METHODS: A total of 6048 patients with no history of HCC who achieved SVR by oral direct-acting antiviral drugs were enrolled in this nationwide study. Patients continued HCC surveillance every 6 months after SVR. The incidence of post-SVR HCC was compared between risk groups using the aMAP score, FIB-4 index, Tahata model, GAF4 criteria, GES score, and ADRES score.
RESULTS: During the observation period with a median duration of 4.0 years after SVR, post-SVR HCC developed in 332 patients (5.5%). All six models performed significantly at stratifying the incidence of HCC. However, Harrell\'s C-index was below 0.8 for all models (range, 0.660-0.748), indicating insufficient stratification ability.
CONCLUSIONS: Although all six proposed models demonstrated a good ability to predict the development of post-SVR HCC, their ability to stratify the risk of post-SVRHCC was unsatisfactory. Further studies are necessary to identify the best model for assessing the risk of post-SVR HCC in regions where early detection of HCC is common.
方法:这项全国性研究共纳入6048例没有肝癌病史的患者通过口服直接作用抗病毒药物获得SVR。患者在SVR后每6个月继续进行HCC监测。使用aMAP评分在风险组之间比较SVR后HCC的发生率,FIB-4指数,Tahata模型,GAF4标准,GES得分,和ADRES得分。
结果:在SVR后中位持续时间为4.0年的观察期内,后SVR肝癌发展332例(5.5%)。所有六个模型在对HCC的发病率进行分层时都有显着表现。然而,所有型号的哈雷尔C指数均低于0.8(范围,0.660-0.748),表明分层能力不足。
结论:尽管所有六个提出的模型都显示出预测SVR后HCC发展的良好能力,他们对SVRHCC后风险进行分层的能力并不令人满意.进一步的研究是必要的,以确定最好的模型来评估后SVRHCC的风险在早期检测HCC是常见的地区。