用于评估肝纤维化的新型纤维化指数（NFI）的验证：与瞬时弹性成像（FibroScan）的比较。

Validation of Novel Fibrosis Index (NFI) for assessment of liver fibrosis: comparison with transient elastography (FibroScan).

作者信息

Hussain Azhar, Gul Muhammad Asif, Khalid Muhammad Usama

机构信息

Ameer-ud-Din Medical College, PGMI, Lahore, Pakistan.

Gastroenterology, Nishtar Medical College and Hospital, Multan, Pakistan.

出版信息

BMJ Open Gastroenterol. 2019 Oct 18;6(1):e000316. doi: 10.1136/bmjgast-2019-000316. eCollection 2019.

BACKGROUND

In this study, we collated cheap and readily available non-invasive biomarkers and FibroScan score in predicting fibrosis stages in chronic hepatitis C virus (HCV) infection.

METHODS

We studied 1898 patients with HCV infection confirmed by presence of HCV RNA in their serum. We compared the FibroScan score and fibrosis indices (FIs): aspartate transaminase (AST) to alanine transaminase (ALT) ratio (AAR), AST to Platelet Ratio Index (APRI), FI, fibrosis-4 (FIB-4), Age-Platelet Index (API), Pohl score, Fibrosis Cirrhosis Index (FCI). We developed a new FI, named Novel Fibrosis Index (NFI) calculated by the following formula: NFI=[(bilirubin×(ALP))/(platelet count (albumin))]-n.

RESULTS

AAR, APRI, FI, FIB-4, API, Pohl score, FCI and NFI were able to predict fibrosis stage with correlation coefficient indices 0.848, 0.711, 0.618, 0.741, 0.529, 0.360, 0.477 and 0.26, respectively. Receiver operating characteristic curves showed sensitivity and specificity for predicting F3 by NFI=75.1% and 41.1% and F4 for NFI=72.1% and 47.1%, AAR=62.8% and 37.6%, APRI=74.6% and 87.6%, FIB-4=53.2% and 72.3%, FI=78.1% and 92.3%, API=78.1% and 60%, Pohl score=38.1% and 78.1% and FCI=78.1% and 88.1%.

CONCLUSIONS

Our NFI predicted F3 and has been found to have more sensitivity and specificity in predicting F4 fibrosis stage than other FIs.

背景

在本研究中，我们整理了廉价且易于获得的非侵入性生物标志物和FibroScan评分，用于预测慢性丙型肝炎病毒（HCV）感染的纤维化阶段。

方法

我们研究了1898例血清中存在HCV RNA确诊为HCV感染的患者。我们比较了FibroScan评分和纤维化指标（FIs）：天冬氨酸转氨酶（AST）与丙氨酸转氨酶（ALT）比值（AAR）、AST与血小板比值指数（APRI）、FIs、纤维化-4（FIB-4）、年龄-血小板指数（API）、波尔评分、纤维化肝硬化指数（FCI）。我们开发了一种新的FIs，名为新型纤维化指数（NFI），通过以下公式计算：NFI = [（胆红素×（碱性磷酸酶））/（血小板计数（白蛋白））]-n。

结果

AAR、APRI、FIs、FIB-4、API、波尔评分、FCI和NFI能够预测纤维化阶段，相关系数指数分别为0.848、0.711、0.618、0.741、0.529、0.360、0.477和0.26。受试者工作特征曲线显示，NFI预测F3的敏感性和特异性分别为75.1%和41.1%，预测F4的敏感性和特异性分别为72.1%和47.1%，AAR分别为62.8%和37.6%，APRI分别为74.6%和87.6%，FIB-4分别为53.2%和72.3%，FIs分别为78.1%和92.3%，API分别为78.1%和60%，波尔评分分别为38.1%和78.1%，FCI分别为78.1%和88.1%。