年龄对慢性乙型肝炎显着纤维化和肝硬化的APRI和FIB-4的诊断

StephenW

Oncotarget. 2017 Apr 27. doi: 10.18632/oncotarget.17470. [Epub ahead of print]
Impact of age on the diagnostic performances and cut-offs of APRI and FIB-4 for significant fibrosis and cirrhosis in chronic hepatitis B.
Li Q1,2, Lu C1, Li W1, Huang Y1,2, Chen L1.
Author information

1    Department of Hepatitis, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
2    Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai 200040, China.

Abstract
AIMS:

Assessing the diagnostic performances of APRI and FIB-4 using age as a categorical marker.
METHODS:

822 chronic hepatitis B (CHB) patients were included. Using METAVIR scoring system as a reference, the performances of APRI and FIB-4 were compared between patients aged≥30 and patients aged<30 years.
RESULTS:

The APRI AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.61 vs 0.70, p<0.001) and cirrhosis (0.64 vs 0.78, p<0.001). The FIB-4 AUROC in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (0.57 vs 0.65, p<0.001) and cirrhosis (0.63 vs 0.72, p<0.001). Using specificity≥90%, the APRI cut-off in patients aged<30 years was lower than patients aged≥30 years for significant fibrosis (1.0 vs 1.2) and cirrhosis (1.2 vs 1.5). Using sensitivity≥90%, the APRI cut-off in patients aged<30 years was also lower than patients aged≥30 years for significant fibrosis (0.2 vs 0.4) and cirrhosis (0.3 vs 0.5). Using specificity≥90%, the FIB-4 cut-off in patients aged<30 years was lower than that in patients aged≥30 years for significant fibrosis (1.2 vs 2.1) and cirrhosis (1.4 vs 2.6). Using sensitivity≥90%, the FIB-4 cut-off in patients aged<30 years was also lower than that in patients aged≥30 years for significant fibrosis (0.5 vs 0.8) and cirrhosis (0.8 vs 1.2).
CONCLUSIONS:

Evaluation of the diagnostic performances of APRI and FIB-4 should take age into consideration.
KEYWORDS:

chronic hepatitis B; cirrhosis; influence factors; liver fibrosis; noninvasive marker

PMID:
    28514753
DOI:
    10.18632/oncotarget.17470

StephenW

Oncotarget。 2017年4月27日。doi：10.18632 / oncotarget.17470。 [提前印刷]
年龄对慢性乙型肝炎显着纤维化和肝硬化的APRI和FIB-4的诊断性能和临界值的影响
Li Q1,2，Lu C1，Li W1，Huang Y1,2，Chen L1。
作者信息

1复旦大学上海公共卫生临床中心肝炎部上海201508。
2复旦大学华山医院感染科，上海200040。

抽象
目的：

使用年龄作为分类标记评估APRI和FIB-4的诊断性能。
方法：

包括822例慢性乙型肝炎（CHB）患者。以METAVIR评分系统为参考，对30岁以上30岁以下患者的APRI和FIB-4的表现进行比较。
结果：

年龄<30岁的患者APRI AUROC低于30岁以上患者显着纤维化（0.61 vs 0.70，p <0.001）和肝硬化（0.64 vs 0.78，p <0.001）。 30岁以下患者的FIB-4 AUROC低于30岁以上的纤维化患者（0.57 vs 0.65，p <0.001）和肝硬化（0.63 vs 0.72，p <0.001）。使用特异度≥90％，APRI在30岁以下患者中的临界值低于30岁以上，显着纤维化（1.0 vs 1.2）和肝硬化（1.2 vs 1.5）。使用灵敏度≥90％，APRI在30岁以下患者中的临界值也低于30岁以上，明显的纤维化（0.2 vs 0.4）和肝硬化（0.3 vs 0.5）。使用特异度≥90％，30岁以下患者的FIB-4临界值低于30岁以上患者明显纤维化（1.2 vs 2.1）和肝硬化（1.4 vs 2.6）。使用灵敏度≥90％时，30岁以下患者的FIB-4临界值也低于30岁以上患者，显着纤维化（0.5 vs 0.8）和肝硬化（0.8 vs 1.2）。
结论：

评估APRI和FIB-4的诊断性能应考虑年龄。
关键词：

慢性乙型肝炎肝硬化;影响因素;肝纤维化;无创标记

结论：
    28514753
DOI：
    10.18632 / oncotarget.17470