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Egy-Score 对慢性丙型肝炎病毒患者显著、晚期肝纤维化和肝硬化的诊断价值与天门冬氨酸氨基转移酶/血小板比值指数、FIB-4 和 Forns 指数的比较。

Value of Egy-Score in diagnosis of significant, advanced hepatic fibrosis and cirrhosis compared to aspartate aminotransferase-to-platelet ratio index, FIB-4 and Forns' index in chronic hepatitis C virus.

机构信息

Internal Medicine Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Egyptian Liver Fibrosis Study Group, Cairo, Egypt.

出版信息

Hepatol Res. 2015 May;45(5):560-70. doi: 10.1111/hepr.12385. Epub 2014 Aug 6.

Abstract

AIM

Serum markers and developed scores are of rising importance in non-invasive diagnosis of hepatic fibrosis. Aspartate aminotransferase-to-platelet ratio index (APRI), FIB-4 and Forns' index are validated scores used for diagnosis of liver fibrosis. The Egy-Score is a newly developed score for detection of hepatic fibrosis with promising results. We aimed to assess the accuracy of the Egy-Score in the diagnosis of significant fibrosis, advanced fibrosis and cirrhosis compared to APRI, FIB-4 and Forns' in chronic hepatitis C virus (HCV) patients.

METHODS

A retrospective study including 100 chronic hepatitis C naïve Egyptian patients was performed. Patients were classified according to stages of fibrosis into three groups: significant fibrosis (≥ F2), advanced fibrosis (≥ F3) and cirrhosis (F4). Egy-Score, APRI, FIB-4 and Forns' index were calculated. Regression analysis and receiver-operator curves were plotted to assess the sensitivity, specificity and predictive values for the significant scores with the best cut-off for diagnosis.

RESULTS

An Egy-Score of 3.28 or more was superior to APRI, FIB-4 and Forns' index for detecting advanced fibrosis with a sensitivity of 91% and specificity of 78%. An Egy-Score of 3.67 or more was superior to APRI, FIB-4 and Forns' index for detecting cirrhosis with a sensitivity of 82% and specificity of 87%. Forns' index was superior to Egy-Score, FIB-4 and APRI for detecting significant fibrosis.

CONCLUSION

The Egy-Score is a promising, accurate, easily calculated, cost-effective score in the prediction of hepatic fibrosis in chronic HCV patients with superiority over APRI, FIB-4 and Forns' index in advanced hepatic fibrosis and cirrhosis.

摘要

目的

血清标志物和评分在肝纤维化的无创诊断中变得越来越重要。天门冬氨酸氨基转移酶-血小板比值指数(APRI)、FIB-4 和福恩斯指数是用于诊断肝纤维化的验证评分。Egy-Score 是一种新开发的用于检测肝纤维化的评分,具有很好的效果。我们旨在评估 Egy-Score 在诊断慢性丙型肝炎病毒(HCV)患者显著纤维化、晚期纤维化和肝硬化方面的准确性,与 APRI、FIB-4 和福恩斯指数相比。

方法

进行了一项回顾性研究,纳入了 100 例埃及初治慢性丙型肝炎患者。根据纤维化分期将患者分为三组:显著纤维化(≥ F2)、晚期纤维化(≥ F3)和肝硬化(F4)。计算 Egy-Score、APRI、FIB-4 和福恩斯指数。进行回归分析和受试者工作特征曲线,以评估显著评分的敏感性、特异性和预测值,并确定最佳截断值用于诊断。

结果

Egy-Score 为 3.28 或更高时,对检测晚期纤维化的敏感性为 91%,特异性为 78%,优于 APRI、FIB-4 和福恩斯指数。Egy-Score 为 3.67 或更高时,对检测肝硬化的敏感性为 82%,特异性为 87%,优于 APRI、FIB-4 和福恩斯指数。福恩斯指数对检测显著纤维化的敏感性优于 Egy-Score、FIB-4 和 APRI。

结论

Egy-Score 是一种有前途的、准确的、易于计算的、具有成本效益的评分,在预测慢性 HCV 患者的肝纤维化方面优于 APRI、FIB-4 和福恩斯指数,在晚期肝纤维化和肝硬化方面更具优势。

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