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Semin Liver Dis 2021; 41(03): 285-297
DOI: 10.1055/s-0041-1730924
Review Article

Application of Risk Scores for Hepatocellular Carcinoma in Patients with Chronic Hepatitis B: Current Status and Future Perspective

Yao-Chun Hsu
1   Center for Liver Diseases, E-Da Hospital, Kaohsiung, Taiwan
2   School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
3   Department of Medicine, Fu-Jen Catholic University Hospital, New Taipei, Taiwan
4   Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan
,
Cheng-Hao Tseng
2   School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
5   Division of Gastroenterology and Hepatology, E-Da Cancer Hospital, Kaohsiung, Taiwan
,
Yen-Tsung Huang
6   Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
,
Hwai-I Yang
7   Genomics Research Center, Academia Sinica, Taipei, Taiwan
8   Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
9   Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
10   Biomedical Translation Research Center, Academia Sinica, Taipei, Taiwan
› Author Affiliations Funding This work was funded by Ministry of Science and Technology in Taiwan (MOST 107-2314-B-030-008-MY3), E-Da Hospital (105-EDN08), and the Tomorrow Medical Foundation (TMF2020P01). None of the funders had any role in the work, from conception to publication.
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Abstract

Accurate risk prediction for hepatocellular carcinoma (HCC) among patients with chronic hepatitis B (CHB) may guide treatment strategies including initiation of antiviral therapy and also inform implementation of HCC surveillance. There have been 26 risk scores developed to predict HCC in CHB patients with (n = 14) or without (n = 12) receiving antiviral treatment; all of them invariably include age in the scoring formula. Virological biomarkers of replicative activities (i.e., hepatitis B virus DNA level or hepatitis B envelope antigen status) are frequently included in the scores derived from patients with untreated CHB, whereas measurements that gauge severity of liver fibrosis and/or reserve of hepatic function (i.e., cirrhosis diagnosis, liver stiffness measurement, platelet count, or albumin) are essential components in the scores developed from treated patients. External validation is a prerequisite for clinical application but not yet performed for all scores. For the future, higher predictive accuracy may be achieved with machine learning based on more comprehensive data.

Keywords

chronic hepatitis B - hepatocellular carcinoma - risk prediction - precision medicine

Authorship

All authors had access to the reviewed data and participated in the drafting, editing, and final approval of the manuscript for publication.


Competing Interests

Yao-Chun Hsu has received research grants from and served as an advisory committee member for Gilead Sciences, and received lecture fees from Abbvie, Bristol-Myers Squibb, Gilead Sciences, Merck Sharp & Dohme, and Novartis, outside the submitted work. Dr. Tseng reports personal fees from Abbvie, personal fees from Bristol-Myers Squibb, personal fees from Gilead Sciences, personal fees from Merck Sharp & Dohme, personal fees from Roche, personal fees from Bayer, outside the submitted work. Yen-Tsung Huang and Hwai-I Yang have nothing to declare.




Publication History

Article published online:
23 June 2021

© 2021. Thieme. All rights reserved.

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