Risk prediction of hepatitis B virus-related hepatocellular carcinoma in the era of antiviral therapy

Abstract

Hepatocellular carcinoma (HCC) is a grave primary liver cancer that has a limited therapeutic option because it is generally diagnosed later in an advanced stage due to its aggressive biologic behavior. The early detection of HCC has a great impact on the treatment efficacy and survival of patients at high risk for cancer. Potential host, environmental, and virus-related risk factors have been introduced. Hepatitis B virus (HBV) is a major cause of end-stage liver diseases such as liver cirrhosis or HCC in endemic areas, and its serologic or virologic status is considered an important risk factor. HCC risk prediction derived from the identification of major risk factors is necessary for providing adequate screening/surveillance strategies to high-risk individuals. Several risk prediction models for HBV-related HCC have been presented recently with simple, efficient, and readily available to use parameters applicable to average- or unknown-risk populations as well as high-risk individuals. Predictive scoring systems of risk estimation to assess HCC development can provide the way to an evidence-based clinical approach for cost- and effort-effective outcomes, capable of inducing a personalized surveillance program according to risk stratification. In this review, the concepts and perspectives of the risk prediction of HCC are discussed through the analysis of several risk prediction models of HBV-related HCC.

Keywords: Hepatocellular carcinoma, Hepatitis B virus, Chronic hepatitis B, Risk prediction, Risk factors

Core tip: This review shows the concepts and perspectives of the risk prediction of hepatitis B virus-related hepatocellular carcinoma. Accurate risk scoring systems to predict hepatocellular carcinoma (HCC) development, derived from independent risk factors integrated in aspects of host, environment, and virus, are necessary for performing the strategic processes such as screening/surveillance, diagnosis, and treatment in high-risk individuals of HCC. Globally standardized consensus for HCC risk prediction models should be established on the basis of simplicity, assessability, and reproducibility of the model characteristics available in real clinical setting.