Ohta Takeyuki, Sakaguchi Kohsaku, Fujiwara Akiko, Fujioka Shin-ichi, Iwasaki Yoshiaki, Makino Yasuhiro, Araki Yasuyuki, Shiratori Yasushi
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Acta Med Okayama. 2006 Apr;60(2):77-84. doi: 10.18926/AMO/30729.
This study was conducted to develop a simple surrogate index comprised of routinely available laboratory tests to reflect the histological fibrosis stage. Clinical characteristics and laboratory data from 368 and 249 consecutive patients with chronic hepatitis C, a training cohort and a validation cohort, respectively, were retrospectively evaluated. Platelet (Plt) count and albumin (Alb) level contributed to the discrimination of the respective fibrosis stages. We derived the fibrosis index (FI), FI = 8.0-0.01 x Plt (10(3)/microliter) - Alb (g/dl), from a multiple regression model. FI significantly correlated with the histological fibrosis stage in both the initial and validation cohort at rho=0.691 and rho=0.661, respectively (Spearman's rank correlation coefficient, p<0.0001). The sensitivity and positive predictive value of FI at a cutoff value < 2.10 for predicting fibrosis stage F0-1 were 66.8% and 78.8% in the initial cohort and 68.5% and 63.6% in the validation cohort, respectively. Corresponding values of FI at a cutoff value > or = 3.30 for the prediction of F4 were 67.7% and 75.0% in the initial cohort and 70.8% and 81.0% in the validation cohort. The fibrosis index comprised of platelet count and albumin level reflected the histological fibrosis stage in patients with chronic hepatitis C.
本研究旨在开发一种由常规实验室检查组成的简单替代指标，以反映组织学纤维化阶段。分别对368例和249例慢性丙型肝炎患者（一个训练队列和一个验证队列）的临床特征和实验室数据进行回顾性评估。血小板（Plt）计数和白蛋白（Alb）水平有助于区分各个纤维化阶段。我们从多元回归模型中得出纤维化指数（FI），FI = 8.0 - 0.01×Plt（10³/微升）- Alb（克/分升）。FI与初始队列和验证队列中的组织学纤维化阶段均显著相关，在初始队列和验证队列中的斯皮尔曼等级相关系数ρ分别为0.691和0.661（p < 0.0001）。在初始队列中，当FI截断值< 2.10时，预测纤维化阶段F0 - 1的敏感性和阳性预测值分别为66.8%和78.8%，在验证队列中分别为68.5%和63.6%。当FI截断值≥ 3.30时，预测F4的相应值在初始队列中为67.7%和75.0%，在验证队列中为70.8%和81.0%。由血小板计数和白蛋白水平组成的纤维化指数反映了慢性丙型肝炎患者的组织学纤维化阶段。
