Abstract

Introduction: Hepatocellular carcinoma (HCC) is a significant complication of cirrhosis, associated with high morbidity and mortality rates. Various scoring systems have been developed to predict the risk of HCC development, including the aMAP score, which was developed and validated in 2020. This study aims to evaluate the efficacy of the aMAP score in predicting the onset of hepatocellular carcinoma.
Patients and methods: We conducted a retrospective analysis of 62 cirrhotic patients monitored in our department between 2006 and 2022. We collected data on demographics, clinical parameters, cirrhosis status, HCC imaging results, and alpha-fetoprotein levels. The aMAP score (ranging from 0 to 100) was calculated based on age, sex, albumin-bilirubin levels, and platelet count. Data were analyzed using SPSS software version 26.
Results: A total of 62 patients were analyzed, with a male-to-female ratio of 1.36. The mean age was 64 ± 12.7 years. The primary causes of cirrhosis included hepatitis C virus (35.5%), hepatitis B virus (30.6%), metabolic dysfunction-associated steatotic liver disease (6.5%), and indeterminate origins (27.4%). During follow-up, 45.2% (n=28) of patients developed HCC, with a mean time to onset of 12 months. Imaging revealed a single nodule in 64.7% (n=11) of cases. The mean aMAP score was 64.54 ± 9.08. The aMAP score was significantly higher in the HCC group compared to the non-HCC group. The predictive performance of the aMAP score for HCC development was significant, with an area under the receiver operating characteristic curve (AUROC) of 0.754 (p < 0.001). The optimal cut-off score was determined to be 57.5, yielding a sensitivity of 89% and a specificity of 56%.
Conclusion: The aMAP score is an accurate and user-friendly tool for predicting hepatocellular carcinoma in patients with cirrhosis. Its application in clinical practice may enhance surveillance, improve early detection of HCC, and potentially reduce mortality rates associated with this malignancy.

Keywords

aMAP score, hepatocellular carcinoma, cirrhosis, risk prediction, surveillance, diagnostic accuracy