Liu Yaoyu, Huang Zhizhen, Lan Xinya, Jia Min, Zheng Xiaoting, Hu Min, Luo Huiying, Zhang Luyun, Li Xuejing, Chen Shaodong, Li Yunru, Liang Huiqing
Hepatology Unit, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, Fujian, China.
Department of Traditional Chinese and Western Medicine, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, Hunan, China.
Gastroenterol Res Pract. 2024 Dec 9;2024:6722810. doi: 10.1155/grp/6722810. eCollection 2024.
HBV-infected individuals are also presenting with MASLD. However, the value of VCTE for detecting hepatic fibrosis and steatosis in CHB patients concurrent with MASLD is unclear. In patients with combined CHB and MASLD, we intend to assess the diagnostic efficacy of VCTE in determining the extent of fibrosis and steatosis. This retrospective study involved 368 patients diagnosed with chronic HBV infection combined with MASLD who received liver biopsy and VCTE at Xiamen City Traditional Chinese Medicine Hospital from June 2018 to June 2023. The cutoff values for liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were determined via the use of the cross-validated area under the receiver operating characteristic (AUROC) curve analyses to identify pairwise fibrosis stage and grade, respectively. The diagnostic statistics were calculated with a 90% fixed sensitivity and 90% specificity. An AUROC of 0.86 (95% CI: 0.76-0.95) was determined by a LSM cutoff value of 11.25 to identify patients with cirrhosis. Patients have the following values: sensitivity, 0.79; specificity, 0.90; PPV, 0.89; and NPV, 0.81. An AUROC of 0.84 (95% CI: 0.76-0.95) was determined by a CAP cutoff value of 313 to identify patients with severe steatotic liver. Patients have the following values: sensitivity, 0.86; specificity, 0.82; PPV, 0.82; and NPV, 0.85. In this investigation of adult patients diagnosed with CHB with MASLD, VCTE demonstrated a robust capability to differentiate cirrhosis and severe steatotic liver.
HBV感染个体也表现出非酒精性脂肪性肝病（MASLD）。然而，瞬时弹性成像（VCTE）在检测慢性乙型肝炎（CHB）合并MASLD患者肝纤维化和脂肪变性方面的价值尚不清楚。在CHB合并MASLD患者中，我们旨在评估VCTE在确定纤维化和脂肪变性程度方面的诊断效能。这项回顾性研究纳入了2018年6月至2023年6月在厦门市中医院接受肝活检和VCTE检查的368例诊断为慢性HBV感染合并MASLD的患者。通过使用受试者操作特征曲线（AUROC）下的交叉验证面积分析来确定肝脏硬度测量（LSM）和受控衰减参数（CAP）的临界值，以分别识别成对的纤维化阶段和分级。诊断统计数据以90%的固定敏感性和90%的特异性计算。通过LSM临界值11.25确定AUROC为0.86（95%CI：0.76 - 0.95）以识别肝硬化患者。患者具有以下值：敏感性为0.79；特异性为0.90；阳性预测值为0.89；阴性预测值为0.81。通过CAP临界值313确定AUROC为0.84（95%CI：0.76 - 0.95）以识别严重脂肪变性肝脏患者。患者具有以下值：敏感性为0.86；特异性为0.82；阳性预测值为0.82；阴性预测值为0.85。在这项对诊断为CHB合并MASLD的成年患者的调查中，VCTE显示出区分肝硬化和严重脂肪变性肝脏的强大能力。
