定量评估肝纤维化（qFibrosis）揭示Ishak“稳定”患者在抗HBV治

StephenW

Sci Rep. 2018 Feb 14;8(1):2989. doi: 10.1038/s41598-018-21179-2.
Quantitative assessment of liver fibrosis (qFibrosis) reveals precise outcomes in Ishak "stable" patients on anti-HBV therapy.Sun Y1, Zhou J1, Wu X1, Chen Y2, Piao H3, Lu L4, Ding H5, Nan Y6, Jiang W7, Wang T8, Liu H9, Ou X1, Wee A10, Theise ND11, Jia J12, You H13.
Author information
1Liver Research Center, Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.2Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.3Infectious Disease Department, Affiliated Hospital of Yanbian University, Yanji, 133000, China.4Department of Gastroenterology and Hepatology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200080, China.5Department of Gastroenterology and Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.6Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, Shijiazhuang, 050051, China.7Department of Gastroenterology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.8Pathology Department, China-Japan Friendship Hospital, Beijing, 100029, China.9Pathology Department, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.10Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, National University Hospital, Singapore, 119074, Singapore.11Department of Pathology, New York University School of Medicine, New York, NY, 10016, USA.12Liver Research Center, Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China. [email protected].13Liver Research Center, Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China. [email protected].

AbstractCurrent widely used semiquantitative histological assessment methods are insensitive to identify subtle changes of liver fibrosis. Therefore, to precisely assess therapeutic efficacy on chronic hepatitis B (CHB), we explored the utility of qFibrosis (a fully-quantitative morphometric method employing second harmonic generation/two photon excitation fluorescence) in liver fibrosis evaluation. Fibrosis changes were evaluated by Ishak fibrosis scoring and qFibrosis in CHB patients with paired liver biopsies before and after 78 weeks' antiviral therapy. A total of 162 patients with qualified paired biopsies were enrolled. Ishak fibrosis scoring revealed that 42.6% (69/162) of the patients achieved fibrosis regression (≥1-point decrease), 51.9% (84/162) remained stable, and 5.5% (9/162) showed progression (≥1-point increase). qFibrosis showed similar trends in the groups of regression and progression patients as evaluated by Ishak. However, in Ishak stable patients, qFibrosis revealed hitherto undetected changes, allowing for further subcategorization into regression ("Regression by qFibrosis"; 40/84, 47.6%), stable (29/84, 34.5%), and progression ("Progression by qFibrosis"; 15/84, 17.9%) groups. These newly fine-tuned categories were supported by changes of morphological parameters of fibrosis, collagen percentage area, and liver stiffness measurements. In conclusion, qFibrosis can be used to quantitatively identify subtle changes of liver fibrosis in CHB patients after antiviral therapy.


PMID:29445243DOI:10.1038/s41598-018-21179-2

StephenW

Sci Rep。2018 Feb 14; 8（1）：2989。 doi：10.1038 / s41598-018-21179-2。
定量评估肝纤维化（qFibrosis）揭示Ishak“稳定”患者在抗HBV治疗中的确切结果。
Sun Y1周1 1吴X1 1陈2 2朴彪H3吕禄4丁5 5楠6 6姜雯7王旺8刘六红O1 X1 Wee A10聂倩ND11嘉嘉12游友H13
作者信息

1
    首都医科大学附属北京友谊医院肝病研究中心，肝硬化转化医学北京市重点实验室，全国消化疾病临床研究中心，北京100050。
2
    南方医科大学南方医院感染科，广东广州510515
3
    延边大学附属医院感染科，延吉，133000
4
    上海交通大学医学院附属上海市总医院消化内科，上海200080
五
    首都医科大学附属北京佑安医院消化内科，北京100069
6
    河北医科大学第三医院中西医结合肝病科，石家庄050051
7
    复旦大学附属中山医院消化内科，上海，200032
8
    中日友好医院病理科，北京100029
9
    首都医科大学附属北京佑安医院病理科，北京100069
10
    新加坡国立大学医院，新加坡国立大学Yong Loo Lin医学院病理学系，119074，新加坡。
11
    纽约大学医学院病理系，纽约，纽约，10016，美国。
12
    首都医科大学附属北京友谊医院肝病研究中心，肝硬化转化医学北京市重点实验室，全国消化疾病临床研究中心，北京100050。 [email protected]。
13
    首都医科大学附属北京友谊医院肝病研究中心，肝硬化转化医学北京市重点实验室，全国消化疾病临床研究中心，北京100050。 [email protected]。

抽象

目前广泛使用的半定量组织学评估方法对识别肝纤维化的细微变化不敏感。因此，为了准确评估对慢性乙型肝炎（CHB）的疗效，我们探索了q纤维化（一种采用二次谐波/双光子激发荧光的全定量形态学方法）在肝纤维化评估中的应用。在78周的抗病毒治疗前后，配对肝活检的CHB患者通过Ishak纤维化评分和q纤维化评估纤维化改变。共有162例合格配对活检患者入组。 Ishak纤维化评分显示42.6％（69/162）的患者纤维化消退（≥1分减少），51.9％（84/162）保持稳定，5.5％（9/162）显示进展（≥1分）点增加）。根据Ishak评估，qFibrosis在回归和进展患者组中显示出类似的趋势。然而，在Ishak稳定患者中，qFibrosis揭示了迄今为止未检测到的变化，允许进一步进一步归类为退化（“由qFibrosis回归”; 40 / 84,47.6％），稳定（29/84,34.5％）和进展qFibrosis“; 15 / 84,17.9％）组。这些新调整的类别得到纤维化形态学参数，胶原百分比面积和肝硬度测量结果的支持。总之，qFibrosis可用于定量鉴别CHB患者抗病毒治疗后肝纤维化的细微变化。

结论：
    29445243
DOI：
    10.1038 / s41598-018-21179-2

StephenW

https://www.nature.com/articles/s41598-018-21179-2