Prospective risk assessment for hepatocellular carcinoma development in patients with chronic hepatitis C by transient elastography

Ryota Masuzaki, Ryosuke Tateishi, Haruhiko Yoshida, Eriko Goto, Takahisa Sato, Takamasa Ohki, Jun Imamura, Tadashi Goto, Fumihiko Kanai, Naoya Kato, Hitoshi Ikeda, Shuichiro Shiina, Takao Kawabe, Masao Omata

Research output: Contribution to journalArticlepeer-review

342 Citations (Scopus)

Abstract

Liver stiffness, noninvasively measured by transient elastography, correlates well with liver fibrosis stage. The aim of this prospective study was to evaluate the liver stiffness measurement (LSM) as a predictor of hepatocellular carcinoma (HCC) development among patients with chronic hepatitis C. Between December 2004 and June 2005, a total of 984 HCV-RNA positive patients, without HCC or a past history of it, visited the University of Tokyo Hospital. LSM was performed successfully in 866 patients, who gave informed consent. During the follow-up period (mean, 3.0 years), HCC developed in 77 patients (2.9% per 1 person-year). The cumulative incidence rates of HCC at 1, 2, and 3 years were 2.4%, 6.0%, and 8.9%, respectively. Adjusting for other significant factors for HCC development, patients with higher LSM were revealed to be at a significantly higher risk, with a hazard ratio, as compared to LSM≤10 kPa, of 16.7 (95% confidence interval [CI], 3.71-75.2; P<0.001) when LSM 10.1-15 kPa, 20.9 (95% CI, 4.43-98.8; P<0.001) when LSM 15.1-20 kPa, 25.6 (95%CI, 5.21-126.1; P < 0.001) when LSM 20.1-25 kPa, and 45.5 (95% CI, 9.75-212.3; P < 0.001) when LSM >25 kPa. Conclusions: This prospective study has shown the association between LSM and the risk of HCC development in patients with hepatitis C. The utility of LSM is not limited to a surrogate for liver biopsy but can be applied as an indicator of the wide range of the risk of HCC development.

Original languageEnglish
Pages (from-to)1954-1961
Number of pages8
JournalHepatology
Volume49
Issue number6
DOIs
Publication statusPublished - Jun 2009
Externally publishedYes

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