Aspartate aminotransferase to platelet ratio index as a prospective predictor of hepatocellular carcinoma risk in patients with chronic hepatitis B virus infection.

Authors

Hie-Won Hann, Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson UniversityFollow
Shaogui Wan, Division of Population Science, Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson University; Institute of Pharmacy, Pharmaceutical College of Henan UniversityFollow
Yinzhi Lai, Division of Population Science, Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson UniversityFollow
Richard Hann, Liver Disease Prevention Center, Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson UniversityFollow
Ronald E. Myers, PhD, DSW, Director, Division of Population Science, and Professor, Department of Medical Oncology, Jefferson Medical CollegeFollow
Fenil Patel, Division of Population Science, Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson University
Kejin Zhang, Division of Population Science, Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson University
Zhong Ye, Division of Population Science, Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson UniversityFollow
Chun Wang, Division of Population Science, Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson UniversityFollow
Hushan Yang, Division of Population Science, Department of Medical Oncology, Kimmel Cancer Center, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

1-1-2015

Comments

This article has been peer reviewed. It was published in: Journal of Gastroenterology and Hepatology (Australia).

Volume 30, Issue 1, 1 January 2015, Pages 131-138.

The published version is available at DOI: 10.1111/jgh.12664

Copyright © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Abstract

BACKGROUND AND AIM: APRI (aspartate aminotransferase [AST] to platelet ratio index) is widely used to assess fibrosis and cirrhosis risk, especially in hepatitis C virus (HCV)-infected patients. Few studies have evaluated APRI and hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) risk. Prospective evidence is needed to assess whether APRI predicts HCC risk in HBV patients.

METHOD: In a prospectively enrolled clinical cohort of 855 HBV patients with a 1-year exclusion window (followed for > 1 year and did not develop HCC within 1 year), the predictive value of APRI in HCC risk was evaluated by Cox proportional hazards model using univariate and multivariate analyses and longitudinal analysis.

RESULTS: Higher APRI prospectively conferred a significantly increased risk of HCC in univariate analysis (quartile analysis, P trend = 2.9 × 10(-7) ). This effect remained highly significant after adjusting for common host characteristics but not cirrhosis (P trend = 7.1 × 10(-5) ), and attenuated when cirrhosis is adjusted (P trend = 0.021). The effect remained prominent when the analysis was restricted to patients with a more stringent 2-year exclusion window (P trend = 0.008 in quartile analysis adjusting all characteristics including cirrhosis), indicating that the association was unlikely due to including undetected HCC patients in the cohort, thus minimizing the reverse-causation limitation in most retrospective studies. Longitudinal comparison demonstrated a persistently higher APRI value in HBV patients who developed HCC during follow-up than those remaining cancer free.

CONCLUSION: APRI might be a marker of HCC risk in HBV patients in cirrhosis-dependent and -independent manners. Further studies are warranted to validate this finding and test its clinical applicability in HCC prevention.

Recommended Citation

Hann, Hie-Won; Wan, Shaogui; Lai, Yinzhi; Hann, Richard; Myers, PhD, DSW, Ronald E.; Patel, Fenil; Zhang, Kejin; Ye, Zhong; Wang, Chun; and Yang, Hushan, "Aspartate aminotransferase to platelet ratio index as a prospective predictor of hepatocellular carcinoma risk in patients with chronic hepatitis B virus infection." (2015). Division of Gastroenterology and Hepatology Faculty Papers. Paper 33.
https://jdc.jefferson.edu/gastro_hepfp/33

PubMed ID

24995497