Hepatocellular carcinoma screening and surveillance in 2293 chronic hepatitis B patients in an endemic area

Table 1 Chronic hepatitis B Patient baseline characteristics n (%)

Characteristics	Total (n = 2293)
Male sex	1078 (47.0)
Marital status (married)	1306 (57.2)
Alcohol consumption	683 (29.7)
Tobacco habit	290 (12.6)
Overweight: BMI > 25	854 (37.2)
HBV status
Hepatitis B e-Ag positive	394 (17.0)
Hepatitis B e-Ag negative with HBV DNA < 2000 IU/mL	1184 (52.0)
Hepatitis B e-Ag negative with HBV DNA ≥ 2000 IU/mL	713 (31.0)
ALT > 60 IU/L	262 (11.4)
Cirrhosis	77 (3.3)

BMI: Body mass index; ALT: Alanine aminotransferase.

Table 2 Hepatocellular carcinoma patient characteristics

Patient No.	Age (yr)	Sex	Time from entry to diagnosis (mo)	TumorNo.	Size (cm)	Cirrhosis	BCLC stage	AFP at diagnosis (μg/L)	Treatment
1	50	M	At entry	1	6.5	Y	A	391	Segmental resection
2	63	M	At entry	2	6.4	N	B	8419	TACE then segmental resection
3	54	M	At entry	1	4.5	Y	A	4	Hepatectomy
4	57	M	At entry	1	7.8	Y	A	25	TACE, PVE then hepatectomy
5	44	M	At entry	1	1.7	N	0	4	Segmental resection
6	51	M	At entry	1	6.5	N	A	24	Hepatectomy
7	45	F	At entry	1	4.5	N	A	55	Hepatectomy
8	45	F	6	1	1.4	Y	0	5	TACE
9	62	F	6	2	1.3	Y	0	13	RFA
10	61	M	6	1	4.7	Y	A	22	TACE
11	57	F	12	2	4.0	N	A	15	Segmental resection
12	66	M	24	1	1.7	Y	0	3	Segmental resection
13	40	F	24	1	1.4	N	0	< 1	Segmental resection
14	69	F	30	1	1.4	N	0	2	Segmental resection
15	61	F	39	1	2.2	Y	A	3020	SBRT, TACE
16	64	M	39	1	1.7	Y	0	8.2	RFA
17	48	M	45	1	2.6	N	A	2.5	Segmental resection

AFP: Alpha-fetoprotein; BCLC: Barcelona Clinic Liver Cancer; TACE: Transarterial chemoembolization; PVE: Portal vein embolization; RFA: Radiofrequency ablation; SBRT: Stereotactic body radiation therapy.

Table 3 Cause of alpha-fetoprotein elevation at the initial screening and the number of subjects

Cause	No. of subjects
Hepatocellular carcinoma	5
Cirrhosis	10
Increased ALT levels	10
Pregnancy	2

ALT: Alanine aminotransferase.

Table 4 Performance of screening and surveillance tests for hepatocellular carcinoma

Test	Sensitivity (%)	Specificity (%)
AFP	7/17 (41)	2247/2276 (98)
Ultrasound	16/17 (94)	1879/2276 (82)
Ultrasound and AFP	16/17 (94)	1872/2276 (82)

AFP: Alpha-fetoprotein.

Table 5 Diagnosis of focal liver nodules at initial screening using abdominal ultrasonography

Diagnosis	n (%)
HCC	7 (8)
Hemangioma	49 (51)
Calcified granuloma	8 (8)
Liver cyst	8 (8)
Regenerate nodule	3 (3)
Arteriovenous shunt	6 (6)
Normal liver parenchyma	15 (19)

HCC: Hepatocellular carcinoma.