Verification Of AASLD Guidelines In Diagnosis Of Hepatitis B Related Hepatocellular Carcinoma And Exploration For Diagnostic Criteria

Aim This article is going to validate AASLD criteria for HBV-related hepatocellular carcinoma diagnosis, and to compare the diagnostic significance of radiological performance, liver cirrhosis, HBV infection, serum AFP value, in order to establish the best diagnosis strategy.Methods Patients who were first found liver nodule (≥1cm) during surveillance and received either surgery or biopsy were enrolled and devided into HCC group(190 patients/198 nodules) and non-HCC group(171 patients/171 nodules) according to pathology. Both groups are devided again chronologically into Training Set (HCC 122/127 vs non-HCC 100/100) and Validation Set (HCC 69/71 vs non-HCC 71/71). Training Set was used for diagnosis tests in order to generate superior modalities among which were established on the basis of radiological performance, liver cirrhosis, HBsAg, HBeAg, HBeAb, HBcAb and serum AFP value. Validation Set was used for compare the superior modalities and decide the best diagnosis strategy.Results The best diagnosis modality was described as " characteristic MDCT/MRI performance plus HBsAg or HBeAb positive ", sensitivity, specificity, AUROC of which were 76%,92%,0.838, respectively. AASLD modality as "characteristic MDCT/MRI performance plus liver cirrhosis" also performed good sensitivity, specificity and AUROC, which were 70%, 97%,0.838, respectively.Conclusion The proposed noninvasive diagnosis criteria for for HBV-related HCC was concluded as:Liver nodule≥1cm with characteristic MDCT/MRI performance in HBsAg or HBeAb positive, or cirrhotic patients.