瞬态弹性成像治疗慢性乙型肝炎肝纤维化和肝硬化的Meta分析

StephenW

Can J Gastroenterol Hepatol. 2018 May 24;2018:3406789. doi: 10.1155/2018/3406789. eCollection 2018.
Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis.
Qi X1,2, An M3, Wu T2, Jiang D2, Peng M4, Wang W5, Wang J4, Zhang C1, Chess Study Group OBOT2.
Author information

1
    Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
2
    CHESS, Hepatic Hemodynamic Lab, Institute of Hepatology, Nanfang Hospital, Southern Medical University, Guangdong Provincial Research Center for Liver Fibrosis, Guangzhou, China.
3
    The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
4
    Department of Hepatobiliary Disease, The Affiliated (T.C.M) Hospital of Southwest Medical University, Luzhou, China.
5
    Department of Hepatobiliary Surgery, Shunde Hospital, Southern Medical University, Foshan, China.

Abstract
Background:

The hepatitis B virus infection is a global health issue and the stage of liver fibrosis affects the prognosis in patients with chronic hepatitis B (CHB). We performed the meta-analysis describing diagnostic accuracy of transient elastography (TE) for predicting CHB-related fibrosis.
Methods:

We performed an adequate literature search to identify studies that assessed the diagnostic accuracy of TE in CHB patients using biopsy as reference standard. Hierarchical summary receiver-operating curves model and the bivariate mixed-effects binary regression model were applied to generate summary receiver-operating characteristic curves and pooled estimates of sensitivity and specificity.
Results:

The area under the summary receiver-operating curve for significant fibrosis and cirrhosis was 0.86 (95% confidence interval (CI): 0.83-0.89) and 0.92 (95% CI: 0.90-0.94), respectively. The sensitivity, specificity, and diagnostic odds ratio of TE for significant fibrosis were 0.78 (95% CI: 0.73-0.81, p < 0.01; I2 = 85.59%), 0.81 (95% CI: 0.77-0.84, p < 0.01; I2 = 88.20%), and 14.44 (95% CI: 10.80-19.31, p < 0.01; I2 = 100%) and for cirrhosis were 0.84 (95% CI: 0.80-0.88, p < 0.01; I2 = 76.67%), 0.87 (95% CI: 0.84-0.90, p < 0.01; I2 = 90.89%), and 36.63 (95% CI: 25.38-52.87, p < 0.01; I2 = 100%), respectively. The optimal cut-off values of TE were 7.25 kPa for diagnosing significant fibrosis and 12.4 kPa for diagnosing cirrhosis, respectively.
Conclusion:

TE is of great value in the detection of patients with CHB-related cirrhosis but has a suboptimal accuracy in the detection of significant fibrosis.

PMID:
    29977884
PMCID:
    PMC5994263
DOI:
    10.1155/2018/3406789

StephenW

Can J Gastroenterol Hepatol。 2018年5月24日; 2018年：3406789。 doi：10.1155 / 2018/3406789。 eCollection 2018。
瞬态弹性成像治疗慢性乙型肝炎肝纤维化和肝硬化的Meta分析。
齐X1,2，安M3，吴T2，江D2，彭M4，王W5，王J4，张C1，国际象棋学习组OBOT2。
作者信息

1
    山东大学附属山东省立医院消化内科，济南，中国。
2
    CHESS，南方医科大学南方医院肝病研究所肝脏血液动力学实验室，广东省肝纤维化研究中心，广州，中国。
3
    南方医科大学第二临床医学院，广州
4
    西南医科大学附属（T.C.M）医院肝胆疾病科，泸州
五
    南方医科大学顺德医院肝胆外科，佛山

抽象
背景：

乙型肝炎病毒感染是全球性健康问题，肝纤维化阶段影响慢性乙型肝炎（CHB）患者的预后。我们进行了荟萃分析，描述了瞬态弹性成像（TE）的诊断准确性，用于预测CHB相关的纤维化。
方法：

我们进行了充分的文献检索，以确定使用活组织检查作为参考标准评估TE在CHB患者中的诊断准确性的研究。应用分层汇总接收器 - 操作曲线模型和双变量混合效应二元回归模型来生成汇总接收器操作特征曲线和灵敏度和特异性的汇总估计。
结果：

显着纤维化和肝硬化的汇总接受者 - 操作曲线下面积分别为0.86（95％置信区间（CI）：0.83-0.89）和0.92（95％CI：0.90-0.94）。 TE对显着纤维化的敏感性，特异性和诊断比值比为0.78（95％CI：0.73-0.81，p <0.01; I2 = 85.59％），0.81（95％CI：0.77-0.84，p <0.01; I2 = 88.20％）和14.44（95％CI：10.80-19.31，p <0.01; I2 = 100％）和肝硬化为0.84（95％CI：0.80-0.88，p <0.01; I2 = 76.67％），0.87 （95％CI：0.84-0.90，p <0.01; I2 = 90.89％）和36.63（95％CI：25.38-52.87，p <0.01; I2 = 100％）。 TE的最佳临界值分别为7.25 kPa诊断显着纤维化和12.4 kPa诊断肝硬化。
结论：

TE在检测CHB相关性肝硬化患者中具有重要价值，但在检测显着纤维化方面具有次优的准确性。

结论：
    29977884
PMCID：
    PMC5994263
DOI：
    10.1155 /三百四十零万六千七百八十九分之二千零十八