Andrés-Otero María Jesús, De-Blas-Giral Ignacio, Puente-Lanzarote Juan José, Serrano-Aulló Trinidad, Morandeira María José, Lorente Sara, Lou-Bonafonte José Manuel
Servicio de Bioquímica Clínica, HCU Lozano Blesa, Zaragoza, Spain.
Dpto. Patología Animal, Universidad de Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón, Zaragoza, Spain.
Clin Biochem. 2016 May;49(7-8):560-5. doi: 10.1016/j.clinbiochem.2015.12.017. Epub 2016 Mar 9.
The aim of this study was to compare fourteen non-invasive indexes/scores: AAR, APRI, Fibroindex, MODEL3, Forns index, FIB4, GUCI, FI, FCI, Pohl score, AP index, CDS, HGM-1 and HGM-2, in order to diagnose the hepatic fibrosis stage in a survey of patients with chronic hepatitis C.
84 patients with chronic hepatitis C were studied. Liver fibrosis was staged according to the Scheuer scoring system. The diagnostic accuracy of these indexes/scores was evaluated by AUROC, contingency tables and logistic regression analysis.
The best AUROCs (>0.9) to discriminate cirrhosis (F=4), were observed for CDS, FI, AAR, MODEL3, FIB4, HGM-2 and FCI. To discriminate at least advance fibrosis (F≥3), the best AUROCs (>0.89) were for CDS, FI, FIB4, HGM2-2, MODEL3 and FCI. To discriminate at least significant fibrosis (F≥2), the best AUROCs (>0.8) were for FIB4, GUCI, APRI, FI, Forns index, HGM-2 and FCI. Contingency tables and logistic regression analysis supported the results obtained by AUROC.
This study compares the diagnostic performance of fourteen indexes for the diagnosis of liver fibrosis stage in the same group of CHC patients. These results allow the selection of the best indexes for further studies in larger populations, in order to build diagnostic algorithms as an alternative to liver biopsy for fibrosis staging in patients with chronic HCV infection. These algorithms would allow to take therapeutical decisions and the continuous follow-up of hepatic fibrosis in these patients.
本研究旨在比较14种非侵入性指标/评分：天冬氨酸氨基转移酶与血小板比值指数（AAR）、天门冬氨酸氨基转移酶与血小板比率指数（APRI）、纤维指数（Fibroindex）、MODEL3、福恩斯指数（Forns index）、FIB4、全球慢性肝炎纤维化指数（GUCI）、纤维化指数（FI）、纤维化-4指数（FCI）、波尔评分（Pohl score）、AP指数、慢性肝病纤维化评分（CDS）、肝纤维化基因甲基化指数-1（HGM-1）和肝纤维化基因甲基化指数-2（HGM-2），以便在一项慢性丙型肝炎患者调查中诊断肝纤维化阶段。
对84例慢性丙型肝炎患者进行研究。根据Scheuer评分系统对肝纤维化进行分期。通过受试者工作特征曲线下面积（AUROC）、列联表和逻辑回归分析评估这些指标/评分的诊断准确性。
对于鉴别肝硬化（F = 4），CDS、FI、AAR、MODEL3、FIB4、HGM-2和FCI观察到最佳AUROC（>0.9）。对于鉴别至少进展期纤维化（F≥3），最佳AUROC（>0.89）为CDS、FI、FIB4、HGM2-2、MODEL3和FCI。对于鉴别至少显著纤维化（F≥2），最佳AUROC（>0.8）为FIB4、GUCI、APRI、FI、福恩斯指数、HGM-2和FCI。列联表和逻辑回归分析支持了AUROC获得的结果。
本研究比较了14种指标对同一组慢性丙型肝炎患者肝纤维化阶段诊断的诊断性能。这些结果有助于选择最佳指标，以便在更大人群中进行进一步研究，从而构建诊断算法，作为慢性丙型肝炎感染患者纤维化分期肝活检的替代方法。这些算法将有助于做出治疗决策，并对这些患者的肝纤维化进行持续随访。
