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.
[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, SOMBIR, 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.
|
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