肝硬化患者肝细胞癌风险评估与临床弹性成像控制衰减参数

StephenW

Yonago Acta Med. 2017 Jun 26;60(2):106-112. eCollection  2017 Jun.
Risk Assessment of Hepatocellular Carcinoma in General Population by Liver Stiffness in Combination with Controlled Attenuation Parameter using Transient Elastography: A Cross Sectional Study.Sugihara T1, Koda M1, Matono T1, Okamoto K1, Murawaki Y1, Isomoto H1, Tokunaga S2.
Author information
1Division of Medicine and Clinical Science, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.2†Nonohana Clinic, 3-341 Gyotoku, Tottori 680-0824, Japan.

AbstractBACKGROUND: Hepatocellular carcinoma (HCC) in patients without hepatitis B (HBV) and -C virus (HCV) infection are increasing in Japan. Method for detecting high-risk liver diseases of HCC in general population has still not been established. Liver stiffness measurement (LSM) and Controlled Attenuation Parameter (CAP) using transient elastography (TE; FibroScan System) are useful for detecting liver fibrosis and steatosis. The aim of this study is to clarify TE for risk assessment of HCC in general population.
METHODS: This cross-sectional study was performed for residents aged ≥ 40 years in an intermountain town in Japan with a population of 3,493. Blood laboratory testing included tumor markers, abdominal ultrasound (AUS), and TE was performed.
RESULTS: Among 175 subjects (64 men, 111 women), TE was evaluated and three patients with HCC were detected by AUS. For detecting HCC, the cut-off value of LSM was 5.3 kPa sensitivity 100%, specificity 75%, AUROC 0.88). The combination of LSM and CAP (LSM > 5.3 kPa with any CAP and CAP > 248 dB/m with any LSM) could detect the high-risk liver diseases of HCC (HCC, nonalcoholic fatty liver/steatohepatitis, HBV or HCV related chronic viral hepatitis with alanine transaminase (ALT) > 30 IU/L for men or > 19 IU/L for women or cirrhosis of any cause) with high sensitivity (sensitivity 90%, specificity 55%, positive predictive value 10%, negative predictive value 99%, P = 0.006).
CONCLUSION: The combination of LSM and CAP can be useful in detecting high-risk liver diseases of HCC out of general population.


KEYWORDS: controlled attenuation parameter; liver stiffness measurement; transabdominal ultrasound; transient elastography

PMID:28701893PMCID:PMC5502222

StephenW

米ago ago 2017年6月26日; 60（2）：106-112。 eCollection 2017年6月
肝硬化患者肝细胞癌风险评估与临床弹性成像控制衰减参数组合：横断面研究。
Sugihara T1，Koda M1，Matono T1，Okamoto K1，Murawaki Y1，Isomoto H1，Tokunaga S2。
作者信息

1
    医学与临床科学系，鸟取大学医学部医学部多学科内科系，日本米色683-8504。
2
    †Nonohana Clinic，3-341 Gyotoku，Tottori 680-0824，Japan。

抽象
背景：

日本乙肝（乙肝）和丙型肝炎病毒（HCV）感染患者肝细胞癌（HCC）增多。一般人群肝癌高危肝病检测方法尚未确定。使用瞬态弹性成像（TE; FibroScan系统）的肝硬度测量（LSM）和受控衰减参数（CAP）可用于检测肝纤维化和脂肪变性。本研究的目的是澄清TE对一般人群HCC的风险评估。
方法：

在日本的山区城镇，对40岁以上的居民进行了横断面研究，人口为3,493人。血液实验室检查包括肿瘤标志物，腹部超声（AUS）和TE。
结果：

在175名受试者（64名男性，111名女性）中，评估了TE，并且AUS检测到3名HCC患者。对于检测肝癌，LSM的临界值为5.3 kPa，敏感性为100％，特异性为75％，AUROC为0.88）。 LSM和CAP（LSM> 5.3 kPa，任何CAP和CAP> 248 dB / m与任何LSM）的组合可以检测HCC（HCC，非酒精性脂肪肝/脂肪性肝炎，HBV或HCV相关慢性病毒）的高风险肝病具有高灵敏度（灵敏度90％，特异性55％，阳性预测值10％，阴性预测值99）的丙氨酸转氨酶（ALT）> 30 IU / L，男性> 30 IU / L或任何原因肝硬化> 19 IU / ％，P = 0.006）。
结论：

LSM和CAP的组合可用于检测一般人群中HCC的高风险肝病。
关键词：

受控衰减参数;肝硬度测量;经腹超声;瞬时弹性成像

结论：
    28701893
PMCID：
    PMC5502222