视觉形态和在肝纤维化的评价三个非侵入性标记物在慢性肝

StephenW

research article
Visual morphometry and three non-invasive markers in the evaluation of liver fibrosis in chronic liver disease
Swastik Agrawal, Caroline L. Hoad, Susan T. Francis, Indra N. Guha, Philip Kaye & Guruprasad P. Aithal
Page 1-16 | Received 24 Jul 2016, Accepted 31 Aug 2016, Accepted author version posted online: 12 Sep 2016, Published online: 12 Sep 2016

    Download citation http://dx.doi.org/10.1080/00365521.2016.1233578
   
Accepted author version
Abstract

Objective: Liver fibrosis is traditionally graded into categorical stages with cirrhosis as the highest stage. However, cirrhosis stage may vary between individuals widely in terms of the amount of fibrosis which is not assessed by traditional staging systems. We aimed to utilise visual morphometry to quantify the amount of fibrosis in liver biopsy and compare how non-invasive methods of quantifying liver fibrosis correlated with histological measures.

Materials and Methods: Liver biopsy specimens from 115 consecutive chronic liver disease patients were assessed by a single pathologist for fibrosis stage by the Clinical Research Network and METAVIR systems as well as percentage fibrosis by visual morphometry. Liver T1 relaxation times, liver stiffness measurement (LSM) by transient elastography and Enhanced Liver Fibrosis (ELF) score were compared between fibrosis stages. In addition these parameters were correlated with pathologist’s visual estimate of percentage fibrosis and their predictive ability for advanced fibrosis and cirrhosis assessed by area under receiver operating curve (AUROC).

Results: All four parameters increased sequentially from fibrosis stage F0 to F4 (P < 0.001 for each). AUROCs for advanced fibrosis and cirrhosis were 0.931and 1.000 respectively for pathologist’s estimate of fibrosis, 0.707and 0.926 for ELF score, 0.763 and 0.972 for T1 and 0.881and 0.989 for LSM. LSM, ELF score and T1 correlated significantly with pathologist’s estimate of percentage fibrosis.

Conclusion: Non-invasive markers of fibrosis LSM, ELF and T1relaxation time provide continuous surrogates for categorical histopathological staging of fibrosis which can be useful as markers of progression and regression of fibrosis on follow-up.
Keywords: Cirrhosis, fibrosis, morphometry, transient elastography, MRI,

StephenW

研究文章
视觉形态和在肝纤维化的评价三个非侵入性标记物在慢性肝病
耍斯梯阿格拉瓦尔，卡罗琳L. Hoad，苏珊T.弗朗西斯，因陀罗N.古哈，菲利普·凯和Guruprasad P. Aithal
1-16页|收到2016年7月24日，接受2016年8月31日，笔者接受的版本在网上发布：2016年9月12日，在线发表时间：2016年9月12日

    下载引文http://dx.doi.org/10.1080/00​​365521.2016.1233578
   
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目的：肝纤维化是传统的分级与肝硬化的最高阶段分类阶段。然而，肝硬化阶段可以在不通过传统的分期系统评估纤维化量计广泛的个体之间变化。我们的目的是利用视觉形态量化纤维化的量在肝活组织检查和比较如何非侵入性定量与组织学措施相关的肝纤维化的方法。

材料和方法：由115个连续的慢性肝病患者肝活检标本进行用于由临床研究网络和METAVIR系统纤维化阶段的单一病理学家以及由视觉形态百分比纤维化评估。肝T1弛豫时间，肝脏硬度测量（LSM）由瞬时弹性成像和增强肝纤维化（ELF）评分进行纤维化分期进行比较。此外，这些参数用百分比纤维化病理的视觉估计和他们的先进纤维化和肝硬化受试者工作曲线（AUROC）下按面积分摊的预测能力相关。

结果：所有四个参数顺序地从纤维化阶段F0（对于每个P <0.001）增加至F4。 AUROCs先进纤维化和肝硬化分别0.931and 1.000纤维化的病理医生的估计，0.707and 0.926为ELF得分，0.763和0.972 T1和0.881and 0.989的LSM。 LSM，ELF评分和T1与百分比纤维化的病理医生的估计显著相关。

结论：肝纤维化LSM的非侵入性的标记，ELF和T1relaxation时间为纤维化的病理组织学分类分期它可以为后续的进展和纤维化的消退标志有用连续的代理人。
关键词：肝硬化，肝纤维化，形态，瞬时弹性成像，MRI，