Help
Subscribe


All of GastroHep is now free access! - Click here to register Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Laboratory-based algorithm predicts liver cancer in Hep C and cirrhosis

May's issue of Gastroenterology reports on a new laboratory-based algorithm to predict development of hepatocellular carcinoma in patients with Hepatitis C and cirrhosis.

News image

Serum levels of α-fetoprotein (AFP) are influenced not only by the presence of hepatocellular carcinoma (HCC), but also by the underlying severity and activity of liver disease, which is reflected by liver function tests.

Dr Hashem El-Serag and colleagues from Texas, USA constructed an AFP-based algorithm that included these factors to identify patients at risk for HCC, and tested its predictive ability in a large set of patients with cirrhosis.

The team used used the national Department of Veterans Affairs Hepatitis C Virus Clinical Case Registry to identify patients with cirrhosis, results from at least 1 AFP test, and 6 months of follow-up.

The researchers' algorithm included data on age, levels of aspartate aminotransferase, alanine aminotransferase (ALT), alkaline phosphatase, total bilirubin, albumin, creatinine, and hemoglobin, prothrombin time, and numbers of platelets and white cells.

The team examined the operating characteristics (calibration, discrimination, predictive values) of several different algorithms for identification of patients who would develop HCC within 6 months of the AFP test.

The probabilities of HCC, based only on 120 ng/mL AFP, were 11%
Gastroenterology

The research team assessed our final model in the development and validation subsets.

The team identified 11,721 patients with hepatitis C virus−related cirrhosis in whom 35,494 AFP tests were performed, and 987 patients developed HCC.

A predictive model that included data on levels of AFP, ALT, and platelets, along with age at time of AFP test, best discriminated between patients who did and did not develop HCC.

Using this AFP-adjusted model, the predictive accuracy increased at different AFP cutoffs compared with AFP alone.

At any given AFP value, low numbers of platelets and ALT and older age were associated with increased risk of HCC, and high levels of ALT and normal/high numbers of platelets were associated with low risk for HCC.

For example, the probabilities of HCC, based only on 20 ng/mL and 120 ng/mL AFP, were 4% and 11%, respectively.

However, the team noted that patients with the same AFP values  who were 70 years old, with ALT levels of 40 IU/mL and platelet counts of 100,000, had probabilities of developing HCC of 8% and 29%, respectively.

Dr El-Serag's team concludes, "We developed and validated an algorithm based on levels of AFP, platelets, and ALT, along with age, which increased the predictive value for identifying patients with hepatitis C virus−associated cirrhosis likely to develop HCC within 6 months."

"If validated in other patient groups, this model would have immediate clinical applicability."

Gastroenterol 2014: 146(5): 1249-1255.e1
28 April 2014

Go to top of page Email this page Email this page to a colleague

 02 April 2015

Advanced search
 02 April 2015 
Physical activity and NAFLD
 02 April 2015 
Genetic risk for Crohn's disease
 02 April 2015 
EUS for detection of pancreatic neuroendocrine tumors
 01 April 2015 
Analysis of liver fibrosis
 01 April 2015 
Obeticholic acid in primary biliary cirrhosis
 01 April 2015 
Mortality rates for upper GI bleeds
 31 March 2015 
HCV-HIV co-infection combination therapy
 31 March 2015 
Placement of nasoenteral feeding tubes
 31 March 2015 
Hepatic fat and gallbladder polyps
 30 March 2015 
Minimally invasive approach in colorectal procedures
 30 March 2015 
Prevalence of IBD in USA residents of Indian ancestry
 30 March 2015 
Treatment of pediatric IBD
 27 March 2015 
Screening for fecal incontinence
 27 March 2015 
Deep remission in Crohn's disease
 27 March 2015 
Sexual functioning in IBD
 26 March 2015 
Survival of untreated hepatocellular carcinoma
 26 March 2015 
Antimicrobial therapy in cirrhosis with spontaneous bacterial peritonitis
 26 March 2015 
Metformin as a chemopreventive agent for Barrett's
 25 March 2015 
Genetics and Crohn's disease
 25 March 2015 
Mortality in Barrett’s–related T1 esophageal adenocarcinoma
 25 March 2015 
Cytomegalovirus and IBD
 24 March 2015 
Prevention of colorectal cancer after screening
 24 March 2015 
Functional GI disorders and body mass index
 24 March 2015 
Quality of life in children with fecal incontinence
 23 March 2015 
Fibrosis in NAFLD vs NASH
 23 March 2015 
The unmasking of Whipple's disease
 23 March 2015 
Predicting the quality of colon cancer care
 20 March 2015 
Interventions for eosinophilic esophagitis
 20 March 2015 
Screening for Barrett's esophagus
 20 March 2015 
Colorectal cancer risk and genetic variants
 19 March 2015 
Dedicated care for diverticular disease
 19 March 2015 
Hypnotherapy for IBS
 19 March 2015 
Poor mental and physical health in HCV
 18 March 2015 
Practice guidelines for colorectal polyps
 18 March 2015 
Out-of-hours endoscopy for upper GI bleeding
 18 March 2015 
H. pylori eradication and lipids
 17 March 2015 
H. pylori test-and-treat program and gastric cancer
 17 March 2015 
Adalimumab in Crohn’s disease
 17 March 2015 

Low-dose PPIs and GI bleeding in patients receiving aspirin

 16 March 2015 
Microscopic colitis
 16 March 2015 
Cholestasis of pregnancy with HCV
 16 March 2015 
Hybrid therapy for H. pylori
 13 March 2015 

Racial disparities in gluten-sensitive problems

 13 March 2015 
Medicare patients and payments to gastroenterologists
 13 March 2015 
Appendectomy in ulcerative colitis
 12 March 2015 
Predicting IBD in IBS patients
 12 March 2015 
Patient knowledge of IBS
 12 March 2015 
Nonceliac gluten sensitivity
 11 March 2015 

Prediction of malignant bile duct obstruction

 11 March 2015 
NAFLD–related hepatocellular carcinoma
 11 March 2015 
Assessment of eosinophilic esophagitis
 10 March 2015 
Risk for gastroesophageal reflux symptoms
 10 March 2015 
Poor disease course in pediatric ulcerative colitis
 10 March 2015 
Outcomes in Crohn's therapy
 09 March 2015 
Fibre usage in ulcerative colitis in remission
 09 March 2015 
Risk of C. difficile upon hospital admission
 09 March 2015 
Gastric Cancer detection during GI endosocopy
 06 March 2015 
Steroid therapy for eosinophilic esophagitis
 06 March 2015 
Second anti-TNF in IBD
 06 March 2015 
Efficacy of Hep E vaccine

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us