Zuo Z B, Cui H Z, Huang C X, Guo Y, Pan K R, Wang M C, Du W, Huang B, Xu A F
Hangzhou Sixth People's Hospital, Hangzhou 310014, China.
Zhonghua Gan Zang Bing Za Zhi. 2019 Jun 20;27(6):430-435. doi: 10.3760/cma.j.issn.1007-3418.2019.06.008.
To evaluate the using value of FibroTouch and six serological models in detecting the degree of liver fibrosis in patients with chronic hepatitis B, in an attempt to provide reference for accurate diagnosis. Two hundred and fifty-eight cases with chronic hepatitis B admitted to Xixi Hospital of Hangzhou from September 1, 2015 to September 1, 2017 were selected. All patients underwent liver histopathological examination and FibroTouch measurement to determine liver stiffness (LSM). Serum biochemical parameters were detected and the scoring values of six serological models were calculated. SAS 9.4 statistical software was used for statistical analysis, and the correlation between FibroTouch and the six serological models was analyzed by Spearman correlation. The diagnostic value of FibroTouch and six serological models was analyzed by receiver operating characteristic curve (ROC) based on liver histopathological findings. The median LSM of 258 cases with chronic hepatitis B was 9.4 (6.5-13.8) kPa. In the six serological models, the median value of aspartate transaminase to platelet ratio index (APRI), FIB-4 index, S-index, Forn's index, PRPindex, and FIB-5 were 0.42 (0.28-0.62), 1.27 (0.78-2.03), 0.11 (0.07-0.20), 6.95 (5.89-8.51), 0.000 8 (0.000 6-0.000 9),and 38.59 (36.28-40.97). FibroTouch had positive correlation with APRI, FIB-4, S-index, Forn's index, PRP, fibrosis stage (= 0.73,< 0.001) and inflammation grade, and had negative correlation with FIB-5, and both had statistical significance. The area under curve (AUC) of FT-LSM at S≥2, S≥3, S = 4 were 0.89, 0.90 and 0.85, respectively, which was significantly higher than serological models (< 0.001). The AUC of S-index model at S≥2, S≥3, S = 4 were higher than other five serological models. The diagnostic performance of FibroTouch is significantly better than serological model. S-index model has the best diagnostic performance in the six serological models, and the combination of S-index and FT-LSM may better diagnose the grading of liver fibrosis, and thus can be applied and promoted in clinic.
为评估FibroTouch及六种血清学模型在检测慢性乙型肝炎患者肝纤维化程度中的应用价值,以期为准确诊断提供参考。选取2015年9月1日至2017年9月1日在杭州市西溪医院收治的258例慢性乙型肝炎患者。所有患者均接受肝脏组织病理学检查及FibroTouch检测以测定肝脏硬度值(LSM)。检测血清生化参数并计算六种血清学模型的评分值。采用SAS 9.4统计软件进行统计分析,通过Spearman相关性分析FibroTouch与六种血清学模型之间的相关性。基于肝脏组织病理学结果,采用受试者工作特征曲线(ROC)分析FibroTouch及六种血清学模型的诊断价值。258例慢性乙型肝炎患者的LSM中位数为9.4(6.5 - 13.8)kPa。在六种血清学模型中,天冬氨酸转氨酶与血小板比值指数(APRI)、FIB - 4指数、S指数、Forn指数、PRP指数及FIB - 5的中位数分别为0.42(0.28 - 0.62)、1.27(0.78 - 2.03)、0.11(0.07 - 0.20)、6.95(5.89 - 8.51)、0.000 8(0.000 6 - 0.000 9)及38.59(36.28 - 40.97)。FibroTouch与APRI、FIB - 4、S指数、Forn指数、PRP、纤维化分期(r = 0.73,P< 0.001)及炎症分级呈正相关,与FIB - 5呈负相关,且均具有统计学意义。FT - LSM在S≥2、S≥3、S = 4时的曲线下面积(AUC)分别为0.89、0.90及0.85,显著高于血清学模型(P< 0.001)。S指数模型在S≥2、S≥3、S = 4时的AUC高于其他五种血清学模型。FibroTouch的诊断性能显著优于血清学模型。S指数模型在六种血清学模型中诊断性能最佳,S指数与FT - LSM联合可能更好地诊断肝纤维化分级,可在临床推广应用。