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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 9
Sep.  2018
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Article Contents

A cost-effectiveness analysis of Gd-EOB-DTPA contrast-enhanced magnetic resonance imaging versus ultrasound in hepatocellular carcinoma screening

DOI: 10.3969/j.issn.1001-5256.2018.09.018
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  • Received Date: 2018-03-05
  • Published Date: 2018-09-20
  • Objective To investigate the cost-effectiveness ratio of Gd-EOB-DTPA contrast-enhanced magnetic resonance imaging (EMRI) versus ultrasound in liver cancer screening for the high-risk population. Methods The Tree Age Pro 2011 software was used to establish a decision-tree model. A mathematical model was used to simulate the costs and benefits of EMRI or ultrasound screening every 6 months in patients with liver cirrhosis, and the cost-effectiveness ratios under different screening models were calculated. Results The EMRI group had a mean cost of liver cancer screening of 2050. 2 RMB each person each time and mean benefits of 0. 11 YLG, while the ultrasound group had a mean cost of 262. 6 RMB and mean benefits of 0. 02 YLG. When the incidence rate of liver cancer was 17. 8%, the EMRI group had a similar cost-effectiveness ratio as the ultrasound group, and the cost of 1 YLG was 11445 RMB; EMRI tended to have a lower cost and a better effect in screening with the increase in the incidence rate of liver cancer. The cost-effectiveness ratio of EMRI gradually decreased with the reduction in its price, and its effect in screening gradually increased with the reduction in price. Conclusion The cost-effectiveness of liver cancer screening is closely related to the incidence rate of liver cancer and the price of screening. EMRI has a good cost-effectiveness ratio in screening when the risk of liver cancer is higher than 17. 8%.

     

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  • [1]FITZMAURICE C, DICKER D, PAIN A, et al.The global burden of cancer 2013[J].JAMA Oncol, 2015, 1 (4) :505-527.
    [2]CHEN JG.Trends in the incidence of liver cancer and its primary prevention in China[J].J Clin Hepatol, 2012, 28 (4) :256-260. (in Chinese) 陈建国.中国肝癌发病趋势和一级预防[J].临床肝胆病杂志, 2012, 28 (4) :256-260.
    [3]ZUO TT, ZHENG RS, ZHANG SW, et al.Incidence and mortality of liver cancer in China in 2011[J].Chin J Cancer, 2015, 34 (11) :508-513.
    [4]WANG R, CHEN XZ, ZHANG MG, et al.Incidence and mortality of liver cancer in mainland China:Changes in first decade of 21st century[J].Hepatogastroenterology, 2015, 62 (137) :118-121.
    [5]ZUO TT, ZHENG RS, ZENG HM, et al.Analysis of liver cancer incidence and trend in China[J].Chin J Oncol, 2015, 37 (9) :691-696. (in Chinese) 左婷婷, 郑荣寿, 曾红梅, 等.中国肝癌发病状况与趋势分析[J].中华肿瘤杂志, 2015, 37 (9) :691-696.
    [6]EL-SERAG HB.Hepatocellular carcinoma[J].N Engl J Med, 2011, 365 (12) :1118-1127.
    [7]FORNER A, LLOVET JM, BRUIX J.Hepatocellular carcinoma[J].Lancet, 2012, 379 (9822) :1245-1255.
    [8]ALLEMANI C, WEIR HK, CARREIRA H, et al.Global surveillance of cancer survival 1995-2009:Analysis of individual data for25, 676, 887 patients from 279 population-based registries in 67countries (CONCORD-2) [J].Lancet, 2015, 385 (9972) :977-1010.
    [9]BRUIX J, SHERMAN M.Management of hepatocellular carcinoma:An update[J].Hepatology, 2011, 53 (3) :1020-1022.
    [10]SINGAL A, VOLK ML, WALJEE A, et al.Meta-analysis:Surveillance with ultrasound for early-stage hepatocellular carcinoma in patients with cirrhosis[J].Aliment Pharmacol Ther, 2009, 30 (1) :37-47.
    [11]YU NC, CHAUDHARI V, RAMAN SS, et al.CT and MRI improve detection of hepatocellular carcinoma, compared with ultrasound alone, in patients with cirrhosis[J].Clin Gastroenterol Hepatol, 2011, 9 (2) :161-167.
    [12]ZHANG CY, FU Y, LI XD, et al.Advances in imaging diagnosis of liver cancer[J].J Clin Hepatol, 2017, 33 (7) :1266-1269. (in Chinese) 张春雨, 付宇, 李晓东, 等.肝癌的影像学诊断进展[J].临床肝胆病杂志, 2017, 33 (7) :1266-1269.
    [13]KIM HD, LIM YS, HAN S, et al.Evaluation of early-stage hepatocellular carcinoma by magnetic resonance imaging with gadoxetic acid detects additional lesions and increases overall survival[J].Gastroenterology, 2015, 148 (7) :1371-1382.
    [14]KIM SY, AN J, LIM YS, et al.MRI with liver-specific contrast for surveillance of patients with cirrhosis at high risk of hepatocellular carcinoma[J].JAMA Oncol, 2017, 3:456-463.
    [15]WANG JH, CHANGCHIEN CS, HU TH, et al.The efficacy of treatment schedules according to Barcelona Clinic Liver Cancer staging for hepatocellular carcinoma-survival analysis of 3892 patients[J].Eur JCancer, 2008, 44 (7) :1000-1006.
    [16]KAO WY, CHAO Y, CHANG CC, et al.Prognosis of early-stage hepatocellular carcinoma:The clinical implications of substages of Barcelona clinic liver cancer system based on a cohort of 1265 patients[J].Medicine (Baltimore) , 2015, 94 (43) :1929.
    [17]VEL ZQUEZ RF, RODR GUEZ M, NAVASCU S CA, et al.Prospective analysis of risk factors for hepatocellular carcinoma in patients with liver cirrhosis[J].Hepatology, 2003, 38 (4) :520-527.
    [18]FATTOVICH G, STROFFOLINI T, ZAGNI I, et al.Hepatocellular carcinoma in cirrhosis:Incidence and risk factors[J].Gastroenterology, 2004, 127 (1) :35-50.
    [19]KUPER H, YE W, BROOM U, et al.The risk of liver and bile duct cancer in patients with chronic viral hepatitis, alcoholism, or cirrhosis[J].Hepatology, 2001, 34 (4) :714-718.
    [20]GOOSSENS N, NAKAGAWA S, SUN X, et al.Cancer biomarker discovery and validation[J].Transl Cancer Res, 2015, 4 (3) :256-269.
    [21]SORENSEN HT, FRIIS S, OLSEN JH, et al.Risk of liver and other types of cancer in patients with cirrhosis:A nationwide cohort study in Denmark[J].Hepatology, 1998, 28 (4) :921-925.
    [22]LI P, DING HG, XU H, et al.Shortening liver cancer screening interval may improve the prognosis of patients with hepatitis B cirrhosis-related hepatocellular carcinoma[J].J Clin Hepatol, 2017, 33 (7) :1301-1304. (in Chinese) 李鹏, 丁惠国, 徐辉, 等.缩短肝癌筛查间隔对乙型肝炎肝硬化相关肝细胞癌患者预后的影响[J].临床肝胆病杂志, 2017, 33 (7) :1301-1304.
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