The validation of the 2010 American Association for the Study of Liver Diseases guideline for the diagnosis of hepatocellular carcinoma in an endemic area. Issue 2 (February 2015)

• Record Type: Journal Article
• Authors: Lin, Ming‐Tsung; Chang, Kuo‐Chin; Chou, Yeh‐Pin; Tseng, Po‐Lin; Yen, Yi‐Hao; Wang, Chih‐Chi; Tsai, Ming‐Chao; Cheng, Yu‐Fan; Eng, Hock‐Liew; Wu, Cheng‐Kung; Hu, Tsung‐Hui
• Is Part Of: Journal of gastroenterology and hepatology. Volume 30:Issue 2(2015:Feb.)
• Page Start: 345
• Page End: 351
• Publication Date: 2015-02
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.12699
• Languages: English
• ISSNs: 0815-9319

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jgh12699-sec-0001" sec-type="section"> <title>Background and Aim</title> <p>Hepatocellular carcinoma (HCC) diagnosis could be made with one typical imaging study in a cirrhotic liver by the guideline of the American Association for the Study of Liver Diseases (AASLD) in 2010. Patients with hepatitis B who may not have fully developed cirrhosis could be applied. We aim to retrospectively analyze and validate the diagnostic power of the 2010 guideline in an HCC endemic area (Taiwan).</p> </sec> <sec id="jgh12699-sec-0002" sec-type="section"> <title>Methods</title> <p>From January 2006 to December 2010, a total of 648 patients with liver tumor post‐surgical resection were reviewed. The fibrotic scores were verified by METAVIR score 4. Among the 648 patients, 569 (87.8%) were HCC patients. Hepatitis B accounts for 54.5%, hepatitis C 21.9%, hepatitis B + C 2.8%, and non‐hepatitis B or C 20.7% of patients. Two hundred eighty‐eight of 648 (44%) patients were with cirrhotic liver.</p> </sec> <sec id="jgh12699-sec-0003" sec-type="section"> <title>Results</title> <p>The diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value, and accuracy of the 2010 AASLD guideline f are 99.1%, 36.7%, 91.9%, 85.3%, and 91.5%, respectively. Cirrhotic liver exhibited a higher PPV (<italic>P</italic> < 0.001) but lower specificity (<italic>P</italic> = 0.0479) than non‐cirrhotic liver. In both cirrhotic and non‐cirrhotic condition, no difference existed in patients with hepatitis B or hepatitis C (<italic>P</italic> > 0.05).</p> </sec> <sec id="jgh12699-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Similar sensitivity of HCC diagnosis existed between cirrhotic and non‐cirrhotic liver, and across different fibrotic stages. But cirrhotic liver exhibited a higher PPV. Hepatitis B or C has no decisive effect in HCC diagnosis.</p> </sec> </abstract>