中国乙型肝炎肝纤维化17种无创评估模型的验证与比较。

StephenW

Liver Int. 2018 Jan 3. doi: 10.1111/liv.13688. [Epub ahead of print]
Validation and Comparison of Seventeen Noninvasive Models for Evaluating Liver Fibrosis in Chinese Hepatitis B Patients.Dong M1, Wu J1, Yu X1, Li J1, Yang S1, Qi X1, Mao R1, Zhang Y1, Yu J1, Zhu H1, Yang F1, Qin Y1, Zhang J1.
Author information
1Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, 200040, China.

AbstractBACKGROUND & AIMS: To avoid liver biopsy, many noninvasive models comprised of serum markers for liver fibrosis assessment have been developed. Given that most of them were developed in hepatitis C cohorts and few of them have been validated in Chinese hepatitis B patients, we aim to conduct this validation and compare their diagnostic accuracies in such a population.
METHODS: A total of 937 HBV infected patients who underwent liver biopsy were included in this single-center retrospective study. The diagnostic accuracies of the 17 noninvasive models were assessed by areas under the receiver operating characteristic curves (AUROCs), using histologically-evaluated fibrotic stages of the biopsy specimens as standards. To compare efficiencies of the models, a grading system based on AUROC levels was developed.
RESULTS: For discriminating significant fibrosis in all patients, the best three noninvasive models were King's score (AUROC=0.756), Virahep-C model (AUROC=0.756) and GPR (AUROC=0.744); and for diagnosing cirrhosis, Lok index (AUROC=0.832), FI (AUROC=0.820) and FIB-4 (AUROC=0.818) got the first three places. AUROCs in HBeAg-positive group were generally higher than those in HBeAg-negative group. In addition, based on the grading system, Virahep-C and GPR outstood others in evaluating liver fibrosis in all patients.
CONCLUSIONS: In Chinese HBV infected patients, Virahep-C models and GPR had high accuracies in diagnosing liver fibrosis and cirrhosis, while the most discussed models like APRI and FIB-4 didn't outstand. Assessment should take into account the HBeAg sero-status, since these noninvasive models were more appropriate for HBeAg-positive patients than HBeAg-negative ones. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

KEYWORDS: hepatitis B; liver fibrosis; noninvasive models

PMID:29314613DOI:10.1111/liv.13688

StephenW

肝脏Int。 2018年1月3日doi：10.1111 / liv.13688。 [电子版提前打印]
中国乙型肝炎肝纤维化17种无创评估模型的验证与比较。
M1 M1 M1，Wu J J Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong Dong，
作者信息

1
    复旦大学附属华山医院感染科，上海200040

抽象
背景与目的：

为了避免肝活检，已经开发了许多包含用于肝纤维化评估的血清标志物的非侵入性模型。鉴于其中大部分是在丙型肝炎队列中开发的，其中少数已经在中国乙肝患者中得到验证，我们的目标是进行这种验证，并比较这些人群中的诊断准确性。
方法：

本次单中心回顾性研究共纳入937例接受肝活检的HBV感染患者。 17例非侵袭性模型的诊断准确性通过接受者操作特征曲线（AUROCs）下的区域评估，使用组织学评估的活检样本的纤维化阶段作为标准。为了比较模型的效率，开发了基于AUROC水平的分级系统。
结果：

（AUROC = 0.756），Virahep-C模型（AUROC = 0.756）和GPR（AUROC = 0.744），对于所有患者的显着纤维化鉴别，最佳的三种无创模型为： Lok指数（AUROC = 0.832），FI（AUROC = 0.820）和FIB-4（AUROC = 0.818）分别为前三位。 HBeAg阳性组的AUROCs水平普遍高于HBeAg阴性组。此外，根据分级系统，Virahep-C和GPR在所有患者中评估了肝纤维化。
结论：

在中国HBV感染者中，Virahep-C模型和GPR在诊断肝纤维化和肝硬化方面具有较高的准确性，而大多数讨论的模型如APRI和FIB-4没有突出。评估应考虑到HBeAg血清学状况，因为这些非侵入性模型比HBeAg阴性患者更适合HBeAg阳性患者。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

乙肝;肝纤维化;无创模型

结论：
    29314613
DOI：
    10.1111 / liv.13688