한빛사 논문
연세대학교
Abstract
Kyu Sik Jung1,‡, Seung Up Kim1,‡, Sang Hoon Ahn1,2,5,6, Young Nyun Park3, Do Young Kim1,2,5, Jun Yong Park1,2,5, Chae Yoon Chon1,2,5, Eun Hee Choi4, Kwang-Hyub Han1,2,5,6,*,§
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
2Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
3Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
4Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea
5Liver Cirrhosis Clinical Research Center, Seoul, Korea
6Brain Korea 21 Project of Medical Science, Seoul, Korea
*Correspondence: Kwang-Hyub Han, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, Korea
†Potential conflict of interest: Nothing to report.
‡These authors equally contributed to this work.
§fax: (82)-2-393-6884
Abstract
Liver stiffness measurement (LSM) using FibroScan accurately assesses the degree of liver fibrosis and the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C. This study investigated the usefulness of LSM as a predictor of HCC development in patients with chronic hepatitis B (CHB). A total of 1,130 patients with non-biopsy?proven CHB who underwent LSM between May 2005 and December 2007 were enrolled in this prospective study. After LSM was performed, patients attended regular follow-up as part of a surveillance program for the detection of HCC. The mean age of the patients (767 men, 363 women) was 50.2 years, and the median LSM was 7.7 kPa. Six hundred seventy-two (59.5%) patients received antiviral treatment before or after enrollment. During the follow-up period (median, 30.7 months; range, 24.0-50.9 months), HCC developed in 57 patients (2.0% per 1 person-year). The 1-, 2-, and 3-year cumulative incidence rates of HCC were 0.80%, 3.26%, and 5.98%, respectively. On multivariate analysis, together with old age, male sex, heavy alcohol consumption (>80 g/day), serum albumin, and hepatitis B e antigen positivity, patients with a higher LSM (>8 kPa) were at a significantly greater risk of HCC development, with the following hazard ratios: 3.07 (95% confidence interval [CI], 1.01-9.31; P = 0.047) for LSM 8.1-13 kPa; 4.68 (95% CI, 1.40-15.64; P = 0.012) for LSM 13.1-18 kPa; 5.55 (95% CI, 1.53?20.04; P = 0.009) for LSM 18.1-23 kPa; and 6.60 (95% CI, 1.83-23.84; P = 0.004) for LSM >23 kPa. Conclusion: Our data suggest that LSM could be a useful predictor of HCC development in patients with CHB. (HEPATOLOGY 2011)
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