Copyright
©2010 Baishideng. All rights reserved
Precise prediction model and simplified scoring system for sustained combined response to interferon-α
Qian-Guo Mao, Jin-Shui Pan, Kuang-Nan Fang, Ru-Mian Zhang, Qing-Yang Hong, Min-Ning Song, Jian-Ping Zhu, Wen-Qi Huang, Li-Min Chen, Mei-Zhu Hong
Qian-Guo Mao, Ru-Mian Zhang, Hepatology Unit and Department of Infectious Diseases, Xiamen Hospital of Traditional Chinese Medicine, Xiamen 361000, Fujian Province, China
Jin-Shui Pan, Division of Gastroenterology, Zhongshan Hospital Xiamen University, Gastroenterology Institute of Xiamen University, Gastroenterology Center of Xiamen, Xiamen 361004, Fujian Province, China
Kuang-Nan Fang, Jian-Ping Zhu, Department of Planning and Statistics, Xiamen University, Xiamen 361005, Fujian Province, China
Qing-Yang Hong, College of Information Science and Technology, Xiamen University, Xiamen 361005, Fujian Province, China
Min-Ning Song, Wen-Qi Huang, Mei-Zhu Hong, Division of Infectious Diseases, the 174th Hospital of PLA, Xiamen 361003, Fujian Province, China
Li-Min Chen, Division of Infectious Diseases, the People’s Hospital of Macheng, Macheng 431600, Hubei Province, China
Author contributions: Mao QG, Pan JS and Fang KN contributed equally to the research; Pan JS and Hong MZ generated the study concept and design; Mao QG, Pan JS, Zhang RM, Song MN, Huang WQ, Chen LM and Hong MZ provided the material; Fang KN, Hong QY and Zhu JP analyzed and interpreted the data and performed the statistical analysis; Pan JS and Hong MZ drafted the manuscript; Pan JS critically revised the manuscript for important intellectual content.
Correspondence to: Mei-Zhu Hong, MD, Division of Infectious Diseases, the 174th Hospital of PLA, Xiamen 361003, Fujian Province, China. hongmeizhu28@yahoo.com.cn
Telephone: +86-592-6335715 Fax: +86-592-6335715
Received: January 20, 2010
Revised: February 22, 2010
Accepted: March 1, 2010
Published online: July 21, 2010
AIM: To establish a predictive algorithm which may serve for selecting optimal candidates for interferon-α (IFN-α) treatment.
METHODS: A total of 474 IFN-α treated hepatitis B virus e antigen (HBeAg)-positive patients were enrolled in the present study. The patients’ baseline characteristics, such as age, gender, blood tests, activity grading (G) of intrahepatic inflammation, score (S) of liver fibrosis, hepatitis B virus (HBV) DNA and genotype were evaluated; therapy duration and response of each patient at the 24th wk after cessation of IFN-α treatment were also recorded. A predictive algorithm and scoring system for a sustained combined response (CR) to IFN-α therapy were established. About 10% of the patients were randomly drawn as the test set. Responses to IFN-α therapy were divided into CR, partial response (PR) and non-response (NR). The mixed set of PR and NR was recorded as PR+NR.
RESULTS: Stratified by therapy duration, the most significant baseline predictive factors were alanine aminotransferase (ALT), HBV DNA level, aspartate aminotransferase (AST), HBV genotype, S, G, age and gender. According to the established model, the accuracies for sustained CR and PR+NR, respectively, were 86.4% and 93.0% for the training set, 81.5% and 91.0% for the test set. For the scoring system, the sensitivity and specificity were 78.8% and 80.6%, respectively. There were positive correlations between ALT and AST, and G and S, respectively.
CONCLUSION: With these models, practitioners may be able to propose individualized decisions that have an integrated foundation on both evidence-based medicine and personal characteristics.
