Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.
J Gastroenterol Hepatol. 2018 Jan;33(1):291-297. doi: 10.1111/jgh.13834.
The diagnostic accuracy of a novel serological panel (BioFibroScore®) to predict hepatic fibrosis in patients with chronic hepatitis C virus (HCV) infection is unknown.
Three markers of BioFibroScore, including urokinase plasminogen activator, matrix metalloproteinase-9, and beta-2 microglobulin, were retrospectively evaluated in 635 HCV-infected patients who received percutaneous liver biopsy and FibroScan®. The formula of BioFibroScore to predict the severity of hepatic fibrosis was developed by adaptive boosting algorithm. The diagnostic accuracy of hepatic fibrosis was assessed both for BioFibroScore and FibroScan, taking METAVIR fibrosis score as the reference standard.
Urokinase plasminogen activator and beta-2 microglobulin were positively and matrix metalloproteinase-9 was negatively associated with the severity of hepatic fibrosis. Thirty-five (5.5%) patients had failed FibroScan assessment. By adaptive boosting model for BioFibroScore and the established reference ranges for FibroScan, 85.7% and 89.0% of the patients had an identical result for F0-1, F2, F3, and F4, as compared with liver biopsy. The concordance rate between BioFibroScore and FibroScan was 80.7%. BioFibroScore overestimated and underestimated the stage of hepatic fibrosis in 8.3% and 6.0% patients, and most patients had one stage error. Among patients with failed FibroScan assessment, 82.9% of them were correctly diagnosed by BioFibroScore. Bootstrap analysis for BioFibroScore showed the diagnostic accuracy was 80.9-88.4%.
BioFibroScore is accurate to assess the stage of hepatic fibrosis in HCV-infected patients. Applying this noninvasive test can substantially reduce the need for invasive liver biopsy and can play a role for fibrosis evaluation when FibroScan assessment was unavailable or unreliable.
新型血清学标志物（BioFibroScore®）预测慢性丙型肝炎病毒（HCV）感染者肝纤维化的诊断准确性尚不清楚。
对 635 例接受经皮肝活检和 FibroScan®的 HCV 感染患者进行了 BioFibroScore 的 3 项标志物（尿激酶纤溶酶原激活物、基质金属蛋白酶-9 和β2-微球蛋白）的回顾性评估。通过自适应增强算法建立了预测肝纤维化严重程度的 BioFibroScore 公式。以 METAVIR 纤维化评分作为参考标准，评估了 BioFibroScore 和 FibroScan 对肝纤维化的诊断准确性。
尿激酶纤溶酶原激活物和β2-微球蛋白与肝纤维化的严重程度呈正相关，基质金属蛋白酶-9呈负相关。35 例（5.5%）患者的 FibroScan 评估失败。通过自适应增强模型的 BioFibroScore 和已建立的 FibroScan 参考范围，与肝活检相比，85.7%和 89.0%的患者在 F0-1、F2、F3 和 F4 时结果相同。BioFibroScore 与 FibroScan 的一致性率为 80.7%。BioFibroScore 高估和低估肝纤维化分期的患者分别占 8.3%和 6.0%，且大多数患者的分期误差为 1 级。在 FibroScan 评估失败的患者中，82.9%的患者通过 BioFibroScore 得到正确诊断。BioFibroScore 的 Bootstrap 分析显示诊断准确性为 80.9%-88.4%。
BioFibroScore 可准确评估 HCV 感染患者的肝纤维化分期。应用这种非侵入性检测方法可显著减少肝活检的需求，在 FibroScan 评估不可用或不可靠时，可用于纤维化评估。
