title: Prediction of liver stiffness hepatocellular carcinoma in chronic hepatitis C patients on interferon-based anti-viral therapy.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the usefulness of liver stiffness measurement (LSM) for assessing the risk of hepatocellular carcinoma (HCC) in chronic hepatitis C (CHC) patients receiving interferon (IFN) therapy.
  
  
  METHODS
  One hundred fifty-one CHC patients who underwent LSM and received IFN therapy were included in the estimation cohort, and 56 were included in the validation study. The cumulative HCC incidences were evaluated using Kaplan-Meier plot analysis and the log-rank test. Multivariate Cox proportional hazard analyses were used to estimate the hazard ratios (HRs) of variables for HCC.
  
  
  RESULTS
  In the estimation cohort, 9 of 151 patients developed HCC during the median follow-up time of 722 days. Multivariate analysis identified three independent risk factors for HCC: LSM (≥ 14.0 kPa, HR 5.58, P = 0.020), platelet count (< 14.1 × 10(4) /μL, HR 5.59, P = 0.034), and non-sustained virological response (HR 8.28, P = 0.049). The cumulative incidence of HCC development at 3 years was 59.6%, 8.2%, and 0.0% in patients with all three risk factors, one to two risk factors, and none of these risk factors, respectively. The incidence of HCC was significantly different between these groups (P < 0.001). In the validation cohort, HCC incidence was also significantly different with respect to these risk factors (P = 0.037).
  
  
  CONCLUSIONS
  LSM, platelet count, and IFN-therapeutic effect could be used to successfully stratify the risk of HCC in patients receiving IFN therapy and demonstrate the usefulness of LSM before IFN therapy for the management of CHC patients.
authors.affiliation: Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Narita
authors.forename: Takuya
authors.initials: T
authors.lastname: Genda
authors.forename: Hironori
authors.initials: H
authors.lastname: Tsuzura
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Sato
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kanemitsu
authors.forename: Sachiko
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Tetsu
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Katsuharu
authors.initials: K
authors.lastname: Hirano
authors.forename: Katsuyori
authors.initials: K
authors.lastname: Iijima
authors.forename: Ryo
authors.initials: R
authors.lastname: Wada
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ichida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000008:administration & dosage*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology*; D054459:Elasticity Imaging Techniques; D005260:Female; D005544:Forecasting; D019698:Hepatitis C, Chronic / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008099:Liver / Q000000981:diagnostic imaging* / Q000473:pathology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011994:Recombinant Proteins / Q000008:administration & dosage; D012254:Ribavirin / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin
keywords: chronic hepatitis C; hepatocellular carcinoma; liver stiffness; risk factor