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We read with great interest the recent paper by Abu-Amara et al 1 showing that hepatocellular carcinoma (HCC) risk scores derived from Asian cohorts with chronic hepatitis B (CHB) were applicable to a heterogeneous North American patient population as well. They reported that the scoring systems were especially accurate in identifying low-risk patients and as such it is reasonable to use them to guide HCC surveillance recommendations. Out of the five risk scores evaluated, the Chinese University (CU)-HCC and Guide with Age, Gender, HBV DNA, Core promoter mutations and Cirrhosis (GAG-HCC) performed the best.2 ,3 However, HBV DNA titres are needed in both scores and additionally, core mutation determination is needed for even better prediction in the GAG-HCC. Liu et al 4 showed that HBsAg titre is useful in stratifying HCC risk in non-viraemic patients and a recent risk score published by Lin et al 5 included HBsAg titre. These are costly tests that are not universally available.
We have …
Contributors ZP and C-KT contributed equally to the data and to the writing of the letter. LS contributed to the statistical analyses, risk model derivation and statistical reporting. VWW, M-FY, B-BGG and P-EJC contributed to the writing of the letter. C-JC, M-FY, HL-YC, H-IY, W-KS and VWW contributed to the validation datasets and to the refinement of the letter. CYL contributed to the data.
Competing interests None declared.
Ethics approval SingHealth Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
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