title: Development of Risk Prediction Model for Hepatocellular Carcinoma Progression of Indeterminate Nodules in Hepatitis B Virus-Related Cirrhotic Liver.
abstract: This study was performed to evaluate long-term outcome of indeterminate nodules detected on cirrhotic liver and to develop risk prediction model for hepatocellular carcinoma (HCC) progression of indeterminate nodules on hepatitis B virus (HBV)-related cirrhotic liver.
  
  
  
  Indeterminate nodules up to 2 cm with uncertain malignant potential detected on computed tomography of cirrhotic liver during HCC surveillance were analyzed retrospectively. HCC risk prediction model of indeterminate nodules in HBV-related cirrhotic liver was deduced based on result of Cox regression analysis.
  
  
  
  A total of 494 indeterminate nodules were included. Independent risk factors of HCC progression were old age, arterial enhancement, large nodule size, low serum albumin level, high serum α-fetoprotein (AFP) level, and prior HCC history in all included subjects. In subjects with chronic hepatitis B, old age (year; hazard ratio (HR)=1.06; P<0.001), arterial enhancement (HR=2.62; P=0.005), large nodule size (>1 cm; HR=7.34; P<0.001), low serum albumin level (≤3.5 g/dl; HR=3.57; P=0.001), high serum AFP level (≥100 ng/ml; HR=6.04; P=0.006), prior HCC history (HR=4.24; P=0.001), and baseline hepatitis B e antigen positivity (HR=2.31; P=0.007) were associated with HCC progression. We developed a simple risk prediction model using these risk factors and identified patients at low, intermediate, and high risk for HCC; 5-year cumulative incidences were 1%, 14.5%, and 63.1%, respectively. The developed risk score model showed good performance with area under the curve at 0.886 at 3 years, and 0.920 at 5 years in leave-one-out cross-validation.
  
  
  
  We developed a useful and accurate risk score model for predicting HCC progression of indeterminate nodules detected on HBV-related cirrhotic liver.
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Hyo Jung
authors: HJ
authors: Cho
authors: Department of Radiology, Ajou University School of Medicine, Suwon, South Korea.
authors: Bohyun
authors: B
authors: Kim
authors: Office of Biostatistics, Ajou University School of Medicine, Suwon, South Korea.
authors: Jung-Dong
authors: JD
authors: Lee
authors: Office of Biostatistics, Ajou University School of Medicine, Suwon, South Korea.
authors: Dae Ryong
authors: DR
authors: Kang
authors: Department of Radiology, Ajou University School of Medicine, Suwon, South Korea.
authors: Jai Keun
authors: JK
authors: Kim
authors: Department of Radiology, Ajou University School of Medicine, Suwon, South Korea.
authors: Jei Hee
authors: JH
authors: Lee
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Sung Jae
authors: SJ
authors: Shin
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Kee Myung
authors: KM
authors: Lee
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Byung Moo
authors: BM
authors: Yoo
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Kwang Jae
authors: KJ
authors: Lee
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Soon Sun
authors: SS
authors: Kim
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Jae Youn
authors: JY
authors: Cheong
authors: Department of Gastroenterology, Ajou University School of Medicine, Suwon, South Korea.
authors: Sung Won
authors: SW
authors: Cho
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000378:metabolism; D006801:Humans; D034141:Hypoalbuminemia / Q000453:epidemiology; D015994:Incidence; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications* / Q000378:metabolism; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D000509:alpha-Fetoproteins