Clinical Epidemiology and Evidence-Based Medical Center, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis, National Clinical Research Center for Digestive Disease, Beijing 100050, China.
Comput Math Methods Med. 2019 Jul 21;2019:7239780. doi: 10.1155/2019/7239780. eCollection 2019.
The diagnostic performance of an artificial neural network model for chronic HBV-induced liver fibrosis reverse is not well established. Our research aims to construct an ANN model for estimating noninvasive predictors of fibrosis reverse in chronic HBV patients after regular antiviral therapy. In our study, 141 consecutive patients requiring liver biopsy at baseline and 1.5 years were enrolled. Several serum biomarkers and liver stiffness were measured during antiviral therapy in both reverse and nonreverse groups. Statistically significant variables between two groups were selected to form an input layer of the ANN model. The ROC (receiver-operating characteristic) curve and AUC (area under the curve) were calculated for comparison of effectiveness of the ANN model and logistic regression model in predicting HBV-induced liver fibrosis reverse. The prevalence of fibrosis reverse of HBV patients was about 39% (55/141) after 78-week antiviral therapy. The Ishak scoring system was used to assess fibrosis reverse. Our study manifested that AST (aspartate aminotransferase; importance coefficient = 0.296), PLT (platelet count; IC = 0.159), WBC (white blood cell; IC = 0.142), CHE (cholinesterase; IC = 0.128), LSM (liver stiffness measurement; IC = 0.125), ALT (alanine aminotransferase; IC = 0.110), and gender (IC = 0.041) were the most crucial predictors of reverse. The AUC of the ANN model and logistic model was 0.809 ± 0.062 and 0.756 ± 0.059, respectively. In our study, we concluded that the ANN model with variables consisting of AST, PLT, WBC, CHE, LSM, ALT, and gender may be useful in diagnosing liver fibrosis reverse for chronic HBV-induced liver fibrosis patients.
基于人工神经网络的慢性乙型肝炎肝纤维化逆转的诊断性能尚未得到充分证实。本研究旨在构建一种人工神经网络模型,用于评估慢性乙型肝炎患者经规范抗病毒治疗后纤维化逆转的非侵入性预测因子。本研究共纳入 141 例基线及 1.5 年时需要行肝组织活检的连续患者。在抗病毒治疗过程中,分别对两组患者的多个血清生物标志物和肝硬度进行了测量。选择两组间具有统计学差异的变量作为人工神经网络模型的输入层。计算 ROC(受试者工作特征)曲线和 AUC(曲线下面积),以比较人工神经网络模型和逻辑回归模型预测乙型肝炎病毒诱导的肝纤维化逆转的有效性。经过 78 周抗病毒治疗后,乙型肝炎患者的纤维化逆转率约为 39%(55/141)。采用 Ishak 评分系统评估纤维化逆转。研究结果表明,AST(天门冬氨酸氨基转移酶;重要性系数=0.296)、PLT(血小板计数;IC=0.159)、WBC(白细胞计数;IC=0.142)、CHE(胆碱酯酶;IC=0.128)、LSM(肝硬度测量值;IC=0.125)、ALT(丙氨酸氨基转移酶;IC=0.110)和性别(IC=0.041)是逆转的最重要预测因子。人工神经网络模型和逻辑模型的 AUC 分别为 0.809±0.062 和 0.756±0.059。本研究表明,由 AST、PLT、WBC、CHE、LSM、ALT 和性别组成的人工神经网络模型可能有助于诊断慢性乙型肝炎肝纤维化患者的肝纤维化逆转。