Clinical Scoring System to Predict Hepatocellular Carcinoma in Chronic Hepatitis B Carriers
ABSTRACT Hepatitis B virus (HBV) infection is an important etiology for hepatocellular carcinoma (HCC). We aim to develop a simple clinical score in predicting the risk of HCC among HBV carriers.
We first evaluated 1,005 patients and found that the following five factors independently predicted HCC development: age, albumin, bilirubin, HBV DNA, and cirrhosis. These variables were used to construct a prediction score ranging from 0 to 44.5. The score was validated in another prospective cohort of 424 patients.
During a median follow-up of 10 years, 105 patients (10.%) in the training cohort and 45 patients (10.6%) in the validation cohort developed HCC. Cutoff values of 5 and 20 best discriminated HCC risk. By applying the cutoff value of 5, the score excluded future HCC development with high accuracy (negative predictive value = 97.8% and 97.3% in the training and validation cohorts, respectively). In the validation cohort, the 5-year HCC-free survival rates were 98.3%, 90.5%, and 78.9% in the low-, medium-, and high-risk groups, respectively. The hazard ratios for HCC in the medium- and high-risk groups were 12.8 and 14.6, respectively.
A simple prediction score constructed from routine clinical and laboratory parameters is accurate in predicting HCC development in HBV carriers. Future prospective validation is warranted.
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ABSTRACT: For future high-speed orthogonal frequency division multiplexing (OFDM) wireless communications, two major system requirements will exist: broadband transmission and rich interference elimination. Because of its broadband nature and limited frequency allocations worldwide, interference from co-located wireless LAN operating in the same frequency band will become a serious deployment issue, since interference may have a large amount of multipath and also have similar levels of received power compared to the desired signal. This paper presents recent investigations in OFDM smart antenna systems, more specifically the signal properties in the frequency domain, for co-channel interference detection and rejection. A novel architecture is proposed in this paper, which is a complexity-reduced frequency-domain technique using subcarrier clustering. Research results are presented and show that the proposed architecture can achieve high performance with low complexity, within a rich multipath environment with low signal to noise plus interference ratio (SNIR).Vehicular Technology Conference, 2002. VTC Spring 2002. IEEE 55th; 02/2002
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ABSTRACT: Hepatocellular carcinoma (HCC) is one of the commonest cancers worldwide, and more than half of HCC patients are attributable to persistent hepatitis B virus (HBV) infections. The best and cheapest way to prevent HBV-related HCC is the implementation of universal hepatitis B vaccination program, by which the incidence rates of childhood HCC have been reduced in several countries, including Taiwan. However, there are still hundreds of millions of HBV carriers in the world that remain a global health challenge. In the past decade, several hepatitis B viral factors such as serum HBV DNA level, genotype, and naturally occurring mutants have already been identified to influence liver disease progression and HCC development in HBV carriers. Several easy-to-use scoring systems based on clinical and viral characteristics are developed to predict HCC risk in HBV carriers and may facilitate the communication between practicing physicians and patients in clinical practice. In addition, the role of nonviral factors in HBV-related HCC has also been increasingly recognized. On the basis of these emerging data, it is recommended that HBV carriers should be screened and monitored to identify those who have a higher risk of liver disease progression and require antiviral treatments. Regarding the molecular carcinogenesis of HCC development, despite some progress in the research of cell biology of HCC in the past decade, aberrant pathways involved in maintaining HCC phenotypes have not been completely elucidated yet. In the future, through comprehensive and integrated approaches to analyze the genomes of human HCC, novel target genes or pathways critically involved in hepatocarcinogenesis may hopefully be identified.Advances in Cancer Research 01/2010; 108:21-72. DOI:10.1016/B978-0-12-380888-2.00002-9 · 4.26 Impact Factor