瞬时弹性成像相比血清标记物来预测中国慢性乙肝的人群

StephenW

Source: J Gastroenterol Hepatol  |  Posted 6 days agoTransient elastography compared to serum markers to predict liver fibrosis in a cohort of Chinese patients with chronic hepatitis B;
Jia J, Hou J, Ding H, Chen G, Xie Q, Wang Y, Zeng M, Zhao J, Wang T, Hu X, Schuppan D; Journal of Gastroenterology and Hepatology (Oct 2014)

BACKGROUND AND AIM Liver stiffness measurement (LSM) using transient elastography (FibroScan®) is a useful tool to assess fibrosis in various chronic liver diseases. However, studies were mainly performed in Western countries and largely focused on chronic hepatitis C (CHC). We therefore carried out a multi-center study to validate the accuracy of LSM in the assessment of liver fibrosis in a large cohort of Chinese patients with chronic hepatitis B (CHB).
METHODS We compared LSM results to histological staging and serum fibrosis markers (5 direct markers, APRI and FIB-4) using Spearman correlation analysis and Area Under ROC Curves (AUROCs).
RESULTS 469 patients were enrolled and eligible for statistical analysis. LSM in F0 to F4 was 5.5 ±1.7, 5.8 ±2.2, 7.6 ±3.4, 14.5 ±10.8, and 22.3 ±13.6 kPa, respectively (correlation with fibrosis stage r=0.522, p<0.001). AUROC for LSM to correctly allocate patients to histological fibrosis stage ≥F2, ≥F3 and F4 was 0.82, 0.88, and 0.90, respectively. LSM outperformed serum fibrosis markers for detection of fibrosis F≥2 and F4. Patients with ALT levels 1-5x and>5x the upper limit of normal values had significantly higher stiffness values than stage-matched patients with normal ALT.
CONCLUSIONS Transient elastography is a reliable non-invasive technique to predict significant liver fibrosis in Chinese patients with CHB, being superior to current biomarker panels. However, enhanced inflammatory activity can lead to elevated stiffness values unrelated to histological fibrosis stage.

StephenW

来源：J- Gastroenterol肝脏病杂志|发表于4天前
瞬时弹性成像相比，血清标记物来预测中国慢性乙肝的人群肝纤维化;
贾Ĵ，侯Ĵ，丁H，陈G，谢Q，王勇，曾男，赵Ĵ，王T，胡X，Schuppan D组;
胃肠病学和肝病学（2014年10月）的

   
背景，并使用瞬时弹性成像（FibroScan®）AIM肝脏硬度测量（LSM）是一个有用的工具，以评估各种慢性肝病肝纤维化。然而，研究主要表现在西方国家，并主要集中在慢性丙型肝炎（CHC）。因此，我们进行了一项多中心研究，以验证LSM在肝纤维化评估的准确性中国慢性乙型肝炎（CHB）的大型队列。

方法我们比较LSM结果采用Spearman相关分析和ROC下面积曲线（AUROCs）病理分期与血清肝纤维化指标（5直接标记，APRI和FIB-4）。

结果469名患者参加，并有资格进行统计分析。 LSM的F0至F4为5.5±1.7，5.8±2.2，7.6±3.4，14.5±10.8和22.3±13.6千帕，分别为（纤维化阶段，R =0.522，P <0.001相关性）。 AUROC为LSM正确地分配到患者组织纤维化分期≥F2，≥F3和F4为0.82，0.88和0.90，分别。 LSM跑赢血清肝纤维化标志物检测肝纤维化F≥2和F4的。患者的ALT水平1-5X和>5倍正常值的上限具有比阶段相匹配的患者的ALT正常显著更高的刚度值。

结论瞬时弹性成像是一种可靠的非侵入性技术来预测显著肝纤维化的中国慢性乙肝患者，优于目前的生物标志物板。然而，增强抗炎活性可导致无关的组织纤维化分期升高的刚度值。