ELF得分≥9.8表明先进的肝纤维化和受年龄，脂肪变性及组织

StephenW

ELF score ≥9.8 indicates advanced hepatic fibrosis and is influenced by age, steatosis and histological activity

    Kevin J Fagan1,2,
    Carel J Pretorius3,4,
    Leigh U Horsfall1,2,
    Katharine M Irvine2,
    Urs Wilgen3,4,
    Kihoon Choi2,
    Linda M Fletcher1,3,
    Jill Tate4,
    Michelle Melino2,
    Sharmin Nusrat2,
    Gregory C Miller2,
    Andrew D Clouston2,
    Emma Ballard5,
    Peter O'Rourke5,
    Guy Lampe6,
    Jacobus PJ Ungerer4 and
    Elizabeth E Powell1,2,*

DOI: 10.1111/liv.12760

This article is protected by copyright. All rights reserved.

Vol. 34 Issue 10
Liver International


Author Information

    1    Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
    2    Centre for Liver Disease Research, School of Medicine, The University of Queensland, Brisbane, Australia
    3    School of Medicine, The University of Queensland, Brisbane, Australia
    4    Department of Chemical Pathology, Pathology Queensland, Brisbane, Australia
    5    Statistics Unit, QIMR Berghofer Medical Research Institute, Brisbane, Australia
    6    Pathology Queensland, Princess Alexandra Hospital, Brisbane, Australia

* Correspondence to:
Elizabeth Powell, Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Woolloongabba 4102, Queensland, Australia. [email protected], Telephone: +61-7-34438015 Fax: +61-7-34438015


Abstract
Background and Aims

There is increasing need to identify individuals with advanced liver fibrosis, who are at risk of complications such as hepatocellular carcinoma. The commercially available Enhanced Liver Fibrosis (ELF) test provides a non-invasive assessment of fibrosis severity. This study was designed to determine the diagnostic accuracy of the manufacturer's cut-off value (≥9.8) in identifying advanced fibrosis.

Methods

The relationship between ELF score and fibrosis was examined using serum collected at time of liver biopsy for investigation of liver disease, particularly viral hepatitis. Fibrosis was staged using a modified METAVIR score. If available, liver tissue was recut and stained with Sirius red to determine collagen proportional area and subsinusoidal fibrosis.

Results

ELF score ≥9.8 had a sensitivity of 74.4% and specificity 92.4% for detecting advanced fibrosis. In the whole cohort (n=329), ELF score was more likely to incorrectly classify individuals if age was ≥45 years and METAVIR inflammatory grade was 2 or 3 (adjusted OR 3.71 and 2.62 respectively). In contrast, ELF score was less likely to misclassify individuals in the presence of steatosis (OR 0.37). Neither subsinusoidal fibrosis nor collagen proportional area explained the discordance in ELF score for patients with or without advanced fibrosis.

Conclusion

Although ELF score ≥9.8 reliably identifies advanced fibrosis in patients with chronic liver disease, both age and inflammatory activity need to be considered when interpreting the result. Importantly, ELF score performed well in the presence of steatosis and could thus be helpful in the assessment of fatty liver disease.

This article is protected by copyright. All rights reserved.

StephenW

ELF得分≥9.8表明先进的肝纤维化和受年龄，脂肪变性及组织学活动影响

    凯文ĴFagan1,2，
    卡雷尔ĴPretorius3,4，
    利üHorsfall1,2，
    凯瑟琳·M Irvine2，
    乌尔斯Wilgen3,4，
    Kihoon Choi2，
    琳达·M Fletcher1,3，
    吉尔Tate4，
    米歇尔Melino2，
    Sharmin Nusrat2，
    格雷戈里ÇMiller2，
    安德鲁ðClouston2，
    艾玛Ballard5，
    彼得O'Rourke5，
    盖伊Lampe6，
    雅克布斯PJ Ungerer4和
    伊丽莎白·êPowell1,2，*

DOI：10.1111/ liv.12760

这篇文章是受版权保护的。版权所有。

第一卷。 34问题10
肝国际


作者信息

    胃肠病学和肝病，亚历山德拉公主医院，布里斯班，澳大利亚1系
    2中心肝病研究，医学院，昆士兰大学，澳大利亚布里斯班
    医药，昆士兰大学，布里斯班，澳大利亚3学校
    化学病理学，病理昆士兰州，澳大利亚布里斯班4部
    5统计单位，QIMR Berghofer医学研究所，澳大利亚布里斯班
    6病理昆士兰州，亚历山德拉公主医院，布里斯班，澳大利亚

*通讯作者：
伊丽莎白·鲍威尔，胃肠病学和肝病，亚历山德拉公主医院的Woolloongabba4102，昆士兰州，澳大利亚部。 [email protected]，电话：+61-7-34438015传真：+61-7-34438015


抽象
背景和目的

有越来越多的需要确定了先进的肝纤维化的个体，谁在并发症如肝细胞癌的危险。市售增强肝纤维化（ELF）测试提供纤维化严重程度的非侵入性的评估。这项研究的目的是确定在确定肝纤维化制造商的分界值（≥9.8）的诊断准确性。

方法：

使用血清在肝活检的时间为肝脏疾病，特别是病毒性肝炎调查收集的ELF得分和纤维化之间的关系进行了研究。采用改良METAVIR评分纤维化上演。如果有的话，肝组织重新切割并用天狼星红，以确定胶原比例区和subsinusoidal纤维化。

结果

ELF得分≥9.8有74.4％用于检测肝纤维化的敏感性和特异性92.4％。在整个队列（N=329），ELF得分更容易正确分类的个人，如果年龄≥45岁（分别调整OR3.71和2.62）METAVIR炎症等级为2或3。与此相反，ELF得分是不太可能错误分类的个体中脂肪变性（或0.37）的存在。无论subsinusoidal纤维化，也不胶原比例方面解释不一致的ELF得分患者有无肝纤维化。

结论

虽然ELF得分≥9.8可靠地识别在慢性肝病肝纤维化，年龄和炎症活动需要解释的结果时予以考虑。重要的是，ELF得分中脂肪的存在下表现良好，因此可能是在脂肪肝疾病的评估有帮助的。

这篇文章是受版权保护的。版权所有。