A statistical model predicting high hepatocyte proliferation index and the risk

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Alimentary Pharmacology & Therapeutics

Volume 24 Page 129 - July 2006

doi:10.1111/j.1365-2036.2006.02955.x

Volume 24 Issue 1

A statistical model predicting high hepatocyte proliferation index and the

risk of developing hepatocellular carcinoma in patients with hepatitis C

virus-related cirrhosis

F. AZZAROLI*, A. COLECCHI*, F. LODATO*, D. TRERȆ, M. L. BACCHI REGGIANI‡,

D. FESTI*, G. M. PRATI*, E. ACCOGLI*, S. CASANOVA*, M. DERENZINI†, E. RODA*

& G. MAZZELLA*

Summary

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 ( & #8804;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),

& #947;-globulins (OR 0.111), alanine aminotransferase/aspartate

aminotransferase ratio (OR 0.07), serum ferritin (OR 1.0) and

ultrasonographyc 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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