Liaqat Mahjabeen, Siddique Kashif, Yousaf Imran, Bacha Raham, Farooq S Muhammad Yousaf, Gilani Syed Amir
Radiology, The University of Lahore, Pakistan.
Radiology, Shaukat Khanum Hospital, Pakistan.
J Ultrason. 2021 Aug 16;21(86):e186-e193. doi: 10.15557/JoU.2021.0030. Epub 2021 Sep 9.
In this study, we sought to examine the optimal cutoff values for predicting different stages of liver fibrosis, and to determine the level of agreement between shear wave elastography and aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 index (FIB-4) scores in patients with chronic liver disease. A descriptive, cross-sectional study was performed at the Radiology Department of Shaukat Khanum Memorial Hospital Lahore from 1 Jun 2019 until 1 June 2020. FIB-4 and APRI scores were determined by the following formula: FIB-4 = (age × AST) ÷ (platelet count × (√ (ALT)) and APRI = (AST÷AST upper limit of normal) ÷ platelet × 100. Data was analyzed with the help of SPSS version 24.0 and Microsoft Excel 2013. Eighty individuals were conveniently selected, of which 62.5% were men and 37.5% were women. The mean age of the subjects was 43.47 SD ± 13.85 years. APRI and FIB-4 scores predicted F4 patients using the cutoff values of 0.47 (Sn. 72%, Sp. 70%) and 1.27 (Sn. 78%, Sp. 73%), respectively. The cutoff values of 0.46 for APRI and 1.27 for FIB-4 predicted F3-F4 patients (Sn. 74% and 77%; Sp. 76% and 76%), respectively. To predict F1-F4 compared to F0, the cutoff value was 0.34 (Sn. 68%, Sp. 75%) for APRI, while the cutoff value for FIB was 0.87 (Sn. 72%, Sp. 75%). The findings suggest that FIB-4 shows better diagnostic accuracy than APRI. This study provides optimal cutoff values for different groups of fibrosis patients for both serum markers. Also, the diagnostic accuracy of FIB-4 for predicting liver fibrosis was found to be superior to APRI in all disease stages.
在本研究中，我们试图确定预测不同阶段肝纤维化的最佳临界值，并确定慢性肝病患者中剪切波弹性成像与天冬氨酸氨基转移酶与血小板比值指数（APRI）和纤维化-4指数（FIB-4）评分之间的一致性水平。2019年6月1日至2020年6月1日在拉合尔绍卡特·汗姆纪念医院放射科进行了一项描述性横断面研究。FIB-4和APRI评分通过以下公式确定：FIB-4 =（年龄×AST）÷（血小板计数×（√ALT）），APRI =（AST÷AST正常上限）÷血小板×100。借助SPSS 24.0版和Microsoft Excel 2013对数据进行分析。方便选取了80名个体，其中62.5%为男性，37.5%为女性。受试者的平均年龄为43.47±13.85岁（标准差）。APRI和FIB-4评分分别使用临界值0.47（灵敏度72%，特异度70%）和1.27（灵敏度78%，特异度73%）预测F4期患者。APRI临界值0.46和FIB-4临界值1.27分别预测F3-F4期患者（灵敏度分别为74%和77%；特异度分别为76%和76%）。与F0期相比，预测F1-F4期时，APRI的临界值为0.34（灵敏度68%，特异度75%），而FIB的临界值为0.87（灵敏度72%，特异度75%）。研究结果表明，FIB-4的诊断准确性优于APRI。本研究为两类血清标志物的不同纤维化患者群体提供了最佳临界值。此外，发现在所有疾病阶段，FIB-4预测肝纤维化的诊断准确性均优于APRI。
