Reassessing the accuracy of PAGE-B-related scores to predict hepatocellular carcinoma development in patients with chronic hepatitis B

• Published in: Journal of hepatology 2020-05, Vol.72 (5), p.847-854
• Main Authors: Yip, Terry Cheuk-Fung, Wong, Grace Lai-Hung, Wong, Vincent Wai-Sun, Tse, Yee-Kit, Liang, Lilian Yan, Hui, Vicki Wing-Ki, Lee, Hye Won, Lui, Grace Chung-Yan, Chan, Henry Lik-Yuen
• Format: Article
• Language: English
• Subjects: Antiviral agents; Entecavir; HBV; HCC; Hepatitis B; Hepatocellular carcinoma; Interferon; Liver cancer; Nucleos(t)ide analogues; Patients; Predictions; Risk score; Surveillance; Survival analysis; Tenofovir
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2019.12.005

PAGE-B and modified PAGE-B (mPAGE-B) scores were developed to predict the risk of hepatocellular carcinoma (HCC) in patients on nucleos(t)ide analogue therapy. However, how and when to use these risk scores in clinical practice is uncertain. Consecutive adult patients with chronic hepatitis B who had received entecavir or tenofovir for at least 6 months between January 2005 and June 2018 were identified from a territory-wide database in Hong Kong. The performance of PAGE-B and mPAGE-B scores for HCC prediction at 5 years was assessed by area under the time-dependent receiver operating characteristic curve (AUROC), and different cut-off values of these 2 scores were evaluated by survival analysis. Of 32,150 identified patients with chronic hepatitis B, 20,868 (64.9%) were male. Their mean age was 53.0 ± 13.2 years. At a median (IQR) follow-up of 3.9 (1.8–5.0) years, 1,532 (4.8%) patients developed HCC. The AUROCs (95% CI) for the prediction of HCC at 5 years were 0.77 (0.76–0.78) and 0.80 (0.79–0.81), with PAGE-B and mPAGE-B scores, respectively (p