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Paranaguá-Vezozzo et al. Hepatoma Research 2018;4:11 Hepatoma Research
DOI: 10.20517/2394-5079.2018.17

Original Article Open Access

A potential clinical based score in hepatitis C virus
cirrhotic patients to exclude small hepatocellular
carcinoma

1,2
1
Denise Cerqueira Paranaguá-Vezozzo , Celso Eduardo Lourenço Matielo , Daniel Ferraz de Campos
Mazo , Lucas Souto Nacif , Mario Guimaraes Pessoa , Gleicy Luz Reinoso Pereira , Roque Gabriel
1
1
1
1,3
Rezende de Lima , Patricia Momoyo Yoshimura Zitelli , Suzane Kioko Ono , Flair José Carrilho 1,2
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1 Division of Gastroenterology and Hepatology, Department of Gastroenterology, University of São Paulo School of Medicine, São
Paulo 05403-900, Brazil.
2 São Paulo Clínicas Liver Cancer Group, São Paulo, Cancer Institute of São Paulo, University of São Paulo School of Medicine, São
Paulo 01246-000, Brazil.
3 Division of Gastroenterology (Gastrocentro), School of Medical Sciences, University of Campinas, Campinas 13083-878, Brazil.
Correspondence to: Dr. Denise Cerqueira Paranaguá-Vezozzo, Department of Gastroenterology, University of São Paulo School of
Medicine, Av. Dr. Enéas de Carvalho Aguiar n 255, Instituto Central, # 9159, São Paulo 05403-900, Brazil.
o
E-mail: denise.paranagua@gmail.com
How to cite this article: Paranaguá-Vezozzo DC, Matielo CEL, de Campos Mazo DF, Nacif LS, Pessoa MG, Pereira GLR, de Lima RGR,
Zitelli PMY, Ono SK, Carrilho FJ. A potential clinical based score in hepatitis C virus cirrhotic patients to exclude small hepatocellular
carcinoma. Hepatoma Res 2018;4:11. http://dx.doi.org/10.20517/2394-5079.2018.17
Received: 6 Mar 2018 First Decision: 12 Mar 2018 Revised: 20 Mar 2018 Accepted: 21 Mar 2018 Published: 27 Apr 2018
Science Editor: Guang-Wen Cao Copy Editor: Jun-Yao Li Production Editor: Huan-Liang Wu

Abstract
Aim: Hepatitis C virus (HCV) cirrhosis is an important cause of hepatocellular carcinoma (HCC). This study aimed
to identify factors of HCC presence among HCV cirrhotic patients with and without small diameter HCC (≤ 3 cm).

Methods: A case control transversal study between 1998 and 2003 including 93 patients: 31 with small diameter
HCC and 62 without HCC. Groups were matched by age and gender. Multiple logistic regression analysis using
Akaike Information Criteria to estimate the probability of HCC was performed. A model score was generated and
bootstrap analysis was performed for internal validation.

Results: Three significant laboratorial variables for HCC presence were found: alanine aminotransferase > 37 U/L
[odds ratio (OR): 7.43 (1.61-34.19), P = 0.01], alpha-fetoprotein > 20 ng/mL [OR: 16.2 (4.17-63.01), P < 0.001] and
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platelet count < 100,000/mm [OR: 3.62 (1.43-9.14), P = 0.007]. A model score with an area under curve of 0.79
(95% CI: 0.7-0.89) was built based on these variables. The negative predictive value of those classified as at low
risk of HCC was 99.1%.

Conclusion: An easy and practical model score was generated. It may be an auxiliary tool for identification of HCV
patients with low probability of small diameter HCC at initial evaluation composed of three serum examinations
used in routine outpatient clinical practice.
© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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