High values of liver stiffness play an important role in stratifying the risk of hepatocellular carcinoma in cirrhotic hepatitis C patients.

Background: The identification and selection of patients at-risk for HCC is a recognized challenge in outpatient clinical practice. Limited data on risk factors and the impact of HCC on cirrhotic patients stratified by the elasticity imaging technique are still a potential promise. Aim: To evaluate the clinical contribution of liver stiffness measurement by transient elastography, as a risk factor for Hepatocellular Carcinoma (HCC) occurrence in a prospective cohort of (HCV) patients with cirrhosis. Method: A cohort of 99 consecutive HCV patients was included between 2011 and 2016 with baseline liver stiffness equal or above 12 kPa. We evaluated the patients with serum and mechanical liver tests. Kaplan-Meier method with the log-rank test and the use of Cox Univariate and multivariate analysis assessed the association between variables and clinical results. Results: The mean age was 57.8±10.6 years. In a follow-up over a mean of 3.3 years, 20 (20.2%) patients developed HCC, of which 65% were male and 40% had diabetes. The median time to diagnosis of HCC was 2.6 years. In univariate logistic regression analysis, variables associated with HCC occurrence were: lower platelet count (p=0.0446), higher serum alpha-fetoprotein (p=0.0041) and bilirubin (p=0.0008) values, higher MELD score (p=0.0068) and higher liver stiffness measurement (p=0.0354). High LSM evaluated by TE was independently associated with HCC development, and the best cut-off value for HCC risk was > 21.1kPa (HR: 4.7695; 95%CI: 1.0470-21.7274; p=0.0435). Conclusion: High value of liver stiffness relates substantially to the increased risk for HCC in selected patients with HCV cirrhosis.