Significance of predictive models / risk calculators for HBV-related hepatocellular carcinoma
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摘要: HBV相关性肝细胞癌(HCC)是东南亚地区重要的公共卫生问题。近年来香港、台湾学者通过自然史研究发明了HBV相关性HCC预测模型/危险计算器,可在一定程度上预测HCC发生的可能性。年龄、性别、HBV DNA水平和肝硬化是各个模型常用的危险因素。讨论了目前几种HBV相关性HCC预测模型的演变及其临床意义,探讨了风险计算器的优缺点,更新版REACH-B模型和LSM-HCC模型具有较好的阴性预测值,可以对慢性乙型肝炎(CHB)患者预后予以较好的推测。这些模型可被用于分层筛查HCC,同时也成为管理CHB患者新的评估工具。Abstract: Hepatitis B virus( HBV)- related hepatocellular carcinoma( HCC) is a major public health problem in Southeast Asia. In recent years,researchers from Hong Kong and Taiwan have reported predictive models or risk calculators for HBV- associated HCC by studying its natural history,which,to some extent,predicts the possibility of HCC development. Generally,risk factors of each model involve age,sex,HBV DNA level,and liver cirrhosis. This article discusses the evolution and clinical significance of currently used predictive models for HBV- associated HCC and assesses the advantages and limits of risk calculators. Updated REACH- B model and LSM- HCC model show better negative predictive values and have better performance in predicting the outcomes of patients with chronic hepatitis B( CHB). These models can be applied to stratified screening of HCC and,meanwhile,become an assessment tool for the management of CHB patients.
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Key words:
- carcinoma,hepatocellular /
- hepatitis B virus /
- proportional hazards models
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