To investigate the relationship between liver stiffness and hepatocellular carcinoma (HCC) risk in chronic heptatitis B patients with negative α-fetoprotein (AFP) tests.

From September 2012 to August 2014, this study enrolled a total of 82 HBV-relative native HCC patients as the case group. During the same period, a total of 253 chronic hepatitis B patients were also include in this study as the control group. These 253 patients were followed up for six months. All of the two groups were AFP-negative. Liver stiffness was measured in all patients by transient elastography device Fibroscan?. Logistic regression was applied to assess the risk of HCC incidence, and stratum-specific likelihood ratios (SSLR) was calculated.

The age, liver stiffness measurements and plasma albumin of patients in case group were 53 years old (44-61), 12.00 kPa (7.50-20.75), 43.14 g/L (39.50-46.75) respectively. The age, liver stiffness measurements and plasma albumin of patients in control group were 45 years old (38-56), 8.40 kPa (5.40-13.50), 46.40 g/L (43.75-48.50) respectively. The variables were compared between two groups with unpaired student t test, and the results were statistically significant (t=4.33, 3.56, -4.48, P=0.00, 0.00, 0.00). The patients in case group were older, and had higher liver stiffness measurements and lower plasma albumin than that of the patients in control group. Logistic regression analysis showed that HCC incidence was associated with age, male-gender and liver stiffness, and the odds ratios (OR) was 1.053, 2.432, 6.803 respectively. When liver stiffness was <10 kPa, 10.1-15 kPa, 15.1-25 kPa, >25 kPa, SSLR for HCC presence was 0.67, 1.02, 1.44, 3.98 respectively.

Liver stiffness measured by transient elastography is useful in predicting the risk of HCC incidence in AFP-negative chronic heptatitis B patients. Clinicians needed to carry out close follow-up and appropriate intervention for these patients.