一种诊断早期乙型肝炎病毒相关肝纤维化的无创指标。

StephenW

Eur J Gastroenterol Hepatol. 2018 Oct 1. doi: 10.1097/MEG.0000000000001281. [Epub ahead of print]
A noninvasive indicator for the diagnosis of early hepatitis B virus-related liver fibrosis.
Li B1, Zhang L1, Zhang Z2, Yan G3, Zhu L4, Lu W2, Yu H1.
Author information

1
    Departments of Pathology.
2
    Department of Hepatobiliary Medicine, Shanghai Public Health Clinical Center, Fudan University, Shanghai.
3
    Department of Neurology, The No. 161 People's Liberation Army Hospital, Wuhan, Hubei, China.
4
    Gastroenterology, Changzheng Hospital, Second Military Medical University.

Abstract
BACKGROUND AND AIMS:

Liver stiffness measurement (LSM) detected by FibroScan, combined with biochemical indexes, has shown potential values for assessment of liver fibrosis pathological degrees. Here we aimed to investigate a noninvasive method for hepatitis B virus-related liver fibrosis.
PATIENTS AND METHODS:

In all, 307 patients who underwent liver biopsy and LSM measurement were included. Inflammation grades and fibrosis stages were evaluated according to METAVIR scoring system. Spearman's rank correlation analysis, logistic regression analysis, and receiver operating characteristic (ROC) curves analysis were performed to assess the factors' role in inflammation grades/fibrosis stages.
RESULTS:

Spearman's rank correlation analysis showed that LSM, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and AST-to-platelet ratio index were positively correlated with inflammation grades and histologic fibrosis stages; platelets showed negative correlation, and AST-to-ALT ratio was not related. Logistic regression analysis indicated that LSM and APRI were risk factors for inflammation grades; LSM was the independent risk factor for fibrosis stages, P<0.0001, odds ratio>1. ROC curve analysis found LSM cutoff values and areas under the curve for the diagnosis of fibrosis scores: 6.95 and 0.804, respectively, for the diagnosis of significant fibrosis (F≥F2); 10.35 and 0.856, respectively, for severe fibrosis (F≥F3); 11.35 and 0.897, respectively, for cirrhosis (F=F4). Considering ALT as a confounding factor, ROC analysis was repeated in patients with normal and elevated ALT separately; the results indicated that when ALT was up to 40 U/l, LSM cutoff value and areas under the curve for the diagnosis of significant fibrosis (F≥F2) were 6.55 and 0.748, respectively.
CONCLUSION:

This study provided a noninvasive treatment and prevention indicator for early hepatitis B virus-related liver fibrosis.

PMID:
    30277926
DOI:
    10.1097/MEG.0000000000001281

StephenW

Eur J Gastroenterol Hepatol。 2018年10月1日doi：10.1097 / MEG.0000000000001281。 [提前打印]
一种诊断早期乙型肝炎病毒相关肝纤维化的无创指标。
Li B1，Zhang L1，Zhang Z2，Yan G3，Zhu L4，Lu W2，Yu H1。
作者信息

1
    病理学系。
2
    复旦大学上海市公共卫生临床中心肝胆外科，上海。
3
    湖北省武汉市第161人民解放军医院神经内科。
4
    第二军医大学长征医院消化内科。

抽象
背景和目的：

FibroScan检测到的肝硬度测量（LSM）与生化指标相结合，已显示出评估肝纤维化病理程度的潜在价值。在这里，我们旨在研究乙型肝炎病毒相关肝纤维化的非侵入性方法。
患者和方法：

总共包括307例接受肝脏活检和LSM测量的患者。根据METAVIR评分系统评估炎症等级和纤维化阶段。进行Spearman等级相关分析，逻辑回归分析和接受者操作特征（ROC）曲线分析以评估因子在炎症等级/纤维化阶段中的作用。
结果：

Spearman等级相关分析显示LSM，丙氨酸氨基转移酶（ALT），天冬氨酸氨基转移酶（AST）和AST-血小板比值指数与炎症分级和组织学纤维化分期呈正相关;血小板呈负相关，与AST-ALT比值无关。 Logistic回归分析显示LSM和APRI是炎症分级的危险因素; LSM是纤维化分期的独立危险因素，P <0.0001，优势比> 1。 ROC曲线分析发现LSM临界值和诊断纤维化评分的曲线下面积分别为6.95和0.804，用于诊断显着纤维化（F≥F2）;分别为10.35和0.856，用于严重纤维化（F≥F3）;分别为11.35和0.897，用于肝硬化（F = F4）。考虑到ALT作为混杂因素，对ALT正常和升高的患者分别进行ROC分析;结果表明，当ALT高达40 U / l时，LSM截断值和诊断显着纤维化（F≥F2）的曲线下面积分别为6.55和0.748。
结论：

该研究为早期乙型肝炎病毒相关的肝纤维化提供了一种无创治疗和预防指标。

结论：
    30277926
DOI：
    10.1097 / MEG.0000000000001281