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二维剪切波弹性成像在亚洲原发性胆汁性胆管炎患者中筛查静脉曲张的应用。

Two-dimensional shear wave elastography for screening varices in Asian patients with primary biliary cholangitis.

机构信息

Sichuan University-University of Oxford Huaxi Joint for Gastrointestinal Cancer Centre, Sichuan University, Chengdu, Sichuan, China.

Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Expert Rev Gastroenterol Hepatol. 2021 Aug;15(8):965-973. doi: 10.1080/17474124.2021.1884071. Epub 2021 Feb 15.

Abstract

: The presence of varices affects the survival of patients with primary biliary cholangitis (PBC). The aim of this study is to assess the criteria based on liver stiffness (LS) measured by two-dimensional shear wave elastography (2D-SWE) and platelet count (PLT), and recently published noninvasive models for triaging PBC patients.: 231 patients with PBC who underwent EGD and 2D-SWE examination were enrolled. Areas under the receiver-operating characteristic curve (AUROC) were used to assess the performance of 2D-SWE for predicting all-size varices and high-risk varices. All-size varices and high-risk varices miss rate < 10% and <5%, respectively, were acceptable for screening varices.: The AUROCs of LS for predicting all-size varices and high-risk varices were 0.87 (95%CI: 0.82-0.91) and 0.84 (95%CI: 0.74-0.86), respectively. LS <25 kPa and PLT >110 × 10/L spared 46.3% EGD screening, with 3.7% high-risk varices miss rate and 8.4% all-size varices miss rate. One hundred and sixteen (50.2%) patients met the Newcastle varices in PBC score (cutoff, 0.5), with 4.3% high-risk varices miss rate and 11.2% all-size varices miss rate.: The criteria based on LS and PLT are useful for triaging PBC patients. LS <25 kPa and PLT >110 × 10/L could be the optimal criteria for screening varices.

摘要

: 静脉曲张的存在影响原发性胆汁性胆管炎 (PBC) 患者的生存。本研究旨在评估基于二维剪切波弹性成像 (2D-SWE) 测量的肝硬度 (LS) 和血小板计数 (PLT) 的标准,以及最近发表的用于 PBC 患者分诊的非侵入性模型。: 纳入了 231 名接受 EGD 和 2D-SWE 检查的 PBC 患者。接受者操作特征曲线 (AUROC) 的面积用于评估 2D-SWE 预测所有大小静脉曲张和高危静脉曲张的性能。分别为 10%和 5%的所有大小静脉曲张和高危静脉曲张漏诊率可以接受筛查静脉曲张。: LS 预测所有大小静脉曲张和高危静脉曲张的 AUROC 分别为 0.87(95%CI:0.82-0.91)和 0.84(95%CI:0.74-0.86)。LS <25 kPa 和 PLT >110×10/L 可节省 46.3%的 EGD 筛查,高危静脉曲张漏诊率为 3.7%,所有大小静脉曲张漏诊率为 8.4%。116 名 (50.2%)患者符合 PBC 评分的纽卡斯尔静脉曲张评分 (截点,0.5),高危静脉曲张漏诊率为 4.3%,所有大小静脉曲张漏诊率为 11.2%。: 基于 LS 和 PLT 的标准可用于 PBC 患者的分诊。LS <25 kPa 和 PLT >110×10/L 可能是筛查静脉曲张的最佳标准。

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