Clinical Research Papers:

Validation of risk prediction models for the development of HBV-related HCC: a retrospective multi-center 10-year follow-up cohort study

Yeon Seok Seo, Byoung Kuk Jang, Soon Ho Um, Jae Seok Hwang, Kwang-Hyub Han, Sang Gyune Kim, Kwan Sik Lee, Seung Up Kim _, Young Seok Kim and Jung Il Lee

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Oncotarget. 2017; 8:113213-113224. https://doi.org/10.18632/oncotarget.22375

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Yeon Seok Seo1,*, Byoung Kuk Jang2,*, Soon Ho Um1, Jae Seok Hwang2, Kwang-Hyub Han3, Sang Gyune Kim4, Kwan Sik Lee3, Seung Up Kim3, Young Seok Kim4 and Jung Il Lee3

1Department of Internal Medicine, Korea University, Seoul, Korea

2Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea

3Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea

4Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Korea

*These authors contributed equally to this work

Correspondence to:

Seung Up Kim, email: [email protected]

Young Seok Kim, email: [email protected]

Jung Il Lee, email: [email protected]

Keywords: hepatitis B, hepatocellular carcinoma, transient elastography, risk prediction, liver stiffness

Received: May 31, 2017     Accepted: October 02, 2017     Published: November 03, 2017


Recently, modified REACH-B (mREACH-B) risk prediction model for hepatocellular carcinoma (HCC) development was proposed. We validated the accuracy of the mREACH-B model and compared its accuracy with those of other prediction models. Between 2006 and 2012, 1,241 patients with chronic hepatitis B (CHB) were recruited. All patients underwent transient elastography at enrollment. The median age of the study population (840 males, 401 females) was 49 years. The median PAGE-B, LSM-HCC, and mREACH-B values were 10, 10, and 8, respectively. Among patients without cirrhosis (n = 940, 75.7%), the median REACH-B value was 9. During the follow-up period (median 77.4 months), 66 (5.3%) and 83 (6.7%) patients developed HCC and liver-related events (LRE), respectively. Higher liver stiffness (LS) independently predicted HCC (hazard ratio [HR] = 1.047) and LRE development (HR = 1.047) (all P < 0.05). The mREACH-B significantly predicted HCC (AUC = 0.824 at 3-year and 0.750 at 5-year) and LRE development (AUC = 0.782 at 3-year and 0.739 at 5-year) (all P < 0.001) and it performed similarly or significantly better than the PAGE-B and LSM-HCC (AUC = 0.715-0.809 at 3-year and 0.719-0.742 at 5-year for HCC; AUC = 0.704-0.777 at 3-year and 0.721-0.735 at 5-year for LRE). Among patients without cirrhosis, mREACH-B predicted HCC (AUC = 0.803 vs. 0.654-0.816 at 3-year and 0.684 vs. 0.639-0.738 at 5-year) and LRE development (AUC = 0.734 vs. 0.619-0.789 at 3-year and 0.674 vs. 0.626-0.729 at 5-year) similarly to PAGE-B, REACH-B, and LSM-HCC. mREACH-B appropriately predicted HCC and LRE development in patients with CHB and showed similar or superior accuracy to those of PAGE-B, REACH-B, and LSM-HCC.

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