慢性乙型肝炎患者中，重度纤维化的无创指标

StephenW

Dig Liver Dis. 2018 Jan 5. pii: S1590-8658(17)31365-8. doi: 10.1016/j.dld.2017.12.028. [Epub ahead of print]
A novel noninvasive index for the prediction of moderate to severe fibrosis in chronic hepatitis B patients.Li J1, Mao RC1, Li XL2, Zheng JW2, Qi X1, Yuan Q3, Zhang J2, Zhang JM4, Xia NS2.
Author information
1Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China.2State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Science & School of Public Health, Xiamen University, Xiamen, China; National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Science & School of Public Health, Xiamen University, Xiamen, China.3State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Life Science & School of Public Health, Xiamen University, Xiamen, China; National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Life Science & School of Public Health, Xiamen University, Xiamen, China. Electronic address: [email protected].4Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: [email protected].

AbstractBACKGROUNDS: The evaluation of liver fibrosis stages is essential for the clinical management of chronic hepatitis B (CHB).
AIMS: To develop and validate a novel noninvasive index for moderate to severe fibrosis (≥S2) in CHB patients.
METHODS: A total of 401 CHB patients who underwent liver biopsy were divided into the training (n = 300) and validation (n = 101) cohort. Histological severity was scored using a modified Scheuer system. Clinical and laboratory assessments were collected.
RESULTS: In the training cohort, PACG, a novel index combining the quantitative hepatitis B core antibody (qAnti-HBc), platelet count (PLT), and albumin globulin ratio (A/G), presented better diagnostic performance (AUROC = 0.814) than that of APRI (0.735, p = 0.007) and FIB-4 (0.749, p = 0.014). In the validation cohort, the AUROC of the PACG, APRI, FIB-4 and Fibroscan were 0.834, 0.806, 0.791 and 0.810, respectively. More importantly, a higher and lower cutoff of PACG for predicting ≥S2 fibrosis or not had a >90% sensitivity and specificity, with a diagnostic accuracy of 85.9%.
CONCLUSION: PACG is a promising noninvasive alternative to liver biopsy in CHB patients for the evaluation of moderate to severe fibrosis.

Copyright © 2017. Published by Elsevier Ltd.

KEYWORDS: Chronic HBV infection; Liver fibrosis; Noninvasive marker; Quantitative anti-HBc

PMID:29396134DOI:10.1016/j.dld.2017.12.028

StephenW

挖肝脏。 2018年1月5日。pii：S1590-8658（17）31365-8。 doi：10.1016 / j.dld.2017.12.028。 [电子版提前打印]
慢性乙型肝炎患者中，重度纤维化的无创指标。
李1 1，毛RC1，李XL 2，郑建伟2，齐茜1，袁庆3，张J2 2，张JM4，夏NS2。
作者信息

1
    上海复旦大学附属华山医院感染科
2
    厦门大学生命科学学院公共卫生学院分子疫苗与分子诊断国家重点实验室，厦门;厦门大学生命科学学院公共卫生学院传染病诊断与疫苗研究所
3
    厦门大学生命科学学院公共卫生学院分子疫苗与分子诊断国家重点实验室，厦门;厦门大学生命科学学院公共卫生学院传染病诊断与疫苗研究所电子地址：[email protected]。
4
    上海复旦大学附属华山医院感染科电子地址：[email protected]。

抽象
背景：

慢性乙型肝炎（CHB）的临床处理对肝纤维化分期的评估至关重要。
目的：

开发和验证CHB患者中度至重度纤维化（≥S2）的新型无创指标。
方法：

将401例接受肝活检的CHB患者分为训练组（n = 300）和验证组（n = 101）。组织学严重性使用修改的Scheuer系统进行评分。收集临床和实验室评估。
结果：

在训练队列中，结合定量乙型肝炎核心抗体（qAnti-HBc），血小板计数（PLT）和白蛋白球蛋白比率（A / G）的新指标PACG的诊断性能（AUROC = 0.814）的APRI（0.735，p = 0.007）和FIB-4（0.749，p = 0.014）。在验证队列中，PACG，APRI，FIB-4和Fibroscan的AUROC分别为0.834,0.806,0.791和0.810。更重要的是，PACG预测≥S2纤维化的临界值越高或越低，敏感性和特异性> 90％，诊断准确率为85.9％。
结论：

PACG是一种很有希望的非侵入性CHB患者肝活检的替代方法，用于评估中度至重度纤维化。

版权©2017.出版Elsevier有限公司
关键词：

慢性HBV感染;肝纤维化;无创标记;定量抗HBc

结论：
    29396134
DOI：
    10.1016 / j.dld.2017.12.028