Transaminase levels predict HCC risk in general population; better discrimination than HCV/HBV
FRIDAY, Oct. 19 (HealthDay News) -- Common liver function tests, including measurement of alanine transaminase (ALT) and aspartate transaminase (AST) levels, can be used to reliably predict hepatocellular carcinoma (HCC) risk in the general population with average or unknown risk, according to research published in the Oct. 17 issue of the Journal of the National Cancer Institute.
Chi-Pang Wen, M.D., M.P.H., Dr.P.H., of the National Health Research Institutes in Zhunan, Taiwan, and colleagues conducted a prospective cohort study involving 130,533 subjects with known hepatitis C virus (HCV) test results and 298,051 subjects without HCV results to examine risk prediction models based on clinically available data.
Over an average of 8.5 years of follow-up, 1,668 incident HCCs occurred. The researchers found that age; sex; health history; HCV and hepatitis B virus (HBV) status; and serum levels of ALT, AST, and alfa-fetoprotein all significantly and independently predicted HCC risk. Discrimination was higher using a model with serum transaminases only, compared with HBV or HCV only (area under the curve [AUC] for transaminases, 0.912; AUC for HBV, 0.840; AUC for HCV, 0.841). Discrimination was improved by adding HBV and HCV data to the transaminase-only model (AUC, 0.933). The high discrimination accuracy and calibration of these models was validated internally.
"This simple tool for the general public more accurately assesses risk even among groups previously thought to be at low or average risk and may be helpful to educate and motivate individuals to pursue options beneficial in reducing their risk of liver cancer and all-cause mortality," the authors write.
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