Department of Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Cairo, Egypt.
National Hepatology and Tropical Medicine Research Institute, Cairo University, Cairo, Egypt.
Clin Exp Med. 2018 Feb;18(1):45-50. doi: 10.1007/s10238-017-0463-4. Epub 2017 May 31.
Evaluation of liver fibrosis stage is crucial in the assessment of chronic HCV patients, regarding decision to start treatment and during follow-up. Our aim was to assess the validity of the enhanced liver fibrosis (ELF) score in discrimination of advanced stage of liver fibrosis in naïve chronic HCV patients. We prospectively evaluated liver fibrosis stage in one hundred eighty-one naïve chronic HCV Egyptian patients by transient elastography (TE)-FibroScan. Patients were categorized into mild to moderate fibrosis (≤F2) group and advanced fibrosis (≥F3) group. The ELF score components, hyaluronic acid (HA), amino-terminal propeptide of type-III-procollagen (PIIINP) and tissue inhibitor of metalloproteinase type-1 (TIMP-1), were done using ELISA test. The mean values of ELF and its individual components significantly correlated with the hepatic fibrosis stage as measured by TE-FibroScan (P value 0.001). ELF cutoff value of 9.8 generated a sensitivity of 77.8%, specificity of 67.1%, area under the receiver operator characteristic curve (AUROC) of 0.76 with 95% confidence interval [CI] (0.68-0.83) for detecting advanced fibrosis (F ≥ 3). ELF panel is a good, reliable noninvasive test and showed comparable results to TE-FibroScan in detecting liver fibrosis stage in treatment naïve chronic HCV patients.
评估肝纤维化分期对于慢性 HCV 患者至关重要，无论是在开始治疗前还是在随访期间。我们旨在评估增强型肝纤维化（ELF）评分在鉴别初治慢性 HCV 患者肝纤维化晚期的准确性。我们前瞻性地通过瞬时弹性成像（TE）- FibroScan 评估了 181 例初治埃及慢性 HCV 患者的肝纤维化分期。患者分为轻度至中度纤维化（≤F2）组和晚期纤维化（≥F3）组。ELF 评分成分，透明质酸（HA）、III 型前胶原氨基末端肽（PIIINP）和金属蛋白酶组织抑制剂 1（TIMP-1），通过 ELISA 试验进行检测。ELF 和其各成分的平均值与 TE-FibroScan 测量的肝纤维化分期显著相关（P 值 0.001）。ELF 截断值为 9.8 时，检测晚期纤维化（F≥3）的敏感性为 77.8%，特异性为 67.1%，受试者工作特征曲线（AUROC）下面积为 0.76（95%CI 为 0.68-0.83）。ELF 面板是一种良好、可靠的非侵入性检测方法，在检测初治慢性 HCV 患者肝纤维化分期方面与 TE-FibroScan 具有可比性。
