Editorial
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 7, 2016; 22(29): 6565-6572
Published online Aug 7, 2016. doi: 10.3748/wjg.v22.i29.6565
Prediction and prophylaxis of hepatocellular carcinoma occurrence and postoperative recurrence in chronic hepatitis B virus-infected subjects
Yan Du, Xue Han, Yi-Bo Ding, Jian-Hua Yin, Guang-Wen Cao
Yan Du, Office of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
Xue Han, Division of Chronic Disease Control, Center for Diseases Control and Prevention of Yangpu District, Shanghai 200090, China
Yi-Bo Ding, Jian-Hua Yin, Guang-Wen Cao, Department of Epidemiology, Second Military Medical University, Shanghai 200433, China
Author contributions: All the authors equally contributed to the conception and design of the study, literature review and analysis, drafting, critical revision and editing, and gave approval of the final version.
Supported by the National Key Basic Research Program (973 program), No. 2015CB554000; and the National Natural Science Foundation of China, No. 81302492, No. 81520108021 and No. 91529305.
Conflict-of-interest statement: There are no potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Guang-Wen Cao, MD, PhD, Professor, Chairman, Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, China. gcao@smmu.edu.cn
Telephone: +86-21-81871060 Fax: +86-21-81871060
Received: April 7, 2016
Peer-review started: April 8, 2016
First decision: April 8, 2016
Revised: April 8, 2016
Accepted: June 28, 2016
Article in press: June 28, 2016
Published online: August 7, 2016
Processing time: 113 Days and 4.6 Hours
Abstract

Hepatocellular carcinoma (HCC) is one of the most common and highly fatal malignancies worldwide. Chronic infection with hepatitis B virus (HBV) is a major cause of HCC. High HBV replication rate and related non-resolving inflammation are the major risk factors of HCC occurrence and postoperative recurrence. Early prophylactic options are effective in reducing HCC occurrence and improving survival. Therefore, it is important to identify HBV-infected patients who are at a higher risk of developing HCC and HBV-HCC patients who are more likely to relapse after surgery, thus providing them with more precise prophylactic strategies. Several prediction models of HCC occurrence have been constructed, with satisfactory predictive accuracy and discriminatory ability. However, there is a lack of consensus for their clinical implementation. Several staging systems have been proposed for HCC prognosis. However, the accuracy of these staging systems based on demographic characteristics and clinical measurements needs to be further improved, possibly by systematically incorporating viral and inflammatory factors. Since antiviral treatments are effective in promoting liver function reserve, reducing HCC occurrence and prolonging postoperative survival in some HBV-infected subjects, it is very important to identify subgroups of HBV-infected patients who would most benefit from antiviral treatment.

Keywords: Hepatocellular carcinoma; Chronic hepatitis B; Incidence; Prognosis; Prediction

Core tip: Early prophylactic options are effective in reducing hepatitis B virus (HBV)-hepatocellular carcinoma (HCC) occurrence and improving survival. Therefore, it is important to identify HBV-infected patients who are at a higher risk of developing HCC and HBV-HCC patients who are more likely to relapse after surgery. Several prediction models of HCC occurrence have been constructed, with satisfactory predictive accuracy and discriminatory ability. However, there is a lack of consensus for their clinical implementation. Several staging systems have been proposed for HCC prognosis but none have been universally accepted. We discuss important features when translating risk prediction scores derived from academic studies to clinical practice.