FibroTest联合FibroScan对慢性乙型肝炎肝纤维化的诊断价值

程晓静; 陆伟; 侯伟; 王春妍; 刘勇钢; 王津生; 孟超

doi:10.3969/j.issn.1001-5256.2014.05.010

FibroTest联合FibroScan对慢性乙型肝炎肝纤维化的诊断价值

DOI: 10.3969/j.issn.1001-5256.2014.05.010

1. 天津医科大学研究生院
2. 天津市第二人民医院,天津市肝病医学研究所

基金项目:

中国肝炎防治基金会王宝恩肝纤维化研究基金资助项目(xjs20110402)；

详细信息

中图分类号: R575.2
计量
- 文章访问数: 3288
- HTML全文浏览量: 9
- PDF下载量: 848
- 被引次数: 0
出版历程
- 出版日期: 2014-05-20

Diagnostic value of FibroTest combined with FibroScan for liver fibrosis in patients with chronic hepatitis B

Research funding:

摘要

摘要:
目的探讨FibroTest联合FibroScan对慢性乙型肝炎肝纤维化的诊断价值。方法留取2011年8月至2013年7月天津市第二人民医院的99例行肝活组织检查的慢性乙型肝炎患者的血清,检测α2-巨球蛋白（α2-MG）、结合珠蛋白（HP）和载脂蛋白A1（apoAⅠ）,记录TBil和GGT的数值,并根据其结果结合患者的年龄和性别计算出FibroTest的数值。并对99例慢性乙型肝炎患者用FibroScan测定肝脏硬度值。根据Scheuer肝纤维化分期标准设定2个判定点,分别为显著肝纤维化（S2S4期）,严重肝纤维化（S3S4期）[1]。以肝活组织检查病理结果为金标准绘制出FibroTest及FibroScan的受试者工作特征曲线下面积（AUROC）。评价两者对慢性乙型肝炎肝纤维化的诊断价值,并应用Logistic逐步回归分析方法探讨联合诊断价值。结果 FibroTest与FibroScan对S2S4期的AUROC分别0.805（95%CI:0.7130.897,P<0.001）,0.896（95...
- 肝硬化 /
- 活组织检查,针吸 /
- FibroTest /
- FibroScan
Abstract:
Objective To investigate the diagnostic value of FibroTest combined with FibroScan for liver fibrosis in patients with chronic hepatitis B ( CHB) . Methods Serum samples were collected from 99 CHB patients who underwent liver biopsy in Tianjin Second People's Hospital from August 2011 to July 2013. Serum levels of α2- macroglobulin, haptoglobin, apolipoprotein AI, total bilirubin, and gamma-glutamyl transpeptidase were measured, and FibroTest scores were calculated according to the measurement results, as well as the age and sex of patients. In addition, all patients underwent liver stiffness measurement by FibroScan. According to the Scheuer system, liver fibrosis was staged as significant fibrosis ( S2- S4) and severe fibrosis ( S3- S4) . With liver biopsy as the gold standard, the areas under the receiver operating characteristic curves ( AUCs) of FibroTest and FibroScan were determined. The diagnostic values of FibroTest and FibroScan for liver fibrosis in CHB patients were evaluated accordingly, and their combined diagnostic value was determined by logistic stepwise regression analysis. Results The AUCs of FibroTest and FibroScan for the prediction of significant fibrosis ( S2- S4) were 0. 805 ( 95% CI: 0. 713- 0. 897, P < 0. 001) and 0. 896 ( 95% CI: 0. 833- 0. 959, P < 0. 001) , respectively, and their AUCs for the prediction of severe fibrosis ( S3- S4) were 0. 834 ( 95% CI: 0. 741- 0. 928, P < 0. 001) and 0. 945 ( 95% CI: 0. 891- 0. 999, P < 0. 001) , respectively. Their combined AUC for the prediction of significant fibrosis ( S2- S4) was 0. 911 ( 95% CI: 0. 854- 0. 967, P < 0. 001) . Conclusion The combination of FibroTest and FibroScan can evaluate the liver fibrosis in CHB patients more accurately, and it not only improves diagnostic specificity, but also ensures high diagnostic accuracy, providing guidance for the prognostic evaluation and treatment of CHB.
- liver cirrhosis /
- biopsy, needle /
- FibroTest /
- FibroScan

HTML全文

参考文献(13)

[1]GUO ZJ, CHANG JD, WANG WM, et al.Virtual touch quantification technique in diagnosis of hepatic fibrosis[J].Chin J Interv Imaging, 2012, 9 (10) :718-721. (in Chinese) 郭争捷, 常建东, 王卫民, 等.声触诊组织量化技术诊断肝纤维化[J].中国介入影像与治疗学, 2012, 9 (10) :718-721.

[2]BONNARD P, SOMBIR, LESCURE FX, et al.Comparison of elastography, serum marker scores, and histology for the assessment of liver fibrosis in hepatitisB virus (HBV) -infected patients in Burkina Faso[J].Am J Trop Med Hyg, 2010, 82 (3) :454-458.

[3]CARMACK S, TADDEI T, ROBERT ME, et al.Increased T-cell sinusoidal lymphocytosis in liver biopsies in patients with chronic hepatitis C and mixed cryoglobulinemia[J].Am J Gastroenterol, 2008, 103 (3) :705-711.

[4]D'AMBROSIO R, AGHEMO A, FRAQUELLI M, et al.The diagnostic accuracy of Fibroscan for cirrhosis is influenced by liver morphometry in HCV patients with a sustained virological response[J].J Hepatol, 2013, 59 (2) :251-256.

[5]ZHANG X, LU W, WANG CY.Diagnostic value of fibroscan for liver fibrosis in patients with chronic hepatitis B[J].Tianjin Med J, 2011, 39 (3) :236-238. (in Chinese) 张旭, 陆伟, 王春妍.FibroScan对慢性乙型肝炎肝脏纤维化的诊断价值[J].天津医药, 2011, 39 (3) :236-238.

[6] Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B (2010 version) [J].J Clin Hepatol, 2011, 27 (1) :Ⅰ-ⅩⅥ. (in Chinese) 中华医学会肝病学分会、感染病学分会.慢性乙型肝炎防治指南 (2010年版) [J].临床肝胆病杂志, 2011, 27 (1) :Ⅰ-ⅩⅥ.

[7]ZHAO LR, XU DJ, LU ZH, et al.Validation of FibroTest to diagnose liver fibrosis in patients with chronic hepatitis B[J].Chin J Pract Intern Med, 2007, 27 (16) :1274-1277. (in Chinese) 赵连荣, 许德军, 陆忠华, 等.综合预测模型FibroTest对慢性乙型肝炎肝纤维化的诊断价值[J].中国实用内科杂志, 2007, 27 (16) :1274-1277.

[8]YE XP, RAN H.Research progress of virtual touch tissue quantification technique in noninvasive assessment of liver fibrosis[J].Chin J Interv Imaging, 2012, 9 (4) :311-314. (in Chinese) 叶小萍, 冉海.声触诊组织量化技术无创评估肝纤维化的研究进展[J].中国介入影像与治疗学, 2012, 9 (4) :311-314.

[9]MIREEN FR, WILLIAM R, JULIE P, et al.Comparison of ELF, FibroTest and FibroScan for the non-invasive assessment of liver fibrosis[J].BMC Gastroenterology, 2010, 10 (103) :1-8.

[10]MYERS RP, TAINTURIER MH, RATZIU V, et al.Prediction of liver histological lesions with biochemical markers in patients with chronic hepatitis B[J].J Hepatol, 2003, 39 (2) :222-230.

[11]LIANG XE, CHEN YP, ZHANG Q, et al.Dynamic evaluation of liver stiffness measurement to improve diagnostic accuracy of liver cirrhosis in patients with chronic hepatitis B acute exacerbation[J].Viral Hepat, 2011, 18 (12) :884-891.

[12]MBAYE PS, SARR A, SIRE JM, et al.Liver stiffness measurement and biochemical markers in Senegalese chronic hepatitis B patients with normal ALT and high viral load[J].PLoS One, 2011, 6 (7) :1-7.

[13]CHAN HL, WONG GL, CHOI PC, et al.Alanine aminotransferase-based algorithms of liver stiffness measurement by transient elastography (Fibroscan) for liver fibrosis in chronic hepatitis B[J].Viral Hepat, 2009, 16 (1) :36-44.

施引文献

资源附件(0)

访问统计