aMAP score prediction of hepatocellular carcinoma occurrence and incidence‐free rate after a sustained virologic response in chronic hepatitis C

Yamashita, Yūki; Joshita, Satoru; Sugiura, Ayumi; Yamazaki, Tomoo; Kobayashi, Hiroyuki; Wakabayashi, Shun‐ichi; Yamada, Yosuke; Shibata, Soichiro; Kunimoto, Hideo; Iwadare, Takanobu; Matsumura, Makiko; Miyabayashi, Chiharu; Okumura, Taiki; Ozawa, Sachie; Nozawa, Yuichi; Kobayashi, Natsuko; Komatsu, Michiharu; Fujimori, Naoyuki; Saito, Hiromi; Umemura, Takeji

doi:10.1111/hepr.13689

Cited by 19 publications

(22 citation statements)

References 32 publications

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“…Meanwhile, eradication of HCV with SVR decreases the risk for HCC, and the American Association for the Study of Liver Diseases guidelines recommend that HCC surveillance is not recommend in patients with chronic hepatitis C without cirrhosis 36 . Moreover, there are some scoring systems of achieving SVR patients after DAA therapy 37–39 . Although the optimal screening tests remain controversial, we identified criteria that identified a set of low‐risk patients, which could be incorporated into surveillance programs.…”

Section: Discussionmentioning

confidence: 99%

Real‐world long‐term analysis of daclatasvir plus asunaprevir in patients with hepatitis C virus infection

et al. 2022

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Background and Aim This study aimed to evaluate the long‐term clinical course of patients achieving a sustained virologic response (SVR) with daclatasvir plus asunaprevir (DCV/ASV) therapy. Methods A total of 911 patients who achieved SVR with DCV/ASV were assessed. To evaluate pretreatment factors contributing to hepatocellular carcinoma (HCC) after SVR, univariate and multivariate analyses were performed in all patients, in those with preexisting HCC, and in those without preexisting HCC. We selected a low‐risk group of HCC cases after SVR. Finally, we evaluated liver function after achieving SVR. Results In multivariable analyses, male sex, older age, patients with a history of HCC treatment, excess alcohol use, lower albumin, and low platelet count remained significant in the overall group; male sex and low albumin remained significant in patients with a history of HCC treatment; and male sex, older age, excess alcohol use, low platelet count, high alpha‐fetoprotein (AFP), and high des‐γ‐carboxy prothrombin (DCP) remained significant in those without a history of HCC treatment. Patients who had not received treatment for HCC, females, those under 70 years of age, and those with platelet count ≥13 (×104/μL), AFP <6 ng/mL, and DCP <23 mAU/mL were at low risk of HCC. The process of liver function improvement was different according to the factors. Conclusions The incidence rate of HCC, risk factors associated with HCC, group with very low risk of developing HCC, and the clinical course in a real‐world long‐term study were evaluated.

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Section: Discussionmentioning

confidence: 99%

Real‐world long‐term analysis of daclatasvir plus asunaprevir in patients with hepatitis C virus infection

et al. 2022

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“…15,16 Furthermore, Wang et al 18 developed a secondary Doylestown Plus algorithm that incorporated cosylated kininogen as a marker to improve the detection of HCC. Yamashita et al 19 20 Therefore, we believe that the Doylestown algorithm is also suitable for Chinese patients with liver cirrhosis, but the cutoff value needed to be adjusted before application.…”

Section: Discussionmentioning

confidence: 99%

“… 15 , 16 Furthermore, Wang et al 18 developed a secondary Doylestown Plus algorithm that incorporated cosylated kininogen as a marker to improve the detection of HCC. Yamashita et al 19 investigated the clinical utility of the aMAP score for predicting HCC occurrence and the incidence‐free rate after a sustained virologic response in chronic hepatitis C. The current study was a retrospective, longitudinal study applying the AFP, Doylestown algorithm, and aMAP score to consecutive time points for patients with liver cirrhosis to compare the performance of the algorithm in detecting HCC. Additionally, to our knowledge, this study also investigated the application of the Doylestown algorithm to the Chinese population for the first time.…”

Section: Discussionmentioning

confidence: 99%

Validation of the hepatocellular carcinoma early detection screening algorithm Doylestown and aMAP in a cohort of Chinese with cirrhosis

Qian

Li²,

et al. 2022

Clinical Laboratory Analysis

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Background Previous studies have developed some blood‐based biomarker algorithms such as the Doylestown algorithm and aMAP score to improve the detection of Hepatocellular carcinoma (HCC). However, no one has studied the application of the Doylestown algorithm in the Chinese. Meanwhile, which of these two screening models is more suitable for people with liver cirrhosis remains to be investigated. Methods In this study, HCC surveillance was performed by radiographic imaging and testing for tumor markers every 6 months from August 21, 2018, to January 12, 2021. We conducted a retrospective study of 742 liver cirrhosis patients, and among them, 20 developed HCC during follow‐up. Samples from these patients at three follow‐up time points were tested to evaluate alpha‐fetoprotein (AFP), the Doylestown algorithm, and aMAP score. Results Overall, 521 liver cirrhosis patients underwent semiannual longitudinal follow‐up three times. Five patients were diagnosed with HCC within 0–6 months of the third follow‐up. We found that for these liver cirrhosis patients, the Doylestown algorithm had the highest accuracy for HCC detection, with areas under the receiver operating characteristic curve (AUCs) of 0.763, 0.801, and 0.867 for follow‐ups 1–3, respectively. Compared with AFP at 20 ng/ml, the Doylestown algorithm increased biomarker performance by 7.4%, 21%, and 13% for follow‐ups 1–3, respectively. Conclusions Our findings show that the Doylestown algorithm performance appeared to be optimal for HCC early screening in the Chinese cirrhotic population when compared with the aMAP score and AFP at 20 ng/ml.

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“…15 Subsequently, it was also validated in chronic hepatitis C infected patients who achieved sustained virological response. 16 Nevertheless, the predictive role of aMAP score for long-term outcomes is not well known in patients with HBV-ACLF.…”

Section: Introductionmentioning

confidence: 99%

aMAP Score as a Predictor for Long-Term Outcomes in Patients with HBV-Related Acute-on-Chronic Liver Failure

Sun¹,

Li²,

Liao³

et al. 2022

IJGM

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Background and Aim:The long-term outcomes of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) remain not well known. This study aimed to investigate whether aMAP score can predict re-hospitalization, hepatocellular carcinoma (HCC) occurrence and long-term mortality in patients with HBV-ACLF. Methods: A total of 82 patients diagnosed with HBV-ACLF and survived over 6 months were enrolled. The median follow-up period was 105 (75.9, 134.1) months. The Cox proportional hazards or logistic regression analysis was used to determine independent risk factors. Cumulative incidence of HCC and survival rate were evaluated using Kaplan-Meier analysis. Results: Multivariate analysis identified that the aMAP risk score was an independent predictor of re-hospitalization (odds ratio [OR] = 1.112, 95% confidence interval [CI]: 1.021-1.211, p = 0.015), hepatocellular carcinoma occurrence (hazards ratio [HR] = 2.277, 95% CI: 1.014-5.114, p = 0.046) and mortality (HR = 1.366, 95% CI: 1.040-1.794, p = 0.025). High-risk aMAP scores were associated with higher risk of HCC occurrence and mortality. Conclusion: A higher aMAP score was an independent risk predictor of re-hospitalization, HCC occurrence and mortality, respectively, in HBV-ACLF patients who survived over 6 months, which can be applicable for early risk stratification and clinical decision.

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aMAP score prediction of hepatocellular carcinoma occurrence and incidence‐free rate after a sustained virologic response in chronic hepatitis C

Cited by 19 publications

References 32 publications

Real‐world long‐term analysis of daclatasvir plus asunaprevir in patients with hepatitis C virus infection

Real‐world long‐term analysis of daclatasvir plus asunaprevir in patients with hepatitis C virus infection

Validation of the hepatocellular carcinoma early detection screening algorithm Doylestown and aMAP in a cohort of Chinese with cirrhosis

aMAP Score as a Predictor for Long-Term Outcomes in Patients with HBV-Related Acute-on-Chronic Liver Failure

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