Hepatocellular Carcinoma Multidisciplinary Clinic-Cairo University (HMC-CU) score: A new simple score for diagnosis of HCC.


Journal

Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology
ISSN: 2090-2387
Titre abrégé: Arab J Gastroenterol
Pays: Egypt
ID NLM: 101298363

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 17 05 2018
revised: 31 07 2019
accepted: 05 04 2020
pubmed: 23 5 2020
medline: 30 3 2021
entrez: 23 5 2020
Statut: ppublish

Résumé

The risk of hepatocarcinogenesis depends on background liver factors, of which fibrosis is a major determinant. Serum markers and scores are of increasing importance in non-invasive diagnosis of hepatic fibrosis. Our aim was to predict the occurrence of hepatocellular carcinoma (HCC) using a non-invasive fibrosis score calculated using routine patient data. Our retrospective study included 1,291 hepatitis C related-HCC Egyptian patients (Group 1) recruited from the multidisciplinary HCC clinic, Faculty of Medicine, Cairo University in the period between February 2009 and June 2016 and 1072 chronic hepatitis C-naïve patients (Group 2) with advanced fibrosis (≥F3) and cirrhosis (F4). King score, Fibro Q score, Aspartate aminotransferase-to-platelet ratio index (APRI), AST to ALT ratio (AAR), LOK score, Göteborg University Cirrhosis Index (GUCI), Fibro-α and Biotechnology Research Center (BRC) scores were calculated for all patients. Regression analysis and receiver operating characteristics (ROC) were used to calculate the sensitivity, specificity and predictive values for significant scores with the best cut-off for predicting HCC. A regression equation was used to calculate predicted probabilities of HCC using the following variables; age, gender, haemoglobin, international normalised ratio (INR), albumin and alpha fetoprotein. The appropriate score cut-off points yielding optimal sensitivity and specificity were determined by ROC curve analysis. There was a highly significant difference between the two groups for all calculated scores (P = 0.0001). Our new score, the Hepatocellular Carcinoma Multidisciplinary Clinic-Cairo University (HMC-CU) score (Logit probability of HCC =  - 2.524 + 0.152*age - 0.121*Hb - 0.696*INR - 1.059*Alb + 0.022*AFP + 0.976*Sex. Male = 1, Female = 0), with a cut-off of 0.559 was superior to other scores for predicting HCC, having a sensitivity of 90% and specificity of 80.6%. The HMC-CU score is a promising, easily calculated, accurate, cost-effective score for HCC prediction in chronic HCV patients with advanced liver fibrosis.

Sections du résumé

BACKGROUND AND STUDY AIMS OBJECTIVE
The risk of hepatocarcinogenesis depends on background liver factors, of which fibrosis is a major determinant. Serum markers and scores are of increasing importance in non-invasive diagnosis of hepatic fibrosis. Our aim was to predict the occurrence of hepatocellular carcinoma (HCC) using a non-invasive fibrosis score calculated using routine patient data.
PATIENTS AND MTHODS UNASSIGNED
Our retrospective study included 1,291 hepatitis C related-HCC Egyptian patients (Group 1) recruited from the multidisciplinary HCC clinic, Faculty of Medicine, Cairo University in the period between February 2009 and June 2016 and 1072 chronic hepatitis C-naïve patients (Group 2) with advanced fibrosis (≥F3) and cirrhosis (F4). King score, Fibro Q score, Aspartate aminotransferase-to-platelet ratio index (APRI), AST to ALT ratio (AAR), LOK score, Göteborg University Cirrhosis Index (GUCI), Fibro-α and Biotechnology Research Center (BRC) scores were calculated for all patients. Regression analysis and receiver operating characteristics (ROC) were used to calculate the sensitivity, specificity and predictive values for significant scores with the best cut-off for predicting HCC. A regression equation was used to calculate predicted probabilities of HCC using the following variables; age, gender, haemoglobin, international normalised ratio (INR), albumin and alpha fetoprotein. The appropriate score cut-off points yielding optimal sensitivity and specificity were determined by ROC curve analysis.
RESULTS RESULTS
There was a highly significant difference between the two groups for all calculated scores (P = 0.0001). Our new score, the Hepatocellular Carcinoma Multidisciplinary Clinic-Cairo University (HMC-CU) score (Logit probability of HCC =  - 2.524 + 0.152*age - 0.121*Hb - 0.696*INR - 1.059*Alb + 0.022*AFP + 0.976*Sex. Male = 1, Female = 0), with a cut-off of 0.559 was superior to other scores for predicting HCC, having a sensitivity of 90% and specificity of 80.6%.
CONCLUSION CONCLUSIONS
The HMC-CU score is a promising, easily calculated, accurate, cost-effective score for HCC prediction in chronic HCV patients with advanced liver fibrosis.

Identifiants

pubmed: 32439235
pii: S1687-1979(20)30012-5
doi: 10.1016/j.ajg.2020.04.001
pii:
doi:

Substances chimiques

Biomarkers 0
Hemoglobins 0
Serum Albumin 0
alpha-Fetoproteins 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

102-105

Informations de copyright

Copyright © 2020 Pan-Arab Association of Gastroenterology. Published by Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of interests None declared.

Auteurs

Ashraf Omar Abdelaziz (AO)

Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Mohamed Mahmoud Nabil (MM)

Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Dalia Abdelhamid Omran (DA)

Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Ahmed Hosni Abdelmaksoud (AH)

Diagnostic and Interventional Radiology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Noha Asem (N)

Community Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Hend Ibrahim Shousha (HI)

Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: hendshousha@kasralainy.edu.eg.

Tamer Mahmoud Elbaz (TM)

Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Rania Leithy (R)

Endemic Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH