评估 M2BPGi 作为慢性乙型肝炎患者肝纤维化的标志物。

Evaluating M2BPGi as a Marker for Liver Fibrosis in Patients with Chronic Hepatitis B.

机构信息

Department of Gastroenterology, University Medical Center Ho Chi Minh City, 215 Hong Bang Street, Ward 11, District 5, Ho Chi Minh City, 70000, Vietnam.

Department of Internal Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.

出版信息

Dig Dis Sci. 2023 Dec;68(12):4407-4417. doi: 10.1007/s10620-023-08143-5. Epub 2023 Oct 20.

BACKGROUND

The accurate evaluation of liver fibrosis is crucial for the treatment and follow up of chronic hepatitis B (CHB) patients.

AIM

We examined the efficiency of serum Mac-2 Binding Protein Glycosylation isomer (M2BPGi) in diagnosing liver fibrosis stages in CHB patients.

METHODS

A cross-sectional study was conducted on 177 adult CHB patients visiting the University Medical Center Ho Chi Minh City, Vietnam between October 2019 and December 2021. M2BPGi, ARFI, APRI, and FIB-4 were tested against FibroScan® for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The optimal M2BPGi cut-off values were identified based on the area under the receiver operating characteristic (AUROC) curve.

RESULTS

There was a strong agreement between M2BPGi and FibroScan® (r = 0.77, P < 0.001). The optimal M2BPGi cut-off index (C.O.I) for detecting significant fibrosis (F ≥ 2) was 0.79 with an AUROC of 0.77, 67.3% sensitivity, 70% specificity, 60.6% NPV, and 75.3% PPV. Compared with APRI (61%) and FIB-4 (47%), M2BPGi had the greatest sensitivity for diagnosing F ≥ 2. M2BPGi combined with APRI yielded highest diagnosis performance for F ≥ 2 with an AUROC of 0.87. The optimal cut-off index of M2BPGi for diagnosing cirrhosis (F4) was 1.3 with an AUROC of 0.91, 88% sensitivity, 87.4% specificity, 97% NPV, and 61% PPV. The AUROC of M2BPGi for diagnosing F4 was comparable to that of ARFI (0.93).

CONCLUSIONS

With cut-off values of 0.79 C.O.I and 1.3 C.O.I, M2BPGi could be an effective method for diagnosing significant fibrosis and cirrhosis in CHB patients, respectively.

背景

准确评估肝纤维化对于慢性乙型肝炎（CHB）患者的治疗和随访至关重要。

目的

我们研究了血清 Mac-2 结合蛋白糖基化异构体（M2BPGi）在诊断 CHB 患者肝纤维化分期中的效率。

方法

本研究为 2019 年 10 月至 2021 年 12 月期间在越南胡志明市医疗中心就诊的 177 例成年 CHB 患者进行了一项横断面研究。检测 M2BPGi、ARFI、APRI 和 FIB-4 与 FibroScan®的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。根据受试者工作特征（ROC）曲线下面积（AUROC）确定最佳 M2BPGi 截断值。

结果

M2BPGi 与 FibroScan®之间存在很强的一致性（r=0.77，P<0.001）。检测显著纤维化（F≥2）的最佳 M2BPGi 截断指数（C.O.I）为 0.79，AUROC 为 0.77，敏感性为 67.3%，特异性为 70%，NPV 为 60.6%，PPV 为 75.3%。与 APRI（61%）和 FIB-4（47%）相比，M2BPGi 对诊断 F≥2 的敏感性最高。M2BPGi 联合 APRI 对 F≥2 的诊断效能最高，AUROC 为 0.87。M2BPGi 诊断肝硬化（F4）的最佳截断指数为 1.3，AUROC 为 0.91，敏感性为 88%，特异性为 87.4%，NPV 为 97%，PPV 为 61%。M2BPGi 诊断 F4 的 AUROC 与 ARFI（0.93）相当。