论文部分内容阅读
Objective:Hepatocellular carcinoma(HCC)development among hepatitis B surface antigen(HBsAg)carriers shows gender disparity,influenced by underlying liver diseases that display variations in laboratory tests.We aimed to construct a risk-stratified HCC prediction model for HBsAg-positive male adults.Methods:HBsAg-positive males of 35-69 years old(N=6,153)were included from a multi-center population-based liver cancer screening study.Randomly,three centers were set as training,the other three centers as validation.Within 2 years since initiation,we administrated at least two rounds of HCC screening using B-ultrasonography and α-fetoprotein(AFP).We used logistic regression models to determine potential risk factors,built and examined the operating characteristics of a point-based algorithm for HCC risk prediction.Results:With 2 years of follow-up,302 HCC cases were diagnosed.A male-ABCD algorithm was constructed including participant\'s age,blood levels of GGT(γ-glutamyl-transpeptidase),counts of platelets,white cells,concentration of DCP(des-γ-carboxy-prothrombin)and AFP,with scores ranging from 0 to 18.3.The area under receiver operating characteristic was 0.91(0.90-0.93),larger than existing models.At 1.5 points of risk score,26.10％ of the participants in training cohort and 14.94％ in validation cohort were recognized at low risk,with sensitivity of identifying HCC remained 100％ .At 2.5 points,46.51％ of the participants in training cohort and 33.68％ in validation cohort were recognized at low risk with 99.06％ and 97.78％ of sensitivity,respectively.At 4.5 points,only 20.86％ of participants in training cohort and 23.73％ in validation cohort were recognized at high risk,with positive prediction value of 22.85％ and 12.35％ ,respectively.Conclusions:Male-ABCD algorithm identified individual\'s risk for HCC occurrence within short term for their HCC precision surveillance.