慢性丙型肝炎患者肝纤维化血液检测的检测性能概况比较
Comparison of test performance profile for blood tests of liver fibrosis in chronic hepatitis C.
作者信息
Halfon Philippe, Bacq Yannick, De Muret Anne, Penaranda Guillaume, Bourliere Marc, Ouzan Denis, Tran Albert, Botta Danielle, Renou Christophe, Bréchot Marie-Claude, Degott Claude, Paradis Valérie
机构信息
Laboratoire Alphabio, 23 rue Friedland, 13006 Marseille, France.
出版信息
J Hepatol. 2007 Mar;46(3):395-402. doi: 10.1016/j.jhep.2006.09.020. Epub 2006 Nov 7.
BACKGROUND/AIMS: We evaluated the test performance profile (TPP) of blood tests of liver fibrosis.
METHODS
Three hundred and fifty-six patients with C chronic hepatitis were included in two centers. Metavir staging of liver specimens by two independent pathologists and the following tests were evaluated: Fibrotest (FT), APRI, FibroMeter (FM), and Hepascore (HS).
RESULTS
Metavir stages were: F0: 4%, F1: 55%, F2: 26%, F3: 11%, and F4: 4%. The AUROCs were not significantly different, respectively, FT, FM, APRI, HS: >or=F2: 0.79, 0.78, 0.76, >or=0.76; F3: 0.81, 0.85, 0.81, 0.81; and F4: 0.86, 0.94, 0.92, 0.89. The TPP relies on the paired comparison of blood-test misclassification based on liver specimen, e.g. FT vs FM, respectively: F0+1: 18 vs 28% (p=0.0003), >or=F2: 43 vs 31% (p=0.004). There was no center effect.
CONCLUSIONS
In those populations, the four blood tests had a similar performance for significant fibrosis (F>or=2), lying in the lower range of published results which is attributable to a low >or=F2 prevalence, and for >or=F3 and F4. However, FM and FT had performance profiles significantly different as a function of fibrosis stages or diagnostic target (fibrosis cut-off). This has to be considered during the interpretation process. Moreover, the performance should be reported with different diagnostic targets.
背景/目的：我们评估了肝纤维化血液检测的检测性能概况（TPP）。
方法
两个中心纳入了356例慢性丙型肝炎患者。由两名独立病理学家对肝脏标本进行梅塔维分级，并评估以下检测：纤维检测（FT）、天冬氨酸氨基转移酶与血小板比值指数（APRI）、纤维计量器（FM）和肝纤维化评分（HS）。
结果
梅塔维分级为：F0：4%，F1：55%，F2：26%，F3：11%，F4：4%。曲线下面积（AUROC）无显著差异，FT、FM、APRI、HS分别为：≥F2：0.79、0.78、0.76、≥0.76；F3：0.81、0.85、0.81、0.81；F4：0.86、0.94、0.92、0.89。TPP依赖于基于肝脏标本的血液检测错误分类的配对比较，例如FT与FM，分别为：F0 + 1：18%对28%（p = 0.0003），≥F2：43%对31%（p = 0.004）。不存在中心效应。
结论
在这些人群中，这四项血液检测对于显著纤维化（F≥2）的表现相似，处于已发表结果的较低范围，这归因于较低的≥F2患病率，对于≥F3和F4也是如此。然而，FM和FT作为纤维化阶段或诊断靶点（纤维化临界值）的函数，其性能概况有显著差异。在解释过程中必须考虑这一点。此外，应报告不同诊断靶点的性能。
Zotero 插件