studies

392A AASLD ABSTRACTS HEPATOLOGY, October, 2015
(r=0.68). exRNA aligned read counts were lower in cancer
than in normal bile samples. Read counts between cancer and
normal bile exRNA samples had a wide range of correlation (r:
0.64 to 0.95). A set of 14 mature (sense and antisense) miRNA
were differentially expressed > 3SD fold change in expression
(based on reads per million) in bile from CCA compared with
normal bile. Other differentially expressed exRNA identified
included tRNA and piRNA. Summary and Conclusions: Biliary
exRNA sequencing provides a novel strategy for biomarker
discovery. exRNA isolation protocols have a major impact on
yield and quality of exRNA for downstream gene expression
studies. Differentially expressed candidate exRNA biomarkers
have been identified that may be useful for the diagnosis of
CCA.
Disclosures:
The following authors have nothing to disclose: Irene K. Yan, Waseem David,
Swathi Mohankumar, Sarah Nix, Hiroaki Haga, Yan W. Asmann, Tushar Patel
359
Risk Differences of Hepatocellular Carcinoma (HCC)
Among Patients with Chronic Hepatitis C (CHC) of Different
Viral Genotypes: a Historical Cohort Study in the
United States
Mingjuan Jin 2,1 , Changqing Zhao 1,7 , Joseph K. Hoang 1 , Nghia
H. Nguyen 1,3 , An K. Le 1 , Christine Y. Chang 1 , Richard H. Le 1 ,
Alina Kutsenko 4 , Lee Ann Yasukawa 5 , Jian Q. Zhang 6 , Susan C.
Weber 5 , Mindie H. Nguyen 1 ; 1 Division of Gastroenterology and
Hepatology, Stanford University Medical Center, Palo Alto, CA;
2 Department of Epidemiology and Biostatistics, School of Public
Health, Zhejiang University, Hangzhou, China; 3 Department of
Medicine, University of California, San Diego, San Diego, CA;
4 Department of Medicine, Stanford University Medical Center,
Palo Alto, CA; 5 Center for Clinical Informatics, Stanford University
School of Medicine, Palo Alto, CA; 6 Chinese Hospital, San Francisco,
CA; 7 Department of Cirrhosis, Institute of Liver Disease, Shuguang
Hospital, Shanghai University of T.C.M., Shanghai, China
Purpose: Whether there exists differences in the risk for HCC
among patients with CHC of different genotypes is still controversial,
which were explored in the present study in a historical
cohort from 2 ethnically diverse US centers. Methods:
The subject inclusion was as follows: CHC patients aged 20
years or older, presented at study centers between 1/1/1999
and 12/31/2013, followed up for at least 1 year, having
HCV genotype information, and no HCC at baseline. The HCC
cumulative incidence and incidence density were calculated.
Cox proportional hazards models were used to testify the associations
of HCV genotypes with HCC. Results: A total of 1990
eligible CHC patients were included, among whom 1174
(59.0%) were female and 1594 (80.1%) were ≤ 60 years old
with mean age of 53.20±9.63 years. The ethnicity distribution
was 7.9% for Asian, 40.6% for White, 18.3% for Hispanc and
Black, and 33.2% for others and unknown. The frequencies of
genotypes 1a/untyped, 1b, 2, 3, and others (genotype 4 and
6) were 51.4%, 18.6%, 13.0%, 13.1%, and 3.9%, respectively.
Overall, the 1-year, 3-year and 5-year HCC cumulative
incidence were 448.53, 1341.88, and 2354.31 per 10,000
persons, respectively, with the incidence density of 297.37
per 10, 000 person-years in this cohort. Compared to patients
with the most prevalent genotype 1a/untyped, the age-, gender-
and ethnicity-adjusted hazard ratios (95%CIs) were 0.88
(0.64-1.22), 0.58 (0.37-0.93), 1.42 (0.99-2.04), and 1.89
(1.14-3.14) for those with genotype 1b, 2, 3, and 4 and 6,
respectively. Conclusions: The results suggest that HCV genotype
4 and 6 are associated with the highest risk of HCC, and
genotype 2 has the lowest risk, and there were no significant
differences between genotype 1b and 1a/untyped . Preventive
measures such as antiviral therapy and HCC surveillance
efforts should especially target the higher risk groups.
Disclosures:
Mindie H. Nguyen - Advisory Committees or Review Panels: Bristol-Myers
Squibb, Bayer AG, Gilead, Novartis, Onyx; Consulting: Gilead Sciences, Inc.;
Grant/Research Support: Gilead Sciences, Inc., Bristol-Myers Squibb, Novartis
Pharmaceuticals, Roche Pharma AG, Idenix, Hologic, ISIS
The following authors have nothing to disclose: Mingjuan Jin, Changqing Zhao,
Joseph K. Hoang, Nghia H. Nguyen, An K. Le, Christine Y. Chang, Richard H.
Le, Alina Kutsenko, Lee Ann Yasukawa, Jian Q. Zhang, Susan C. Weber
360
Surveillance for Hepatocellular Carcinoma (HCC) Using
Ultrasonography Alone is Associated with Improved
Survival: Results of Inverse Probability of Treatment
Weighting (IPTW)-Based Survival Analysis
Piyanat Chattieng 2 , Jonggi Choi 1 , Nopavut Geratikornsupuk 2 ,
Kessarin Thanapirom 2 , Sombat Treeprasertsuk 2 , Piyawat Komolmit
2 , Roongruedee Chaiteerakij 2,1 ; 1 Mayo Clinic, Rochester, MN;
2 Medicine, Chulalongkorn University, Bangkok, Thailand
Background/Aim: The current American Association for the
Study of Liver Disease guideline recommend HCC surveillance
program using ultrasound modality alone. The impact of the surveillance
program on survival remains unclear due to unavoidable
bias and confounders in observational studies. We aimed
to determine the effect of HCC surveillance on survival using
an IPTW analysis controlling for inherent bias and confounders
existing in observational studies. Methods: We conducted a
retrospective cohort study of 446 patients with cirrhosis and/
or chronic hepatitis B infection who were diagnosed with HCC
between 2007 and 2013 in a major referral center in Bangkok,
Thailand. Surveillance was defined as having repeated
abdominal ultrasonography within 1 year prior to HCC diagnosis.
Survivals of patients with and without surveillance were
estimated using the Kaplan-Meier method with lead-time bias
adjustment and compared using the log-rank test. Hazard ratio
(HR) and 95% confidence interval (CI) of surveillance was
computed using conventional Cox and weighted Cox proportional
hazards analysis with IPTW adjustment. Results: Of the
446 HCC patients, 79% were male with a mean age of 58.1
years. Hepatitis B (54%), hepatitis C (20%), alcohol (11%) and
non-alcoholic fatty liver disease (9%) were the most common
underlying chronic liver diseases. A hundred and three (23%)
were diagnosed with HCC through surveillance. The surveillance
group had a higher proportion of patients diagnosed
with the Barcelona-Clinic Liver Cancer (BCLC) stage A (82% vs.
34%, P