Yarkan Tugsal Handan, Yuksel Selcen, Kabacam Gokhan, Evirgen Sami, Akan Kubra, Akyuz Filiz, Gulluoglu Mine, Erden Esra, Bozdayi A Mithat, Cinar Kubilay, Idilman Ramazan, Yurdaydin Cihan, Kaymakoglu Sabahattin, Bozkaya Hakan
Department of Internal Medicine, Ankara University School of Medicine, Ankara, Turkey.
Department of Biostatistics, Yildirim Beyazit University, Ankara, Turkey.
Hepatol Forum. 2021 Jan 8;2(1):12-19. doi: 10.14744/hf.2020.2020.0027. eCollection 2021 Jan.
This study was designed to predict the fibrosis stage with a clinical scoring system that may reduce the need for liver biopsy.
The study cohort included the treatment of 430 chronic hepatitis B (CHB) and 170 chronic hepatitis C (CHC) of naive patients. The patients were divided into two groups as mild to moderate and severe fibrosis. After an index obtained in the study cohort, the index was tested in a validation cohort and compared with the FIB-4 Index.
The AUC of CHC index was found of 0.89 the sensitivity of 0.91 the specificity of 0.74, the positive predictive value (PPV) of 0.54 and the negative predictive value (NPV) of 0.96. The FIB-4 Index was applied to the CHC study cohort and the ATA Index Hepatitis C was found to be superior in terms of AUC (0.89-0.82), sensitivity (0.91-0.76) and NPV (0.96-0.86). The AUC of CHB Index was determined of 0.92, the sensitivity of 0.90, the specificity of 0.84, the PPV of 0.53 and the NPV of 0.98. Compared to the FIB-4 Index in CHB study cohort, the ATA Index Hepatitis B was predominant in terms of AUC (0.92-0.88), sensitivity (0.90-0.75), NPV (0.98-0.94) and PPV (0.53-0.49).
ATA Indexes can predict the non-existence of severe fibrosis with an accuracy similar to FIB-4 Index and may reduce the need for liver biopsy.
本研究旨在设计一种临床评分系统来预测纤维化阶段,以减少肝活检的必要性。
研究队列包括430例初治慢性乙型肝炎(CHB)患者和170例初治慢性丙型肝炎(CHC)患者的治疗情况。患者被分为轻度至中度纤维化组和重度纤维化组。在研究队列中获得一个指标后,该指标在验证队列中进行测试,并与FIB-4指数进行比较。
CHC指标的曲线下面积(AUC)为0.89,灵敏度为0.91,特异度为0.74,阳性预测值(PPV)为0.54,阴性预测值(NPV)为0.96。将FIB-4指数应用于CHC研究队列,发现ATA丙型肝炎指数在AUC(0.89 - 0.82)、灵敏度(0.91 - 0.76)和NPV(0.96 - 0.86)方面更具优势。CHB指标的AUC为0.92,灵敏度为0.90,特异度为0.84,PPV为0.53,NPV为0.98。与CHB研究队列中的FIB-4指数相比,ATA乙型肝炎指数在AUC(0.92 - 0.88)、灵敏度(0.90 - 0.75)、NPV(0.98 - 0.94)和PPV(0.53 - 0.49)方面更具优势。
ATA指数能够以与FIB-4指数相似的准确性预测不存在重度纤维化的情况,并可能减少肝活检的必要性。