一项无创性评分预测HBeAg阳性乙型肝炎患者肝纤维化正常或极

StephenW

Dis Markers. 2018 Oct 14;2018:3924732. doi: 10.1155/2018/3924732. eCollection 2018.
A Noninvasive Score to Predict Liver Fibrosis in HBeAg-Positive Hepatitis B Patients with Normal or Minimally Elevated Alanine Aminotransferase Levels.
Chen Y1,2, Li Y2, Li N1, Fan X1, Li C1,2, Zhang P1,2, Han Q1, Liu Z1.
Author information

1
    Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061 Shaanxi, China.
2
    Department of Infectious Diseases, Affiliated Hospital of Yan'an University, Yan'an, 716000 Shaanxi, China.

Abstract

Noninvasive fibrosis tests are highly needed but have not been well studied in chronic hepatitis B patients with normal or minimally elevated alanine aminotransferase (ALT) levels. This study is aimed at developing a noninvasive score system to predict liver fibrosis in these patients. HBeAg-positive chronic hepatitis B patients with ALT levels of <80 IU/l and liver histology (n = 290) were assigned to training (n = 203) or validation (n = 87) groups. Training group patients were divided into nonsignificant (F0-1) and significant fibrosis (F2-4) according to METAVIR stages. Logistic regression was performed to identify factors for liver fibrosis and develop a score system. The capacity of the score to identify the severity of fibrosis was displayed by receiver operating characteristic curve (ROC) and area under ROC (AUROC) values. Multivariate logistic regression showed that HBeAg (ratios of the sample to the cutoff values (S/CO)) and liver stiffness measurement (LSM; kilopascals (kPa)) were independent factors of liver fibrosis. A score system composed of HBeAg and LSM by assigning a point of 1, 2, or 3 to different HBeAg and LSM levels, respectively, was developed. The scores 2-3, 4, and 5-6 of the sum of HBeAg and LSM points indicated nonsignificant, indeterminate, and significant fibrosis, respectively. The score system had an AUROC of 0.880 and showed similar performance in validation group patients. The accuracy for identifying significant and nonsignificant fibrosis was 77.14% in validation group patients and 71.26% in the entire group of patients. It is suggested that this noninvasive score system can accurately predict hepatic fibrosis and may reduce the need for liver biopsy in HBeAg-positive patients with normal or minimally elevated ALT levels.

PMID:
    30405859
PMCID:
    PMC6204156
DOI:
    10.1155/2018/3924732

StephenW

Dis Markers。 2018年10月14日; 2018年：3924732。 doi：10.1155 / 2018/3924732。 eCollection 2018。
一项无创性评分预测HBeAg阳性乙型肝炎患者肝纤维化正常或极少升高的丙氨酸氨基转移酶水平。
Chen Y1,2，Li Y2，Li N1，Fan X1，Li C1,2，Zhang P1,2，Han Q1，Liu Z1。
作者信息

1
    西安交通大学第一附属医院感染科，陕西西安710061
2
    延安大学附属医院感染科，陕西延安716000

抽象

非侵入性纤维化试验是非常需要的，但在丙氨酸氨基转移酶（ALT）水平正常或极低的慢性乙型肝炎患者中尚未得到很好的研究。本研究旨在开发一种无创评分系统，以预测这些患者的肝纤维化。 ALT水平<80 IU / l和肝脏组织学（n = 290）的HBeAg阳性慢性乙型肝炎患者被分配到训练组（n = 203）或验证组（n = 87）。根据METAVIR分期，训练组患者分为非显着性（F0-1）和显着纤维化（F2-4）。进行逻辑回归以确定肝纤维化的因素并开发评分系统。通过接受者操作特征曲线（ROC）和ROC（AUROC）值下的面积显示评分鉴定纤维化严重程度的能力。多变量logistic回归分析显示HBeAg（样本与截断值的比值（S / CO））和肝硬度测量值（LSM;千帕（kPa））是肝纤维化的独立因素。通过分别为不同的HBeAg和LSM水平分配1,2或3的点，开发了由HBeAg和LSM组成的评分系统。 HBeAg和LSM点之和的得分2-3,4和5-6分别表明无显着，不确定和显着的纤维化。评分系统的AUROC为0.880，在验证组患者中表现出相似的表现。在验证组患者中鉴定显着和非显着纤维化的准确性为77.14％，在整个患者组中为71.26％。有人提出，这种无创评分系统可准确预测肝纤维化，并可降低ALe水平正常或极低的HBeAg阳性患者的肝活检需求。

结论：
    30405859
PMCID：
    PMC6204156
DOI：
    10.1155 /三百九十二万四千七百三十二分之二千〇一十八

StephenW

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204156/