한빛사논문
- 조회200
Han Ah Lee1,*, Mi Na Kim2,3,*, Hye Ah Lee4, Miyoung Choi5, Jung Hwan Yu6, Young-Joo Jin6, Jihyun An7, Young Eun Chon8, Hee Yeon Kim9, Ji Won Han,10,11 and Seung Up Kim2,3
1Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
3Yonsei Liver Center, Severance Hospital, Seoul, Korea
4Clinical Trial Center, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
5Division of Health Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
6Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
7Department of Gastroenterology and Hepatology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
8Department of Internal Medicine, Institute of Gastroenterology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
9Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea
10The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
11Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
*Han Ah Lee and Mi Na Kim contributed equally as co-first authors.
Address for correspondence: Young Eun Chon, MD, PhD, Jihyun An, MD, PhD
Abstract
Background: Despite advances in antiviral therapy for hepatitis C virus (HCV) infection, hepatocellular carcinoma (HCC) still develops even after sustained viral response (SVR) in patients with advanced liver fibrosis or cirrhosis. This meta-analysis investigated the predictive performance of transient elastography (TE) and fibrosis 4-index (FIB-4) for the development of HCC after SVR.
Methods: We searched PubMed, MEDLINE, EMBASE, and the Cochrane Library for studies examining the predictive performance of these tests in adult patients with HCV. Two authors independently screened the studies' methodological quality and extracted data. Pooled estimates of sensitivity, specificity, and area under the curve (AUC) were calculated for HCC development using random-effects bivariate logit normal and linear-mixed effect models.
Results: We included 27 studies (169,911 patients). Meta-analysis of HCC after SVR was possible in nine TE and 15 FIB-4 studies. Regarding the prediction of HCC development after SVR, the pooled AUCs of pre-treatment TE >9.2-13 kPa and FIB-4 >3.25 were 0.79 and 0.73, respectively. TE >8.4-11 kPa and FIB-4 >3.25 measured after SVR, maintained good predictive performance, albeit slightly reduced (pooled AUCs: 0.77 and 0.70, respectively). The identified optimal cut-off value for HCC development after SVR was 12.6 kPa for pre-treatment TE. That of TE measured after the SVR was 11.2 kPa.
Conclusion: TE and FIB-4 showed acceptable predictive performance for HCC development in patients with HCV who achieved SVR, underscoring their utility in clinical practice for guiding surveillance strategies. Future studies are needed to validate these findings prospectively and validate their clinical impact.
논문정보
- Research article
- 2024년 08월 (BRIC 등록일 2024-08-14)
- 국내 연구진
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