Shortening liver cancer screening interval may improve the prognosis of patients with hepatitis B cirrhosis-related hepatocellular carcinoma

Objective To investigate the influence of shortening liver cancer screening interval on the detection of early-stage hepatocellular carcinoma (HCC) in patients with hepatitis B cirrhosis and their prognosis, as well as proper screening schemes for such patients at a high risk of HCC.Methods A total of 310 patients with hepatitis B cirrhosis who were diagnosed and treated in Department of Gastroenterology and Hepatology, Beijing You An Hospital, from January 2007 to January 2008 were enrolled, and according to the screening interval, they were divided into 3-month screening group (group A) with 78 patients and 6-month screening group (group B) with 232 patients.The screening items included serum alpha-fetoprotein and ultrasound and the patients were followed up for 5 years.The patients with HCC screened out were followed up to the endpoint (death or December 31, 2016) .The detection of HCC and prognosis were compared between the two groups.The t-test was used for comparison of continuous data between groups, the chi-square test or Fisher's exact test was used for comparison of categorical data between groups, and the Kaplan-Meier method was used for survival analysis.Results At the end of the5-year follow-up, 73 patients were diagnosed with HCC, with 21 in group A and 52 in group B.Group A had a significantly higher proportion of patients with early-stage HCC (Barcelona Clinic Liver Cancer stage A) than group B [66.7% (14/21) vs 15.4% (8/52) , χ2=18.685, P<0.001].Group A also had a significantly higher proportion of patients who underwent radical surgery than group B (76.2% vs 36.5%, χ2=9.424, P=0.002) .The patients with HCC were followed up to the endpoint, and compared with group B, group A had a significantly longer cumulative survival time (66.4 ± 8.0 months vs 38.1 ± 4.5 months, t=4.295, P=0.038) and a significantly higher cumulative survival rate [71.4% (15/21) vs 46.2% (24/52) , χ2=3.840, P=0.043].Conclusion For patients with hepatitis B cirrhosis, a 3-month screening interval can increase the early detection rate of HCC, bring the opportunity of radical treatment for these patients, and prolong their survival time.