增强型肝纤维化（ELF）检测用于肝纤维化分期的性能：一项荟萃分析。
The performance of enhanced liver fibrosis (ELF) test for the staging of liver fibrosis: a meta-analysis.
作者信息
Xie Qingsong, Zhou Xiaohu, Huang Pengfei, Wei Jianfeng, Wang Weilin, Zheng Shusen
机构信息
Division of Hepatobilitary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China; Key Laboratory of Combined Multi- Organ Transplantation, Ministry of Public Health, Zhejiang Province, Hangzhou, China; Key laboratory of Organ Transplantation, Zhejiang Province, Hangzhou, China.
出版信息
PLoS One. 2014 Apr 15;9(4):e92772. doi: 10.1371/journal.pone.0092772. eCollection 2014.
BACKGROUND
The enhanced liver fibrosis test (ELF) has been shown to accurately predict significant liver fibrosis in several liver diseases.
AIMS
To perform a meta-analysis to assess the performance of the ELF test for the assessment of liver fibrosis.
STUDY
Electronic and manual searches were performed to identify studies of the ELF test. After methodological quality assessment and data extraction, pooled estimates of the sensitivity, specificity, area under the receiver operating characteristic curve (AUROC), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and summary receiver operating characteristics (sROC) were assessed systematically. The extent of heterogeneity and reasons for it were assessed.
RESULTS
Nine studies were identified for analysis. The pooled sensitivity, specificity, positive LR, negative LR, and DOR values of ELF test, for assessment of significant liver fibrosis, were 83% (95% CI=0.80-0.86), 73% (95% CI=0.69-0.77), 4.00 (95% CI=2.50-6.39), 0.24 (95% CI=0.17-0.34), and 16.10 (95% CI=8.27-31.34), respectively; and, for evaluation of severe liver fibrosis, were 78% (95% CI=0.74-0.81), 76% (95% CI=0.73-0.78), 4.39 (95% CI=2.76-6.97), 0.27 (95% CI=0.16-0.46), and 16.01 (95% CI: 7.15-35.82), respectively; and, for estimation of cirrhosis, were 80% (95% CI=0.75-0.85), 71% (95% CI=0.68-0.74), 3.13 (95% CI=2.01-4.87), 0.29 (95% CI=0.19-0.44), and 14.09 (95% CI: 5.43-36.59), respectively.
CONCLUSIONS
The ELF test shows good performance and considerable diagnostic value for the prediction of histological fibrosis stage.
背景
增强肝纤维化检测（ELF）已被证明能准确预测多种肝脏疾病中的显著肝纤维化。
目的
进行一项荟萃分析，以评估ELF检测在评估肝纤维化方面的性能。
研究
通过电子检索和人工检索来识别关于ELF检测的研究。在进行方法学质量评估和数据提取后，系统地评估了敏感性、特异性、受试者操作特征曲线下面积（AUROC）、阳性似然比（PLR）、阴性似然比（NLR）、诊断比值比（DOR）和汇总受试者操作特征（sROC）的合并估计值。评估了异质性的程度及其原因。
结果
确定了9项研究进行分析。ELF检测用于评估显著肝纤维化的合并敏感性、特异性、阳性似然比、阴性似然比和诊断比值比分别为83%（95%CI = 0.80 - 0.86）、73%（95%CI = 0.69 - 0.77）、4.00（95%CI = 2.50 - 6.39）、0.24（95%CI = 0.17 - 0.34）和16.10（95%CI = 8.27 - 31.34）；用于评估严重肝纤维化的分别为78%（95%CI = 0.74 - 0.81）、76%（95%CI = 0.73 - 0.78）、4.39（95%CI = 2.76 - 6.97）、0.27（95%CI = 0.16 - 0.46）和16.01（95%CI：7.15 - 35.82）；用于评估肝硬化的分别为80%（95%CI = 0.75 - 0.85）、71%（95%CI = 0.68 - 0.74）、3.13（95%CI = 2.01 - 4.87）、0.29（95%CI = 0.19 - 0.44）和14.09（95%CI：5.43 - 36.59）。
结论
ELF检测在预测组织学纤维化分期方面表现良好，具有相当大的诊断价值。
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