Arvaniti Pinelopi, Giannoulis George, Lygoura Vasiliki, Gatselis Nikolaos K, Gabeta Stella, Rigopoulou Eirini, Koukoulis George K, Zachou Kalliopi, Dalekos George N
Department of Medicine and Research Laboratory of Internal Medicine, Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa (Pinelopi Arvaniti, George Giannoulis, Vasiliki Lygoura, Nikolaos K. Gatselis, Stella Gabeta, Eirini Rigopoulou, Kalliopi Zachou, George N. Dalekos).
European Reference Network on Hepatological Diseases (ERN RARE-LIVER), General University Hospital of Larissa (Pinelopi Arvaniti, George Giannoulis, Vasiliki Lygoura, Nikolaos K. Gatselis, Stella Gabeta, Eirini Rigopoulou, Kalliopi Zachou, George N. Dalekos).
Ann Gastroenterol. 2023 Nov-Dec;36(6):661-669. doi: 10.20524/aog.2023.0841. Epub 2023 Nov 3.
FibroMeter and FibroMeter vibration-controlled transient elastography (FibroMeter VCTE) were assessed in a Greek cohort of patients with chronic viral hepatitis (CVH) B and C or metabolic dysfunction-associated steatotic liver disease (MASLD) to evaluate their accuracy in predicting advanced liver fibrosis against other well-validated noninvasive markers.
Group 1: n=83 CVH and group 2: n=38 MASLD patients underwent liver biopsy and transient elastography (TE) on the same day as sera collection. FibroMeter scores APRI and FIB-4 were calculated in all 121 patients, while MASLD fibrosis score (MFS) was also calculated in group 2.
In CVH, FibroMeter VCTE performed equivalently to TE and better than the other markers in predicting advanced (≥F3) and significant (≥F2) fibrosis (area under the receiver operating characteristic curve [AUC] 0.887, P<0.001 for F3; AUC 0.766 P<0.001 for F2). FibroMeter Virus (cutoff 0.61) had lower sensitivity (20%) but performed equivalently to APRI and FIB-4. In MASLD, all markers but APRI performed equivalently in predicting advanced fibrosis. FibroMeter VCTE >0.2154 had the same sensitivity (100%) and specificity (81%) as TE (cutoff >7.1 kPa). FibroMeter MASLD >0.25 performed equivalently to MFS and FIB4, but with higher specificity (100%). Both FibroMeter and FibroMeter VCTE correlated with liver histology but not with liver enzymes.
FibroMeter VCTE predicts accurately advanced fibrosis in CVH and MASLD, irrespectively of transaminase levels. FibroMeter Virus can be applied only as an alternative marker in CVH, while FibroMeter MASLD performs equally to TE and calculated scores (MFS, FIB-4) in predicting advanced fibrosis in MASLD patients.
在一组希腊慢性B型和C型病毒性肝炎(CVH)或代谢功能障碍相关脂肪性肝病(MASLD)患者中,对FibroMeter和FibroMeter振动控制瞬时弹性成像(FibroMeter VCTE)进行评估,以评价其与其他经过充分验证的非侵入性标志物相比,在预测晚期肝纤维化方面的准确性。
第1组:83例CVH患者,第2组:38例MASLD患者在采集血清当天接受肝活检和瞬时弹性成像(TE)检查。计算了全部121例患者的FibroMeter评分APRI和FIB-4,同时也计算了第2组患者的MASLD纤维化评分(MFS)。
在CVH患者中,FibroMeter VCTE在预测晚期(≥F3)和显著(≥F2)纤维化方面与TE表现相当,且优于其他标志物(受试者操作特征曲线下面积[AUC]:F3为0.887,P<0.001;F2为0.766,P<0.001)。FibroMeter Virus(临界值0.61)敏感性较低(20%),但与APRI和FIB-4表现相当。在MASLD患者中,除APRI外的所有标志物在预测晚期纤维化方面表现相当。FibroMeter VCTE>0.2154与TE(临界值>7.1 kPa)具有相同的敏感性(100%)和特异性(81%)。FibroMeter MASLD>0.25与MFS和FIB4表现相当,但特异性更高(100%)。FibroMeter和FibroMeter VCTE均与肝组织学相关,但与肝酶无关。
FibroMeter VCTE可准确预测CVH和MASLD患者的晚期纤维化,与转氨酶水平无关。FibroMeter Virus仅可作为CVH的替代标志物应用,而FibroMeter MASLD在预测MASLD患者晚期纤维化方面与TE及计算评分(MFS、FIB-4)表现相当。