Hepatocellular Carcinoma: Likelihood Ratios

Introduction: Hepatocellular carcinoma often occurs in cirrhotics, though patients with Hepatitis C may develop HCC without Cirrhosis.

Prevalence

The likelihood ratios of findings for Hepatocellular Carcinoma are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Positive Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] AFP	+ 0 -	31	0.7
AFP > 100 in patients with chronic liver disease Study: J Hepatol 2001 Apr;34(4):570-5. PMID 11394657
[ + ] AFP	+ 0 -	22	0.8
AFP > 200 in patients with chronic liver disease Study: J Hepatol 2001 Apr;34(4):570-5. PMID 11394657

Good Positive and Negative Likelihood Ratios
Finding	Result	+LR	-LR
[ + ] Abdominal MRI	+ 0 -	inf	0
Recent performance at one institution. Sensitivity for lesions <2 cm was 82.6% Older literature has sensitivity = 81%, specificity = 85% Study: Radiology. 2011 Dec;261(3):824-33. Epub 2011 Oct 3. PMID 21969663 Am J Gastroenterol. 2006 Mar;101(3):513-23. PMID: 16542288
[ + ] Abdominal US	+ 0 -	12.7	0.2
hepatitis B Study: Hepatology 1995 Aug;22(2):432-8. PMID 7543434
[ + ] Abdominal CT	+ 0 -	9.7	0.3
Study: Am J Gastroenterol. 2006 Mar;101(3):513-23. PMID: 16542288
[ + ] AFP	+ 0 -	6.7	0.4
AFP > 20 in patients with chronic liver disease Study: J Hepatol 2001 Apr;34(4):570-5. PMID 11394657
[ + ] AFP	+ 0 -	5.6	0.4
AFP > 16 mcg/L, in pts with chronic liver disease Study: J Hepatol 2001 Apr;34(4):570-5. PMID 11394657