Liver stiffness measurement as an alternative to fibrotic stage in risk assessment of hepatocellular carcinoma incidence for chronic hepatitis C patients
Article first published online: 14 FEB 2013
© 2013 John Wiley & Sons A/S
Volume 33, Issue 5, pages 756–761, May 2013
How to Cite
Liver Int. 2013: 33: 756–761
- Issue published online: 7 APR 2013
- Article first published online: 14 FEB 2013
- Accepted manuscript online: 25 JAN 2013 12:40PM EST
- Manuscript Accepted: 19 DEC 2012
- Manuscript Received: 10 SEP 2012
- chronic hepatitis C;
- hepatic fibrosis;
- hepatocellular carcinoma;
- liver stiffness measurement;
- transient elastography
Hepatic fibrosis stage is useful in assessing risk of hepatocellular carcinoma (HCC) occurrence.
To evaluate liver stiffness measurement (LSM), in addition to fibrosis stage, in risk assessment of long-term HCC occurrence for patients with chronic hepatitis C.
Patients and methods
Consecutive patients with chronic hepatitis C, without past history and presence of HCC, with concomitant liver biopsy and LSM were enrolled in this study. All patients attended regular surveillance for HCC development every 3–12 months. The medical records were reviewed. Follow-up LSM was performed at least 1 year later.
One hundred and ninety-eight patients (M/F: 112/86) with reliable LSM results were enrolled. Ten patients developed HCC in a median follow-up period of 47.8 months. For patients with initial LSM >24 kPa, 12–24 kPa, and <12 kPa, 5- year HCC incidence was 45.1%, 9.5% and 0.9% respectively. Multivariate analysis showed patients with LSM>24 kPa and patients with LSM 12–24 kPa had higher risks of HCC development (HR: 24.6, CI: 2.7–220.4 and HR:11.7, CI:1.3–105.2). Patients without sustained virological response after treatment also had higher risk of HCC occurrence (HR: 9.7, CI: 1.1–82.2). Among 106 patients with follow-up LSM, there was a higher risk of HCC development for patients with LSM>12 kPa in the initial and follow-up LSM.
As an alternative of fibrosis stage, initial LSM is useful as a non-invasive method in risk assessment of HCC occurrence for patients with chronic hepatitis C. Serial follow-up LSM>12 kPa carries higher risk of HCC development.