Abstract: Objective To evaluate the predictive performance of aMAP score combined with liver stiffness measurement (LSM) for hepatocellular carcinoma associated with hepatitis B cirrhosis.Methods A total of 416 patients with hepatitis B cirrhosis were selected to calculate the aMAP score and evaluate the predictive performance of the aMAP combined with LSM model.Results The predictive performance of aMAP+LSM is the highest, superior to that of aMAP and LSM alone, with corresponding AUROCs of 0.748 (0.703-0.789), 0.697 (0.650-0.740), and 0.721 (0.676-0.764), respectively. The optimal critical value of LSM is 15.35 kPa, with a sensitivity of 70.0% and a specificity of 68.5%. The 3-year and 5-year cumulative incidence rate of hepatocellular carcinoma in high-risk group was higher than that in intermediate and low-risk group (P<0.05), which were 4.5%, 14.5%, 0.0%, 5.8%, 0.0% and 0.0%, respectively. In the intermediate-risk group, when LSM>15.35 kPa, the 3-year and 5-year cumulative incidence rate of HCC is 10.0% and 20.0%, and when LSM<15.35 kPa, the 3-year and 5-year cumulative incidence rate of HCC is only 0.0% and 0.6% (P<0.05).Conclusion The predictive performance of aMAP combined with LSM model is better than that of aMAP score alone, and the variables involved are simple and easy to obtain, making it easy for clinical screening. The optimal critical value of LSM is 15.35 kPa. In the medium risk group, compared with LSM<15.35 kPa, the cumulative incidence rate of hepatocellular carcinoma increased significantly when LSM>15.35 kPa. It should be managed according to the high-risk population of aMAP to screen hepatocellular carcinoma.

Key words: Hepatocellular carcinoma, Liver cirrhosis, aMAP risk score, LSM