Role of Liver Stiffness Measurement in Predicting HCC Occurrence in Direct-Acting Antivirals Setting: A Real-Life Experience
| Autor: | Giovanna Valente, Alessio Trabucco, Barbara Guerrera, Ferdinando Carlo Sasso, Maria Guarino, Luigi Elio Adinolfi, Michele Imparato, Pia Clara Pafundi, Luca Rinaldi, Riccardo Nevola, Antonio Ascione, Natalina Iuliano, Alessandro Perrella, Filomena Morisco, Guido Piai, Luca Fontanella |
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| Přispěvatelé: | Rinaldi, Luca, Guarino, Maria, Perrella, Alessandro, Pafundi, Pia Clara, Valente, Giovanna, Fontanella, Luca, Nevola, Riccardo, Guerrera, Barbara, Iuliano, Natalina, Imparato, Michele, Trabucco, Alessio, Sasso, Ferdinando Carlo, Morisco, Filomena, Ascione, Antonio, Piai, Guido, Adinolfi, Luigi Elio, Rinaldi, L., Guarino, M., Perrella, A., Pafundi, P. C., Valente, G., Fontanella, L., Nevola, R., Guerrera, B., Iuliano, N., Imparato, M., Trabucco, A., Sasso, F. C., Morisco, F., Ascione, A., Piai, G., Adinolfi, L. E. |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Carcinoma Hepatocellular Cirrhosis Transient elastography Physiology Direct-acting antiviral Antiviral Agents Risk Assessment Sensitivity and Specificity Gastroenterology 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Elastic Modulus Internal medicine Humans Medicine HCC business.industry Liver Neoplasms Liver stiffne Reproducibility of Results Hepatitis C Hepatitis C Chronic Middle Aged Hepatology medicine.disease digestive system diseases HCV cirrhosi Liver 030220 oncology & carcinogenesis Hepatocellular carcinoma Elasticity Imaging Techniques Female 030211 gastroenterology & hepatology business Risk assessment Viral hepatitis |
| Popis: | The aim of this study was to evaluate the relationship between the liver stiffness measurement and the risk of developing hepatocellular carcinoma (HCC) in HCV cirrhotic patients undergoing new direct-acting antivirals.From April 2015 to April 2017, all consecutive HCV cirrhotic patients treated by direct-acting antivirals were enrolled. A liver stiffness measurement was computed at baseline, and an ultrasound evaluation was provided for all patients at baseline and every 6 months until 1 year after the stopping of the antiviral therapy. The diagnosis of HCC was performed according to international guidelines by imaging technique workup.Two hundred and fifty-eight HCV patients with a diagnosis of cirrhosis were identified. The median liver stiffness was 25.5 kPa. Thirty-five patients developed HCC. Patients were divided into three groups, based on their liver stiffness: 20 kPa (n = 72), between 20 and 30 kPa (n = 92) and 30 kPa (n = 94). Compared to the 20 kPa and 20-30 kPa groups, the 30 kPa group showed a statistically significant increased risk of HCC (p = 0.019; HR 0.329; 95% CI 0.131-0.830). A ROC curve analysis to assess the overall predictive performance of liver stiffness measurement on the HCC risk was performed. The results allow us to identify a cutoff value of liver stiffness measurement equal to 27.8 kPa, which guarantees the highest sensitivity and specificity (respectively, 72% and 65%).The data underline that the baseline liver stiffness measurement and ultrasound surveillance is a valuable tool for assessing the risk of HCC in cirrhotic patients undergoing the direct-acting antivirals treatment. |
| Databáze: | OpenAIRE |
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