The validation of the 2010 American Association for the Study of Liver Diseases guideline for the diagnosis of hepatocellular carcinoma in an endemic area
The validation of the 2010 American Association for the Study of Liver Diseases guideline for the diagnosis of hepatocellular carcinoma in an endemic area
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DOI：
10.1111/jgh.12699
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发表时间：
2015-02-01
影响因子：
4.1
通讯作者：
Hu, Tsung-Hui
中科院分区：
文献类型：
--
作者：
Lin, Ming-Tsung;Chang, Kuo-Chin;Hu, Tsung-Hui
背景与目的根据2010年美国肝病研究协会（AASLD）的指南，肝细胞癌（HCC）的诊断可通过一次典型的影像学检查来进行。可能未完全发展为肝硬化的B型肝炎患者可适用。我们的目的是回顾性分析和验证2010年指南的诊断能力在肝癌流行区（台湾）。MethodsFrom 2006年1月至2010年12月，共648例肝肿瘤手术切除术后进行了审查。通过METAVIR评分4验证纤维化评分。在648例患者中，569例（87.8%）为HCC患者。其中B型肝炎占54.5%，丙型肝炎占21.9%，B+C型肝炎占2.8%，非B或C型肝炎占20.7%。结果2010年AASLD指南f的诊断敏感性、特异性、阳性预测值（PPV）、阴性预测值和准确性分别为99.1%、36.7%、91.9%、85.3%和91.5%。结论肝硬化与非肝硬化、肝纤维化不同分期之间诊断HCC的敏感性相似。但肝硬化的PPV较高。B型或C型肝炎在HCC诊断中没有决定性作用。
Background and AimHepatocellular carcinoma (HCC) diagnosis could be made with one typical imaging study in a cirrhotic liver by the guideline of the American Association for the Study of Liver Diseases (AASLD) in 2010. Patients with hepatitis B who may not have fully developed cirrhosis could be applied. We aim to retrospectively analyze and validate the diagnostic power of the 2010 guideline in an HCC endemic area (Taiwan).MethodsFrom January 2006 to December 2010, a total of 648 patients with liver tumor post-surgical resection were reviewed. The fibrotic scores were verified by METAVIR score 4. Among the 648 patients, 569 (87.8%) were HCC patients. Hepatitis B accounts for 54.5%, hepatitis C 21.9%, hepatitis B+C 2.8%, and non-hepatitis B or C 20.7% of patients. Two hundred eighty-eight of 648 (44%) patients were with cirrhotic liver.ResultsThe diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value, and accuracy of the 2010 AASLD guideline f are 99.1%, 36.7%, 91.9%, 85.3%, and 91.5%, respectively. Cirrhotic liver exhibited a higher PPV (P0.05).ConclusionsSimilar sensitivity of HCC diagnosis existed between cirrhotic and non-cirrhotic liver, and across different fibrotic stages. But cirrhotic liver exhibited a higher PPV. Hepatitis B or C has no decisive effect in HCC diagnosis.