About this trial
Evaluating the effectiveness of standardized HCC risk stratification management in improving early diagnosis rates in patients with chronic liver disease
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Voluntarily participate in the clinical study, fully understand and be informed of this study, sign the informed consent form, be willing to comply with and have the ability to complete all trial procedures.
Age between 18 and 75 years (inclusive)
Enrolled subjects must meet at least one of the following conditions: [1] Diagnosed with chronic hepatitis B virus infection via in-hospital or out-of-hospital pathways: Hepatitis B surface antigen (HBsAg) positive for 6 months or more; [2] Diagnosed with chronic hepatitis C virus infection via in-hospital or out-of-hospital pathways; [3] Subjects with a first-degree family history of hepatocellular carcinoma (first-degree relatives: parents, children, and full siblings);[4]Diagnosed with liver cirrhosis via in-hospital or out-of-hospital pathways, and meeting at least one of the following criteria: a) Liver biopsy showing cirrhosis (Ishak score ≥ 5 or Metavir score = 4); b) Liver Stiffness Measurement (LSM) assessed by FibroScan ® (Echosens™, Paris, France) ≥ 12.0 kPa with normal total bilirubin (TB) and ALT ≤ 40 IU/mL, or LSM ≥ 17.0 kPa with normal TB and ALT < 200 IU/mL; c) Abdominal imaging findings indicative of cirrhosis (i.e., liver with a coarse texture or with echoes or showing nodularity, parenchymal or morphological abnormalities, and signs of gastroesophageal varices); d) APRI score ≥ 2.0; e) FIB-4 index ≥ 3.25; [5] Diagnosed with metabolic dysfunction-associated fatty liver disease (MAFLD) via in-hospital or out-of-hospital pathways and with moderate liver fibrosis, specifically defined as a liver fibrosis score of F3 or above based on transient elastography, i.e., FibroScan® LSM ≥ 10 kPa or the corresponding threshold for FibroTouch® [24]; or non-invasive liver fibrosis index FIB-4 > 3.25; or NFS > 0.67; or APRI > 1. • The diagnosis of metabolic dysfunction-associated fatty liver disease (MAFLD) requires evidence of >5% hepatic steatosis based on the Controlled Attenuation Parameter (CAP) from transient elastography, or similar parameters, or liver biopsy, concurrently with at least one of the following three conditions: overweight/obesity (BMI > 23 kg/m²), type 2 diabetes, or evidence of metabolic dysregulation. [6] Diagnosed with metabolic dysfunction-associated fatty liver disease (MAFLD) complicated by glucose metabolism abnormalities via in-hospital or out-of-hospital pathways: a) Glucose metabolism abnormality is defined as type 2 diabetes, or prediabetes indicated by fasting plasma glucose 5.6-6.9 mmol/L, or 2-hour postprandial glucose 7.8-11.0 mmol/L, or glycated hemoglobin (HbA1c) 5.7%-6.4%
Disqualifiers
Age < 18 years or > 75 years
Suffering from severe mental illness or cognitive impairment
Pregnant or breastfeeding patients, or patients planning to become pregnant
Individuals who have participated in another clinical trial within the last 3 months or are currently participating in another clinical trial
Trial population
This is a single-arm, observational cohort study. The target liver disease patients include those with chronic hepatitis B virus infection, hepatitis C virus infection, liver cirrhosis, metabolic dysfunction-associated fatty liver disease (MAFLD) with a liver fibrosis index of F3 or above, alcoholic liver disease, MAFLD with abnormal glucose metabolism, and those with a first-degree family history of hepatocellular carcinoma. Based on the number of such patients at Shenzhen Third People's Hospital within one case year, this study plans to enroll 15,000 subjects.
Trial design
Cohort
Prospective
Treatments tested in this trial
Not listed
Trial groups
Trial outcomes
Primary outcomes
Early diagnosis rate of hepatocellular carcinoma (HCC)
The proportion of participants diagnosed with HCC at an early stage from project initiation until completion of follow-up, defined as the percentage of patients with CNLC stages Ia, Ib, and IIa among all participants with HCC detected in this study.
Secondary outcomes
Proportion of participants with regular follow-up
Regular follow-up is defined as the mean follow-up adherence being less than 1/3. Definitions: ① Actual visit interval: time of current visit minus time of previous visit. ② Scheduled visit interval: scheduled return visit time (as prescribed at the previous visit) minus time of the previous visit. ③ Follow-up adherence = (1-①/②)/2. The proportion of participants with regular follow-up is defined as the number of participants who meet the criteria for regular follow-up divided by the total.
Other outcomes
Liver cancer risk-stratified exploratory analyses
This pre-specified domain includes the following exploratory assessments: 3-year cumulative incidence of liver cancer in overall participants.
Sponsors and contacts
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Cai Qingxian
Lead sponsor
Shenzhen Third People's Hospital
Sponsor institution