Models of Yang et al for Predicting the Risk of Hepatocellular Carcinoma (HCC) in a Patient with Chronic Hepatitis B: Model B

Description

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 status and HBV DNA levels

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	2
serum ALT	< 15 IU/L	0
	15 to 44 IU/L	1
	>= 45 IU/L	2

HBEAg	HBV DNA levels	Points
negative	< 300 copies per mL	0
negative	300 to 9,999 copies per mL	1
negative	10,000 to 99,999 copies per mL	3
negative	100,000 to 999,999 copies/mL	4
negative	>= 10^6 copies per mL	5
positive		6

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 20

• The higher the score the greater the risk of the patient developing hepatocellular carcinoma.

Total Score	5 Year Risk	10 Year Risk
0	0.010%	0.03%
1	0.025%	0.05%
2	0.030%	0.08%
3	0.049%	0.12%
4	0.080%	0.21%
5	0.130%	0.4%
6	0.210%	0.66%
7	0.40%	1%
8	0.70%	1.8%
9	1%	3%
10	1.7%	5%
11	3%	8%
12	5%	13%
13	8%	21%
14	12%	33%
15	20%	50%
16	31%	63%
17	50%	90%
18	80%	100%
19	90%	100%
20	100%	100%

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Description

Specialty

ICD-10