| Title | Hepatocellular Carcinoma Prediction Models in Chronic Hepatitis B: A Systematic Review of 14 Models and External Validation |
| Authors | Wu, Shanshan Zeng, Na Sun, Feng Zhou, Jialing Wu, Xiaoning Sun, Yameng Wang, Bingqiong Zhan, Siyan Kong, Yuanyuan Jia, Jidong You, Hong Yang, Hwai-I |
| Affiliation | Capital Med Univ, Beijing Friendship Hosp, Natl Clin Res Ctr Digest Dis, Beijing, Peoples R China Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Hlth Sci Ctr, Beijing, Peoples R China Capital Med Univ, Beijing Friendship Hosp, Beijing Key Lab Translat Med Liver Cirrhosis, Liver Res Ctr, Beijing, Peoples R China Acad Sin, Genom Res Ctr, 128 Acad Rd Sect 2, Taipei 115, Taiwan Natl Yang Ming Univ, Inst Clin Med, Taipei, Taiwan Kaohsiung Med Univ, Coll Med, Grad Inst Med, Kaohsiung, Taiwan |
| Keywords | PATIENTS RECEIVING ENTECAVIR RISK SCORES CLINICAL-OUTCOMES LIVER STIFFNESS SCORING SYSTEM HCC TENOFOVIR GENOTYPES THERAPY SAFETY |
| Issue Date | Dec-2021 |
| Publisher | CLINICAL GASTROENTEROLOGY AND HEPATOLOGY |
| Abstract | BACKGROUND & AIMS: The aim of our study was to characterize the performance of hepatocellular carcinoma (HCC) prediction models in chronic hepatitis B (CHB) patients through meta-analysis followed by external validation. METHODS: We performed a systematic review and meta-analysis of current literature, followed by external validation in independent multi-center cohort with 986 patients with CHB undergoing entecavir treatment (median follow-up: 4.7 years). Model performance to predict HCC within 3, 5, 7, and 10 years was assessed using area under receiver operating characteristic curve (AUROC) and calibration index. Subgroup analysis were conducted by treatment status, cirrhotic, race and baseline alanine aminotransferase. RESULTS: We identified 14 models with 123,885 patients (5,452 HCC cases), with REACH-B, CU-HCC, GAG-HCC, PAGE-B and mPAGE-B models being broadly externally validated. Discrimination was generally acceptable for all models, with pooled AUC ranging from 0.70 (95% CI, 0.63-0.76 for REACH-B) to 0.83 (95% CI, 0.78-0.87 for REAL-B) for 3-year, 0.68 (95% CI, 0.64-0.73 for REACH-B) to 0.81 (95% CI, 0.77-0.85 for REAL-B) for 5-year and 0.70 (95% CI, 0.58-0.80 for PAGE-B) to 0.81 (95% CI, 0.78-0.84 for REAL-B and 0.77-0.86 for AASL-HCC) for 10-year prediction. However, calibration performance was poorly reported in most studies. In external validation cohort, REAL-B showed highest discrimination with 0.76 (95% CI, 0.69-0.83) and 0.75 (95% CI, 0.70-0.81) for 3 and 5-year prediction. The REAL-B model was also well calibrated in the external validation cohort (3-year Brier score 0.066). Results were consistent in subgroup analyses. CONCLUSIONS: In a systematic review of available HCC models, the REAL-B model exhibited best discrimination and calibration. |
| URI | http://hdl.handle.net/20.500.11897/637914 |
| ISSN | 1542-3565 |
| DOI | 10.1016/j.cgh.2021.02.040 |
| Indexed | SCI(E) |
| Appears in Collections: | 公共卫生学院 |
