A statistical model predicting high hepatocyte proliferation index and the risk of developing hepatocellular carcinoma in patients with hepatitis C virus-related cirrhosis.

Full Abstract

BACKGROUND:
Incidence of hepatocellular carcinoma in hepatitis C virus-related cirrhosis is 4% per year. Although cost-effective, current screening could be improved.

AIM:
To develop a statistical model including non-invasive parameters able to identify patients at high risk of developing hepatocellular carcinoma.

METHODS:
One hundred and fifty-eight patients (73F:85M) with compensated chronic hepatitis C virus liver disease underwent evaluation, including argyrophilic nucleolar organizer regions proliferation index, and were followed up for 56.18 +/- 1.44 months.

RESULTS:
Fifty-six patients had chronic hepatitis without cirrhosis and low argyrophilic nucleolar organizer regions proliferation index (< or =25%), 65 had hepatitis C virus-related cirrhosis and low argyrophilic nucleolar organizer regions proliferation index and 37 had hepatitis C virus-related cirrhosis and high argyrophilic nucleolar organizer regions proliferation index (>25%). Groups were similar for gender and viral genotype distribution. None of the patients with chronic hepatitis without cirrhosis developed hepatocellular carcinoma, compared with 6.1% of low argyrophilic nucleolar organizer regions proliferation index and 30.6% of high argyrophilic nucleolar organizer regions proliferation index (P = 0.002). By multivariable logistic regression analysis, the following parameters were independently associated with hepatocellular carcinoma development and used for the development of the statistical model:
platelets (OR 0.98), gamma-globulins (OR 0.111), alanine aminotransferase/aspartate aminotransferase ratio (OR 0.07), serum ferritin (OR 1.0) and ultrasonographic pattern (coarse OR 2.9, coarse nodular OR 10.12). The statistical model properly allocated 95.9% of patients with low argyrophilic nucleolar organizer regions proliferation index and 72.2% of patients with high argyrophilic nucleolar organizer regions proliferation index.

CONCLUSIONS:
The model, to be validated in large prospective studies, may help tailoring screening according to the risk of hepatocellular carcinoma development.

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Author information

Author/s: Azzaroli, F (F); Colecchia, A (A); Colecchi, A (A); Lodato, F (F); Trerè, D (D); Bacchi Reggiani, M L (ML); Festi, D (D); Prati, G M (GM); Accogli, E (E); Casanova, S (S); Derenzini, M (M); Roda, E (E); Mazzella, G (G);

Affiliation: Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy. azzaroli(-atsign-)med.unibo.it

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther), published in England. (Language: eng)

Reference: 2006-Jul; vol 24 (issue 1) : pp 129-36

Dates: Created 2006/06/28; Completed 2007/01/18; Revised 2007/01/19;

PMID: 16803611, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

ErratumIn: Aliment Pharmacol Ther. 2006 Jul 15;24(2):439. (Note: Colecchi, A [corrected to Colecchia, A])

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adult
Aged
Carcinoma, Hepatocellular - virology
Cell Proliferation
Female
Hepatitis C, Chronic - complications; pathology
Hepatocytes - pathology; virology
Humans

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