非侵入分制纤维化的慢性肝炎：建议基于生化，Fibroscan的，

StephenW

Non-Invasive Score System For Fibrosis In Chronic Hepatitis: Proposal For A Model Based On Biochemical, Fibroscan, Ultrasound Data

    Silvia Gaia1,*,
    Daniela Campion1,
    Andrea Evangelista2,
    Maurizio Spandre1,
    Loretta Cosso1,
    Franco Brunello1,
    Giovannino Ciccone2,
    Elisabetta Bugianesi1 and
    Mario Rizzetto1

DOI: 10.1111/liv.12761

Vol. 34 Issue 10
Liver International


Author Information

    1    Department of Gastroenterology, Città della Salute e della Scienza - University Hospital
    2    Department of Epidemiology, Città della Salute e della Scienza - University Hospital, Turin, Italy

*corresponding author: md Silvia Gaia, Department of Gastroenterology, Città della Salute e della Scienza – University Hospital of Turin, c.so Bramante 88, 10100 Turin, Italy. Phone: +390116336485, fax: 0116336752, email: [email protected]

    This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/liv.12761


Abstract
Background and Aims

We elaborate a Non-Invasive Score system for liver Fibrosis (NISF), exploring its diagnostic performance and comparing its accuracy to Fibroscan in patients with chronic viral hepatitis (CH) and Non-Alcoholic Fatty Liver Disease (NAFLD).

Methods

Clinical, biochemical, elastographic and ultrasound parameters derived from patients with CH (n=83) or NAFLD (n=58), undergoing liver biopsy for fibrosis assessment, were prospectively collected as potential predictors of fibrosis. Each parameter was evaluated for its correlation with the liver biopsy (Gold Standard). Candidate predictors with good inter-observer agreement and correlation to histological stages were combined into 2 algorithms (NISF) to predict fibrosis in chronic viral hepatitis and NAFLD.

Results

The CH-NISF included 6 parameters: bluntness of liver edges, irregularity of left lobe surface, diameter of segment 4, liver stiffness measurement, platelet count and ALT values. The ability of the model to discriminate F3-F4 vs F0-F1 stages and F2 vs F0-F1 was high (AUROC of 0.95 and 0.83, respectively) and better than Fibroscan alone, especially in intermediate stages (F2 vs F0-F1), AUROC 0.83 vs 0.57 (p 0.003). The resulting algorithm is available as mathematical formula, nomogram or free on-line links.

The NAFLD-NISF included liver stiffness, platelet count and AST levels, had good ability to discriminate F0-F1 versus F2-F3-F4 stages (AUROC 0.86), however not significantly higher than Fibroscan.

Conclusions

CH-NISF can be proposed as preliminary and easily-available staging tool, superior to Fibroscan alone in predicting histologic fibrosis, especially in intermediate stages. Further validations are needed to improve NISF accuracy in NAFLD.

This article is protected by copyright. All rights reserved.

StephenW

非侵入分制纤维化的慢性肝炎：建议基于生化，Fibroscan的，超声数据模型

    西尔维娅Gaia1，*，
    丹妮拉Campion1，
    安德烈Evangelista2，
    莫里吉奥Spandre1，
    洛雷塔Cosso1，
    佛朗哥Brunello1，
    Giovannino Ciccone2，
    伊丽莎白Bugianesi1和
    马里奥Rizzetto1

DOI：10.1111/ liv.12761

第一卷。 34问题10
肝国际


作者信息

    消化科的Cittàdella Salute的Ë德拉Scienza1系 - 大学医院
    大学医院，都灵，意大利 - 流行病学的Cittàdella Salute的Ë德拉Scienza2部

*通讯作者：MD西尔维娅盖亚，消化科的Cittàdella Salute的Ë德拉Scienza - 都灵大学医院，c.so布拉曼特88，10100都灵，意大利。联系电话：390116336485，传真：0116336752，电子邮件：[email protected]

    这篇文章已被接受发表，并接受全面的同行评审，但经过审稿，排版，分页和校对过程中，这可能会导致这个版本和记录的版本之间的差异一直没有。请引用这篇文章的DOI：10.1111/ liv.12761


抽象
背景和目的

我们精心为肝纤维化（NISF）无创评分系统，探索其诊断性能和精确度慢性病毒性肝炎（CH）和非酒精性脂肪性肝病（NAFLD）比较Fibroscan的。

方法：

来自患者的CH（N =83）或NAFLD（N =58）的临床，生化，弹性成像和超声参数，进行肝活检纤维化评估，前瞻性收集纤维化的潜在危险因素。每个参数与肝活检（金标准）的相关性进行了评估。候选预测具有良好的国际观察员的协议，相关组织学阶段合并为2的算法（NISF）预测纤维化慢性病毒性肝炎和脂肪肝。

结果

在CH-NISF包括6个参数：肝脏边缘，左叶表面不规则，部分4的直径，肝脏硬度测量，血小板计数和ALT值直率。该模型以鉴别F3-F4 VS F0-F1阶段和F2 VS F0-F1是高（0.95和0.83，分别AUROC）优于Fibroscan的单独的能力，特别是在中间级（F2 VS F0-F1）， AUROC0.83 VS0.57（P = 0.003）。所得算法可作为数学公式，列线图或免费在线连接。

在NAFLD-NISF包括肝脏硬度，血小板计数和AST水平，有歧视F0-F1 F2相比，F3-F4级（AUROC0.86）能力不错，比不过Fibroscan的不显著高。

结论

CH-NISF可以提出作为初步易得的分段工具，优于单用肝纤维在预测组织学纤维化，特别是在中间阶段。还需要进一步验证，以提高NISF精度NAFLD。

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