無創性指標在慢性乙型肝炎病毒相關纖維化中的預測價值

StephenW

Predictive value of noninvasive indices in chronic hepatitis B virus-related fibrosis

Öznur, Meltema; Topçu, Birolb; Çelikkol, AliyecAuthor Information

aMedical Pathology Department, Tekirdağ Namik Kemal University Faculty of Medicine

bBiostatistics Department, Tekirdağ Namik Kemal University Faculty of Medicine

cMedical Biochemistry Department, Tekirdağ Namik Kemal University Faculty of Medicine,Tekirdağ, Turkey

Received 5 June 2020 Accepted 21 July 2020

Correspondence to Meltem Öznur, MD, Medical Pathology Department, Tekirdağ Namik Kemal University, Namik Kemal, Kampüs Street, No:1, 59030, Süleymanpaşa,Tekirdag,Turkey, Tel: +90 282 250 7439; fax: +90 282 250 99 50; e-mail: [email protected]
European Journal of Gastroenterology & Hepatology: April 2021 - Volume 33 - Issue 4 - p 577-582
doi: 10.1097/MEG.0000000000002045

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Abstract
Objectives

Despite being an invasive method, liver biopsy followed by pathological grading remains the gold standard in evaluating liver fibrosis resulting from chronic hepatitis B virus (HBV) infection. The present study aims to evaluate the utility of biochemical parameters and their derived indices in predicting development of fibrosis related to HBV infection.
Patients and methods

Pathology results and biochemical parameters of patients who underwent liver biopsy were retrieved from electronic archive records dated 2010–2019 and evaluated retrospectively. Pathological fibrosis grading was performed as per Ishak scoring, with scores of 1–2 considered as mild fibrosis and 3–6 as advanced fibrosis.
Results

The mean age of 302 patients was 37.69 ± 11.33 years. Of the 302 patients, 230 (76.2%) had mild fibrosis and 72 (23.8%) had advanced fibrosis. Age-platelet index, aspartate aminotransferase/platelet ratio index, fibrosis-4 (FIB-4), modified fibrosis-4, platelets count, aspartate aminotransferase to alanine aminotransferase ratio/platelet ratio index, Goteborg University Cirrhosis Index and King’s score were markedly and significantly higher in patients with advanced fibrosis than those with mild fibrosis. FIB-4, age-platelet index and King’s score had higher (>80%) area under the curve values than other indices in the receiver operating characteristics analysis. Evaluation of sensitivity, specificity and accuracy of these indices with the specified cut-off values revealed 87% sensitivity with FIB-4, 70% specificity with King’s score and 72% accuracy with the age-platelet index.
Conclusion

In this study, the highest rates of sensitivity, specificity and accuracy in distinguishing and predicting liver fibrosis were observed with the noninvasive indices FIB-4, King’s score and the age-platelet index, respectively.
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StephenW

無創性指標在慢性乙型肝炎病毒相關纖維化中的預測價值

厄茲努爾，梅爾泰瑪；托普比（Birolb）; Çelikkol，Aliyec作者信息

TekirdağNamik Kemal大學醫學院醫學病理學系

bTekirdağNamik Kemal大學醫學院生物統計學系

cTekirdağNamik Kemal大學醫學院生物醫學化學系，土耳其Tekirdağ

2020年6月5日收到2020年7月21日接受

對應於TekirdağNamik Kemal大學醫學病理學系MeltemÖznur博士，Namik Kemal，Kampüs街，電話：1，59030，Süleymanpaşa，Tekirdag，土耳其，電話：+90 282 250 7439；傳真：+90 282 250 99 50;電子郵件：[email protected]
《歐洲胃腸病學和肝病學雜誌》：2021年4月-第33卷-第4期-第577-582頁
doi：10.1097 / MEG.0000000000002045

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抽象的
目標

儘管是一種侵入性方法，但肝活檢隨後進行病理分級仍是評估慢性乙型肝炎病毒（HBV）感染導致的肝纖維化的金標準。本研究旨在評估生化參數及其衍生指標在預測與HBV感染相關的纖維化發展中的效用。
患者和方法

從2010-2019年的電子檔案記錄中檢索接受肝活檢的患者的病理結果和生化參數，並進行回顧性評估。根據Ishak評分進行病理性纖維化分級，輕度纖維化評分為1–2，晚期纖維化評分為3–6。
結果

302例患者的平均年齡為37.69±11.33歲。在302例患者中，有230例（76.2％）患有輕度纖維化，而72例（23.8％）則患有晚期纖維化。年齡-血小板指數，天冬氨酸轉氨酶/血小板比率指數，纖維化4（FIB-4），改良纖維化-4，血小板計數，天冬氨酸轉氨酶與丙氨酸氨基轉移酶比率/血小板比率指數，哥德堡大學肝硬化指數和King評分顯著晚期纖維化患者明顯高於輕度纖維化患者。在接收器工作特性分析中，FIB-4，血小板指數和King評分在曲線值下的面積比其他指標高（> 80％）。通過指定的臨界值評估這些指標的敏感性，特異性和準確性，發現FIB-4的敏感性為87％，King評分的特異性為70％，血小板指數為72％。
結論

在這項研究中，分別以無創性指標FIB-4，King評分和年齡-血小板指標觀察到了最高的敏感性，特異性和準確性，以區分和預測肝纖維化。
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