Performance of the ADRESS-HCC score in the assessment of the risk of hepatocellular carcinoma in viral cirrhosis in Tunisia

Authors

  • Mouna Medhioub Department of Gastroenterology - Mohamed Taher Maamouri- Hospital, Nabeul / University of Tunis El Manar, Faculty of Medicine, Tunis
  • Amal khsiba Department of Gastroenterology - Mohamed Taher Maamouri- Hospital, Nabeul / University of Tunis El Manar, Faculty of Medicine, Tunis
  • Moufida Mahmoudi Department of Gastroenterology - Mohamed Taher Maamouri- Hospital, Nabeul / University of Tunis El Manar, Faculty of Medicine, Tunis
  • Asma Ben Mohamed Department of Gastroenterology - Mohamed Taher Maamouri- Hospital, Nabeul / University of Tunis El Manar, Faculty of Medicine, Tunis
  • Manel Yakoubi Department of Gastroenterology - Mohamed Taher Maamouri- Hospital, Nabeul / University of Tunis El Manar, Faculty of Medicine, Tunis
  • Lamine Hamzaoui Department of Gastroenterology - Mohamed Taher Maamouri- Hospital, Nabeul / University of Tunis El Manar, Faculty of Medicine, Tunis

Keywords:

Cirrhosis Degeneration, Hepatitis B, Hepatitis C

Abstract

Introduction: The ADRESS-HCC score allows predicting the risk of occurrence of Hepatocellular carcinoma in cirrhosis at one year of follow-up.

Aim: Measuring the performance of ADRESS-HCC in predicting the risk of degeneration on post-viral cirrhosis, in a gastroenterology department in Tunisia.

Methods: Retrospective study, including patients followed for compensated viral cirrhosis in the gastroenterology department of the Mohamed Taher Maamouri hospital. The ADRESS-HCC score was calculated at diagnosis of cirrhosis. We divided patients into two groups depending on whether they developed Hepatocellular carcinoma or not. We evaluated the performance of the ADRESS-HCC score in predicting the risk of Hepatocellular carcinoma according to a threshold value.

Results: We enrolled 60 patients; the mean age was 62 years. Twenty-five patients developed hepatocellular carcinoma during follow-up. The mean value of ADRESS-HCC score was 5.08. To predict the occurrence of hepatocellular carcinoma at 1 year of follow-up, the area under the curve of the ADRESS-HCC score was 0.74 (p=0.01). For a threshold value of 5.63 its sensitivity was 91 % with a negative predictive value of 95.83%.

Conclusion: The ADRESS-HCC score had an average performance in predicting degeneration in post-viral cirrhosis.

Downloads

Download data is not yet available.

References

European Association for the Study of the Liver .EASL Clinical Practice Guidelines for the management of patients with decompensated cirrhosisJ Hepatol. 2018;69(2):406-60.

Raoul JL, Raimbourg J, Hiret S, Adhoute X, Senellart H. Epidémiologie du carcinome hépatocellulaire : simple augmentation d’incidence ou futur drame ? Bull Cancer. 2018;105(5):502-7.

Dimitroulis D, Damaskos C, Valsami S, Davakis S, Garmpis N, Spartalis E, et al. From diagnosis to treatment of hepatocellular carcinoma: an epidemic problem for both developed and developing world. World J Gastroenterol. 2017;23(29):5282.

Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology. 2004;127Suppl 1:S35-S50.

Bruix J, Sherman M. Management of hepatocellular carcinoma: an update. Hepatology. 2011;53(3):1020-2.

Flemming JA, Yang JD, Vittinghoff E, Kim WR, Terrault NA. Risk prediction of hepatocellular carcinoma in patients with cirrhosis: the ADRESS-HCC risk model. Cancer. 2014;120(22):3485-93.

European Association for the Study of the Liver.EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma .J Hepatol. 2018;69(1):182-236

Pugh RN, Murray IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg. 1973;60(8):646-9.

Kamath PS, Kim WR. The model for end-stage liver disease (MELD). Hepatology. 2007;45(3):797-805.

Llovet JM, Bru C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999;19(3):329-38.

Lok AS, Seeff LB, Morgan TR, Dibisceglie AM, Sterling RK, Curto TM, et al. Incidence of hepatocellular carcinoma and associated risk factors in hepatitis C-related advanced liver disease. Gastroenterology. 2009;136(1):138-48.

Bengtsson B, Widman L, Wahlin S, Stål P, Björkström NK, Hagström H . United European Gastroenterol J. 2022 ;10 (5):465-76.

Yang B, Liu JB, So SK, Han SS, Wang SS, Hertz A, et al. Disparities in hepatocellular carcinoma incidence by race/ethnicity and geographic area in california: implications for prevention. Cancer. 2018;124(17):3551-9.

Burra P, Zanetto A, Germani G. Liver transplantation for alcoholic liver disease and hepatocellular carcinoma. Cancers. 2018;10(2):46.

Trichopoulos D, Bamia C, Lagiou P, Fedirko V, Trepo E, Jenab M, et al. Hepatocellular carcinoma risk factors and disease burden in a european cohort: a nested case-control study. J Natl Cancer Inst. 2011;103(22):1686-95.

Yu MW, Lin CL, Liu CJ, Yang SH, Tseng YL, Wu CF. Influence of metabolic risk factors on risk of hepatocellular carcinoma and liver-related death in men with chronic hepatitis B: alarge cohort study. Gastroenterology. 2017;153(4):1006-17.

Yang HI, Lu SN, Liaw YF, You SL, Sun CA, Wang LY, et al. Hepatitis B e antigen and the risk of hepatocellular carcinoma. N Engl J Med. 2002;347(3):168-74.

Chen CJ, Yang HI, Su J, Jen CL, You SL, Lu SN, et al. Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level. Jama. 2006;295(1):65-73.

Yu MW, Yeh SH, Chen PJ, Liaw YF, Lin CL, Liu CJ, et al. Hepatitis B virus genotype and DNA level and hepatocellular carcinoma: a prospective study in men. J Natl Cancer Inst. 2005;97(4):265-72.

Raimondi S, Bruno S, Mondelli MU, Maisonneuve P. Hepatitis C virus genotype 1b as a risk factor for hepatocellular carcinoma development: a meta-analysis. J Hepatol. 2009;50(6):1142-54.

Kanwal F, Kramer JR, Ilyas J, Duan Z, El-Serag HB. HCV genotype 3 is associated with an increased risk of cirrhosis and hepatocellular cancer in a national sample of U.S. veterans with HCV. Hepatology. 2014;60(1):98-105.

Su TH, Hu TH, Chen CY, Huang YH, Chuang WL, Lin CC, et al. Four-year entecavir therapy reduces hepatocellular carcinoma, cirrhotic events and mortality in chronic hepatitis B patients. Liver Int. 2016;36(12):1755-64.

Morgan RL, Baack B, Smith BD, Yartel A, Pitasi M, Falck-Ytter Y. Eradication of hepatitis C virus infection and the development of hepatocellular carcinoma: a meta-analysis of observational studies. Ann Intern Med. 2013;158(5):329-37.

Yang HI, Yuen MF, Chan HL, Han KH, Chen PJ, Kim DY, et al. Risk estimation for hepatocellular carcinoma in chronic hepatitis B (REACH-B): development and validation of a predictive score. Lancet Oncol. 2011;12(6):568-74.

Yuen MF, Tanaka Y, Fong DY, Fung J, Wong DK, Yuen JC, et al. Independent risk factors and predictive score for the development of hepatocellular carcinoma in chronic hepatitis B. J Hepatol. 2009;50(1):80-8.

Wong GL, Chan HL, Chan HY, Tse PC, Tse YK, Mak CW, et al. Accuracy of risk scores for patients with chronic hepatitis B receiving entecavir treatment. Gastroenterology. 2013;144(5):933-44.

Papatheodoridis G, Dalekos G, Sypsa V, Yurdaydin C, Buti M, Goulis J, et al. PAGE-B predicts the risk of developing hepatocellular carcinoma in caucasians with chronic hepatitis B on 5-year antiviral therapy. J Hepatol. 2016;64(4):800-6.

Elserag HB, Kanwal F, Davila JA, Kramer J, Richardson P. A new laboratory-based algorithm to predict development of hepatocellular carcinoma in patients with hepatitis C and cirrhosis. Gastroenterology. 2014;146(5):1249-55.

Nam JY, Sinn DH, Bae J, Jang ES, Kim JW, Jeong SH. Deep learning model for prediction of hepatocellular carcinoma in patients with HBV-related cirrhosis on antiviral therapy.JHEP Rep. 2020 ;2(6):100175 .

Additional Files

Published

2023-09-27

Issue

Section

Original articles

Categories