Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang Liaoning Province, China.
Department of Health Management, Shengjing Hospital of China Medical University, Shenyang Liaoning Province, China.
Aging (Albany NY). 2020 Aug 24;12(16):16072-16082. doi: 10.18632/aging.103522.
Liver stiffness measurement (LSM) frequently overestimates the severity of liver fibrosis because of steatosis. However, the impact of the controlled attenuation parameter (CAP) on liver stiffness cutoff values remains unknown; CAP was used to quantify and diagnose the severity of hepatic steatosis. The study was conducted to determine the effect of CAP on liver stiffness cutoff values in chronic hepatitis B (CHB) patients. A retrospective cross-sectional study was performed in liver biopsy-proven CHB patients. The median LSM (kPa) in the elevated CAP group was higher than that in the normal CAP group at the same fibrosis stage. For S2-4, the area under the receiver operating characteristic (AUROC) curve of LSM was 0.78 and 0.72 in the normal and elevated CAP groups, respectively. When a cutoff value of 8.9 kPa was used, the diagnostic accuracy was 77.82% and 63.41% in the normal and elevated CAP groups, respectively. Compared with the alanine transaminase (ALT)-based LSM algorithm, the CAP-based LSM algorithm had a similar correct diagnosis rate (33.64% vs. 33.94%, respectively) but a lower misdiagnosis rate (16.97% vs. 20.30%, respectively). The new CAP-based LSM diagnostic algorithm will improve the diagnostic accuracy of liver fibrosis in CHB patients.
肝脏硬度测量（LSM）常因脂肪变性而高估肝纤维化的严重程度。然而，受控衰减参数（CAP）对肝硬度截断值的影响尚不清楚；CAP 用于量化和诊断肝脂肪变性的严重程度。本研究旨在确定 CAP 对慢性乙型肝炎（CHB）患者肝硬度截断值的影响。对经肝活检证实的 CHB 患者进行了回顾性横断面研究。在相同纤维化分期时，CAP 值升高组的中位 LSM（kPa）高于 CAP 值正常组。对于 S2-4，LSM 的受试者工作特征（ROC）曲线下面积（AUROC）在 CAP 值正常和升高组分别为 0.78 和 0.72。当使用 8.9 kPa 的截断值时，CAP 值正常和升高组的诊断准确性分别为 77.82%和 63.41%。与基于丙氨酸氨基转移酶（ALT）的 LSM 算法相比，基于 CAP 的 LSM 算法的正确诊断率相似（分别为 33.64%和 33.94%），但误诊率较低（分别为 16.97%和 20.30%）。新的基于 CAP 的 LSM 诊断算法将提高 CHB 患者肝纤维化的诊断准确性。
