Department of Gastroenterology, China-Japan Union Hospital of Jilin University, Changchun, China.
Department of Critical Care Medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Saudi J Gastroenterol. 2022 Sep-Oct;28(5):362-368. doi: 10.4103/sjg.sjg_527_21.
We aimed to validate the predictive value of the cirrhosis, age, male sex, and diabetes (CAMD) score and age, albumin, sex, and liver cirrhosis (AASL) score for chronic hepatitis B (CHB) patients, treated with nucleos(t)ide analogues (NUCs) in Northeast China.
From January 2009 to June 2020, 945 patients diagnosed with CHB who received NUC therapy at China-Japan Union Hospital of Jilin University were included. Comprehensive medical records were retrospectively analyzed, and the predictive values of the CAMD score and AASL score for hepatocellular carcinoma (HCC) were evaluated.
A total of 58 patients (5.94%) were diagnosed with HCC. Multivariate analysis revealed that age [odds ratio (OR) = 1.041, 95% confidence interval (CI) 1.009-1.073, P < 0.011] and cirrhosis (OR = 3.297, 95% CI 1.383-7.861, P < 0.007) were independent predictors of HCC. Either the CAMD or AASL score was significantly higher in the HCC group compared to the non-HCC group. The area under the receiver operating characteristic (ROC) curve (AUC) of CAMD and AASL was 0.721 (95% CI 0.663-0.780) and 0.718 (95% CI 0.662-0.774), respectively. Risk stratification using either CAMD or AASL revealed significant differences in the one-, three-, and five-year cumulative incidence rates of HCC between the low-, intermediate-, and high-risk groups (all P < 0.001, log-rank test).
Both CAMD and AASL scores have predictive value for HCC risk of CHB patients in Northeast China. In future, the optimal monitoring frequency and methods should be personalized.
本研究旨在验证肝硬化、年龄、性别和糖尿病（CAMD）评分以及年龄、白蛋白、性别和肝硬化（AASL）评分对中国东北接受核苷（酸）类似物（NUCs）治疗的慢性乙型肝炎（CHB）患者的预测价值。
本研究纳入了 2009 年 1 月至 2020 年 6 月期间在吉林大学中日联谊医院接受 NUC 治疗的 945 例 CHB 患者。对其进行回顾性分析，评估了 CAMD 评分和 AASL 评分对肝细胞癌（HCC）的预测价值。
共有 58 例（5.94%）患者被诊断为 HCC。多因素分析显示，年龄（比值比 [OR] = 1.041，95%置信区间 [CI] 1.009-1.073，P < 0.011）和肝硬化（OR = 3.297，95% CI 1.383-7.861，P < 0.007）是 HCC 的独立预测因素。HCC 组的 CAMD 或 AASL 评分均显著高于非 HCC 组。CAMD 和 AASL 的受试者工作特征（ROC）曲线下面积（AUC）分别为 0.721（95% CI 0.663-0.780）和 0.718（95% CI 0.662-0.774）。使用 CAMD 或 AASL 进行风险分层，低、中、高危组之间的 HCC 1 年、3 年和 5 年累积发生率存在显著差异（均 P < 0.001，对数秩检验）。
CAMD 和 AASL 评分均对中国东北 CHB 患者的 HCC 风险具有预测价值。未来，应根据患者的具体情况制定最佳的监测频率和方法。
