Although the prevalence of hepatitis B in Korea is decreasing compared to the past due to the hepatitis B vaccination program, hepatitis B is still the most important cause of hepatocellular carcinoma (liver cancer). The so-called ‘functional cure for hepatitis B’, in which the hepatitis B surface antigen is lost, has a good prognosis, but some patients may still develop liver cancer.
A team led by Professor Jang Jeong-won (corresponding author) and Eunpyeong St. Mary’s Hospital Professor Yang Hyun (first author) of Seoul St. Mary’s Hospital, Department of Gastroenterology, Catholic University of Korea, developed a model for predicting the risk of liver cancer in patients with hepatitis B surface antigen loss for the first time in the world.
Prof. Jang’s team studied a total of 1,443 chronic hepatitis B patients who had lost the hepatitis B surface antigen for up to 30 years and studied using a large-long-term cohort. Excessive alcohol consumption (more than 2 drinks a day for men and more than 1 drink a day for women) ▲ A family history of hepatocellular carcinoma was found to be a risk factor for liver cancer even after hepatitis B surface antigen loss.
Using these four risk factors, a risk prediction model for HCC was developed, and the 5-year, 10-year, and 15-year predictive values evaluated by the time-dependent ROC (Receiver Operating Characteristic) curve were 0.799, 0.835, and 0.817, respectively. was confirmed to be excellent. The ROC curve is a performance evaluation index, and when the ROC curve area is 0.8 or more, it is evaluated as a predictive model with excellent performance. In addition, internal verification to confirm the accuracy of predictions was also effective.
Hepatitis B is the most important risk factor for liver cancer in Korea and accounts for about 60~70% of all liver cancer patients. In Korea, about 2.5 to 3% of the total population are carriers of the hepatitis B virus, which has a high prevalence. About 20% of chronically infected patients with hepatitis B virus for more than 6 months progress to cirrhosis, and about 2-7% of cirrhosis patients develop liver cancer every year. In addition, it is known that hepatitis B virus carriers are about 100 times more likely to develop liver cancer than normal people.
Professor Yang said, “This study is meaningful in that it revealed that liver cancer can occur even after hepatitis B is cured and which patients should be closely followed. Even after hepatitis B is cured, it is important to not miss the liver cancer monitoring test if you already have cirrhosis, have a family history of liver cancer, if you drink a lot, or if you are an elderly person.” he emphasized.
Professor Jang said, “The model developed through this study is the world’s first predictive model for the risk of liver cancer after hepatitis B is cured. This model using the patient’s health information, which can be easily obtained through regular examinations, is expected to contribute to the development of a guide for the proper clinical management of patients who have been cured of hepatitis B in the future.” said
The results of this study were published in the September issue of the ‘Journal of Hepatology’ (IF=30.083), the most prestigious international academic journal in the field of hepatitis, under the title of “A risk prediction model for hepatocellular carcinoma after hepatitis B surface antigen seroclearance”.