Screening for infantile hepatic hemangioma in patients with cutaneous infantile hemangioma: A multicenter prospective study - 06/01/21

Doi : 10.1016/j.jaad.2020.11.062

Yi Ji, MD, PhD ^a,^⁎ , Siyuan Chen, MD, PhD ^b,^⁎ , Kaiying Yang, MD ^a, Bo Xiang, MD, PhD ^a, Xian Jiang, MD, PhD ^c, Xuewen Xu, MD, PhD ^d, Lizhi Li, MD ^e, Tong Qiu, MD ^a, Jiangyuan Zhou, MD ^a, Shiyi Dai, MD ^a, Xuepeng Zhang, MD ^b, Guoyan Lu, MD ^f, Feiteng Kong, MD ^g, Gang Yang, MD ^a,^h, Qingxia Qiu, MD ^h
^a Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu, China
^b Pediatric Intensive Care Unit, Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China
^c Department of Dermatology, West China Hospital of Sichuan University, Chengdu, China
^d Department of Burns and Plastic Surgery, West China Hospital of Sichuan University, Chengdu, China
^e Department of Pediatric Surgery, Fujian Provincial Hospital, Fuzhou, China
^f Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
^g Department of Pediatric Surgery, Sichuan Women and Children's Hospital, Chengdu, China
^h Department of Pediatric Surgery, Chengdu Shangjin Nanfu Hospital, Chengdu, China

^∗Correspondence to: Yi Ji, MD, PhD, Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, #37 Guo-Xue-Xiang, Chengdu, 610041, China.Division of OncologyDepartment of Pediatric SurgeryWest China Hospital of Sichuan University#37 Guo-Xue-XiangChengdu610041China^∗Siyuan Chen, MD, PhD, Pediatric Intensive Care Unit, Department of Critical Care Medicine, West China Hospital of Sichuan University, #37 Guo-Xue-Xiang, Chengdu, 610041, China.Pediatric Intensive Care UnitDepartment of Critical Care MedicineWest China Hospital of Sichuan University#37 Guo-Xue-XiangChengdu610041China

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 06 January 2021
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Abstract

Background

Abdominal ultrasonography has been proposed to screen for infantile hepatic hemangioma (IHH) in patients with multiple cutaneous infantile hemangiomas (IHs).

Objectives

The aim of this study was to establish the optimal cutoff point for the number of cutaneous IHs needed to screen for IHH.

Methods

We performed a prospective, multicenter study to screen for IHH in patients younger than 9 months who had multiple cutaneous IHs (n ≥ 3) on ultrasonography. For comparison, a group of patients with 1 or 2 focal cutaneous IHs was also recruited.

Results

In total, 676 patients with at least 3 cutaneous IHs and 980 patients with 1 or 2 focal cutaneous IHs were enrolled. Thirty-one patients were found to have IHH. A higher number of cutaneous IHs was associated with an increased risk of IHH (R = 0.973; P < .001). Receiver operating characteristic curve analysis showed that 5 cutaneous IHs was the optimal cutoff point to screen for IHH, with an area under the curve of 0.872 (P < .001; 95% confidence interval, 0.789-0.955).

Limitations

This was an uncontrolled study.

Conclusions

Screening for IHH is recommended in patients younger than 9 months who present with 5 or more cutaneous IHs.

Le texte complet de cet article est disponible en PDF.

Key words : cutoff point, infantile hemangioma, infantile hepatic hemangioma, multiple, screening

Abbreviations used : CI, IH, IHH, MRI, OR, ROC

Plan

Methods

Study design and participants

Definitions

Measurement and screening program

Diagnosis of disorders associated with IHH

Study visits and management

Statistical analysis

Results

Participants

Detection of IHHs and comorbidities

Higher numbers of cutaneous IHs confer a greater risk of IHH

Optimal cutoff point for cutaneous IHs to screen for IHH

Follow-up and outcomes

Discussion

Conclusions

	Drs Ji and Chen are cofirst authors.
	Funding sources: Supported by the National Natural Science Foundation of China (grant nos. 81400862 and 81401606), the Key Project of the Science and Technology Program of Sichuan Province (grant no. 2019YFS0322), the Science Foundation for The Excellent Youth Scholars of Sichuan University (grant no. 2015SU04A15), and the 1·3·5 Project for Disciplines of Excellence–Clinical Research Incubation Project, West China Hospital of Sichuan University (grant nos. 2019HXFH056 and 2020HXFH048).
	IRB approval status: The study protocol was approved by the ethics committees for medical research of each participating site.
	Reprints not available from the authors.