Prediction of hepatocellular carcinoma development by aminotransferase to platelet ratio index in primary biliary cholangitis.

Abstract

AIM:

To investigate the usefulness of aspartate aminotransferase to platelet ratio index (APRI) in predicting hepatocellular carcinoma (HCC) risk in primary biliary cholangitis (PBC).

METHODS:

We identified PBC patients between 2000 and 2015 by searching the electronic medical database of a tertiary center. The hazard ratio (HR) of HCC with different risk factors was determined by Cox proportional hazards model.

RESULTS:

One hundred and forty-four PBC patients were recruited. Patients were diagnosed at a median age of 57.8 years [interquartile range (IQR): 48.7-71.5 years), and 41 (28.5%) patients had cirrhosis at baseline. The median follow-up duration was 6.9 years (range: 1.0-26.3 years). Twelve patients developed HCC, with an incidence rate of 10.6 cases per 1000 patient-years. The overall 5-, 10- and 15-year cumulative incidences of HCC were 2.3% 95%CI: 0%-4.8%), 8.4% (95%CI: 1.8%-14.5%) and 21.6% (6.8%-34.1%), respectively. Older age (HR = 1.07), cirrhosis (HR = 4.38) and APRI at 1 year after treatment (APRI-r1) > 0.54 (HR = 3.94) were independent factors for HCC development. APRI-r1, when combined with treatment response, further stratified HCC risk (log rank P < 0.05). The area under receiver operating curve of APRI-r1 in predicting HCC was 0.77 (95%CI: 0.64-0.88).

CONCLUSION:

APRI-r1 can be used to predict the development of HCC in PBC patients. Combination of APRI-r1 with treatment response can further stratify the HCC risk.

• Authors: Ka-Shing Cheung, Wai-Kay Seto, James Fung, Lung-Yi Mak, Ching-Lung Lai, Man-Fung Yuen
• Journal: World journal of gastroenterology (World J Gastroenterol) Vol. 23 Issue 44 Pg. 7863-7874 (Nov 28 2017) ISSN: 2219-2840 [Electronic] United States
• PMID: 29209127 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Aspartate Aminotransferases

Topics

• Aged
• Aspartate Aminotransferases (blood)
• Carcinoma, Hepatocellular (epidemiology, etiology)
• Cholangitis, Sclerosing (blood, complications, therapy)
• Female
• Follow-Up Studies
• Humans
• Incidence
• Kaplan-Meier Estimate
• Liver Cirrhosis, Biliary (blood, epidemiology, etiology, therapy)
• Liver Neoplasms (epidemiology, etiology)
• Male
• Middle Aged
• Platelet Count
• Predictive Value of Tests
• ROC Curve
• Risk Assessment (methods)
• Risk Factors
• Treatment Outcome