التفاصيل البيبلوغرافية
| العنوان: |
Personalized surveillance for hepatocellular carcinoma in cirrhosis - using machine learning adapted to hcv status |
| المؤلفون: |
Audureau, Etienne, Carrat, Fabrice, Layese, Richard, Cagnot, Carole, Asselah, Tarik, Guyader, Dominique, Larrey, Dominique, De Ledinghen, Victor, Ouzan, Denis, Zoulim, Fabien, Roulot, Dominique, Tran, Albert, Bronowicki, Jean-Pierre, Zarski, Jean-Pierre, Riachi, Ghassan, Cales, Paul, Peron, Jean-Marie, Alric, Laurent, Bourliere, Marc, Mathurin, Philippe, Blanc, Jean-Frederic, Abergel, Armand, Chazouilleres, Olivier, Mallat, Ariane, Grange, Jean-Didier, Attali, Pierre, D'alteroche, Louis, Wartelle, Claire, Dao, Thong, Thabut, Dominique, Pilette, Christophe, Silvain, Christine, Christidis, Christos, Nguyen-Khac, Eric, Bernard-Chabert, Brigitte, Zucman, David, Di Martino, Vincent, Sutton, Angela, Pol, Stanislas, Nahon, Pierre, Marcellin, Patrick, Fontaine, Helene, Leroy, Vincent, Dharancy, Sebastien |
| المساهمون: |
CHU Lille, Inserm, Université de Lille, Hôpital Henri Mondor, CHU Saint-Antoine AP-HP, Agence Nationale de Recherches sur le Sida et les Hépatites Virales ANRS, Hôpital Beaujon AP-HP, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Hôpital Saint Eloi CHRU Montpellier, Hôpital Haut-Lévêque CHU Bordeaux, Institut Arnault Tzanck, Hospices Civils de Lyon HCL, Hôpital Avicenne AP-HP, Centre Hospitalier Universitaire de Nice CHU Nice, Centre Hospitalier Régional Universitaire de Nancy CHRU Nancy, Hôpital Michallon, CHU Rouen, Centre Hospitalier Universitaire d'Angers CHU Angers, Centre Hospitalier Universitaire de Toulouse CHU Toulouse, Hôpital Saint-Joseph Marseille, Hôpital Claude Huriez Lille, CHU Bordeaux, CHU Clermont-Ferrand, CHU Tenon AP-HP, Hôpital Paul Brousse, CHU Trousseau Tours, Centre Hospitalier d'Aix en Provence Aix-en-Provence CHIAP, Hôpital Côte de Nacre CHU Caen, CHU Pitié-Salpêtrière AP-HP, Centre Hospitalier Le Mans (CH Le Mans), Centre hospitalier universitaire de Poitiers = Poitiers University Hospital CHU de Poitiers, Institut Mutualiste de Montsouris IMM, CHU Amiens-Picardie, Hôpital Robert Debré, Hôpital Foch Suresnes, Hôpital JeanMinjoz, Hôpital Jean Verdier AP-HP, Hôpital Cochin AP-HP, Centre Hospitalier Régional Universitaire CHU Lille CHRU Lille |
| سنة النشر: |
2024 |
| المجموعة: |
LillOA (Lille Open Archive - Université de Lille) |
| مصطلحات موضوعية: |
Cirrhosis, HCV clearance, Liver cancer, Machine learning, Screening |
| الوصف: |
Refining hepatocellular carcinoma (HCC) surveillance programs requires improved individual risk prediction. Thus, we aimed to develop algorithms based on machine learning approaches to predict the risk of HCC more accurately in patients with HCV-related cirrhosis, according to their virological status. Patients with compensated biopsy-proven HCV-related cirrhosis from the French ANRS CO12 CirVir cohort were included in a semi-annual HCC surveillance program. Three prognostic models for HCC occurrence were built, using (i) Fine-Gray regression as a benchmark, (ii) single decision tree (DT), and (iii) random survival forest for competing risks survival (RSF). Model performance was evaluated from C-indexes validated externally in the ANRS CO22 Hepather cohort (n = 668 enrolled between 08/2012-01/2014). Out of 836 patients analyzed, 156 (19%) developed HCC and 434 (52%) achieved sustained virological response (SVR) (median follow-up 63 months). Fine-Gray regression models identified 6 independent predictors of HCC occurrence in patients before SVR (past excessive alcohol intake, genotype 1, elevated AFP and GGT, low platelet count and albuminemia) and 3 in patients after SVR (elevated AST, low platelet count and shorter prothrombin time). DT analysis confirmed these associations but revealed more complex interactions, yielding 8 patient groups with varying cancer risks and predictors depending on SVR achievement. On RSF analysis, the most important predictors of HCC varied by SVR status (non-SVR: platelet count, GGT, AFP and albuminemia; SVR: prothrombin time, ALT, age and platelet count). Externally validated C-indexes before/after SVR were 0.64/0.64 [Fine-Gray], 0.60/62 [DT] and 0.71/0.70 [RSF]. Risk factors for hepatocarcinogenesis differ according to SVR status. Machine learning algorithms can refine HCC risk assessment by revealing complex interactions between cancer predictors. Such approaches could be used to develop more cost-effective tailored surveillance programs. Patients with HCV-related cirrhosis must ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| Relation: |
Journal of hepatology; J. Hepatol.; http://hdl.handle.net/20.500.12210/40759 |
| الاتاحة: |
https://hdl.handle.net/20.500.12210/40759 |
| Rights: |
info:eu-repo/semantics/closedAccess |
| رقم الانضمام: |
edsbas.4380AF64 |
| قاعدة البيانات: |
BASE |