Validation of D2AS model for prediction of early hepatitis B virus-related hepatocellular carcinoma / 中华传染病杂志

ABSTRACT

Objective To validate the predictive value of hepatitis B virus ( HBV )-related hepatocellular carcinoma ( HCC) risk score model D2AS in chronic HBV infection patients without antiviral therapy.Methods A total of 93 patients with chronic HBV infection were selected between January 2015 and July 2017 in the Third Affiliated Hospital of Hebei Medical University.Clinical data including age , gender, medical history, ultrasonography, hepatitis B surface antigen ( HBsAg), hepatitis B surface antibody ( anti-HBs), hepatitis B e antigen ( HBeAg), hepatitis B e antibody ( anti-HBe), hepatitis B core antibody ( anti-HBc), HBV DNA and alanine aminotransferase levels were collected by information center .REACH-B score and D2AS score were used to predict the risk of HCC.Receiver operating characteristic curve (ROC) was used to evaluate the discrimination , and Hosmer-Lemeshow ( H-L) goodness-of-fit test was used to evaluate the calibration of the model.Results REACH-B score and D2 AS score for the 95 chronic HBV infection patients were 9 (8,12) and 0.95 (0.57,2.08), respectively.The area under the curve ( AUC) for REACH-B score and D2 AS score were 0.916 (95% confidence interval [ CI] 0.834-0.998) and 0.784 (95%CI 0.587-0.981), respectively.The difference was not statistically significant ( P ＝0.195).However, for HBeAg-negative patients with chronic HBV infection , the AUC for D2 AS score and REACH-B score were 0.952 (95%CI 0.876-1.000) and 0.913 (95%CI 0.821-1.000), respectively (P＝0.458).The H-L goodness-of-fit test was P＞0.05.Conclusions The D2 AS score can be used for HCC prediction among patients who do not meet antiviral criteria.The predictive value of the D 2AS score for HCC is comparable to the REACH-B score in HBeAg-negative patients with chronic HBV infection.