carcinoma.
|
Total Score |
5 Year Risk |
10 Year Risk |
|
0 |
0.032% |
0.092% |
|
1 |
0.05% |
0.13% |
|
2 |
0.10% |
0.23% |
|
3 |
0.14% |
0.40% |
|
4 |
0.24% |
0.70% |
|
5 |
0.40% |
1% |
|
6 |
0.70% |
2% |
|
7 |
1.1% |
3% |
|
8 |
2% |
5.2% |
|
9 |
3% |
8% |
|
10 |
5% |
11% |
|
11 |
8% |
20% |
|
12 |
12% |
33% |
|
13 |
22% |
50% |
|
14 |
31% |
70% |
|
15 |
50% |
90% |
|
16 |
70% |
100% |
|
17 |
90% |
100% |
Purpose: To predict the risk of an adult in Taiwan with chronic hepatitis B developing hepatocellular carcinoma based on Model A of Yang et al.
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
Objective: risk factors, selection
ICD-10: C22.0,
