Evidence map›Paper›PMID 38079023›Full record

ArticleHepatology international2024

Incidence and predictors of hepatocellular carcinoma in NAFLD without diagnosed cirrhosis: a nationwide real-world U.S. study.

Daniel Q Huang, Sally Tran, Scott Barnett, Biyao Zou, Yee Hui Yeo, Ramsey Cheung, Mindie H Nguyen

Abstract read
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In one paragraph

Article in Hepatology international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Article
  4. [Research advances in occurrence risk assessment and early-stage diagnosis of hepatocellular carcinoma].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025
    Review
  5. Review
  6. [Research progress in the extent of hepatocellular carcinoma in the year 2024].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025
    Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Daniel Q HuangDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Sally TranDivision of Gastroenterology and Hepatology, Stanford University Medical Center, 780 Welch Road, Palo Alto, CA, 94304, USA.
Scott BarnettDivision of Gastroenterology and Hepatology, Stanford University Medical Center, 780 Welch Road, Palo Alto, CA, 94304, USA.
Biyao ZouDivision of Gastroenterology and Hepatology, Stanford University Medical Center, 780 Welch Road, Palo Alto, CA, 94304, USA.
Yee Hui YeoDivision of General Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Ramsey CheungDivision of Gastroenterology and Hepatology, Stanford University Medical Center, 780 Welch Road, Palo Alto, CA, 94304, USA.
Mindie H NguyenDivision of Gastroenterology and Hepatology, Stanford University Medical Center, 780 Welch Road, Palo Alto, CA, 94304, USA. mindiehn@stanford.edu.ORCID http://orcid.org/0000-0002-6275-4989
Stanford Medicine · USCedars-Sinai Medical Center · USNational University of Singapore · SGStanford Health Care · USVA Palo Alto Health Care System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA substantial proportion of patients with nonalcoholic fatty liver disease (NAFLD)-related hepatocellular carcinoma (HCC) do not have cirrhosis. Data regarding the incidence and predictors of HCC development in NAFLD without cirrhosis are limited. We conducted a large, national study of NAFLD patients without documented cirrhosis to examine the incidence and predictors for HCC development.

methodsThis retrospective study included 751,603 NAFLD patients (54% female) without documented cirrhosis derived from the deidentified Optum Clinformatics

resultsThe mean age was 53.7 ± 15.0 years, 45.9% were male, 39.5% had diabetes, 57.6% were White, 18.4% Hispanic, 8.2% Black and 4.9% were Asian. The mean platelet count was 264,000 ± 72,000/µL, and 96.3% of patients had a FIB-4 < 1.30. Over 1,686,607 person-years of follow-up, there were 76 incident cases of HCC, resulting in an HCC incidence rate of 0.05 per 1000 person-years. There was a higher HCC incidence rate among patients with platelets ≤ 150,000/µL, versus those with platelets > 150,000/µL (0.23 per 1000 person-years, vs. 0.04 per 1000 person-years, p = 0.02) but not in subgroup analyses for age, sex, race/ethnicity or diabetes. Using multivariable Cox proportional hazards model adjusted multiple confounders, platelet count ≤ 150,000/µL remained an independent predictor of HCC development (adjusted HR 5.80, 95% CI 1.67-20.1, p = 0.006).

conclusionHCC incidence in NAFLD without documented cirrhosis was below the threshold for cost-effective HCC surveillance in overall and multiple subgroup analyses. Platelet count < 150,000/µL may be a useful predictor of HCC development in this population.

Indexed as

Carcinoma, HepatocellularDiabetes MellitusLiver NeoplasmsNon-alcoholic Fatty Liver DiseaseAdultAgedFemaleFibrosisHumansIncidenceLiver CirrhosisMaleMiddle AgedRetrospective StudiesRisk FactorsDiabetes mellitusHCC surveillanceHepatomaLiver cancerNatural historyNon-cirrhoticPlatelet countScreeningSteatosisThrombocytopenia

Identifiers

PMID38079023
OpenAlexW4389562496

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.