APRI和FIB-4作為慢性病毒性肝炎患者肝纖維化轉變指標的適用

StephenW

Applicability of APRI and FIB-4 as a transition indicator of liver fibrosis in patients with chronic viral hepatitis
Jun Itakura  1 , Masayuki Kurosaki  1 , Hiroko Setoyama  2 , Tetsuro Simakami  3 , Noriko Oza  4 , Masaaki Korenaga  5 , Motohiko Tanaka  6 , Takuji Torimura  7 , Naoya Sakamoto  8 , Nobuyuki Enomoto  9 , Yoshiyuki Ueno  10 , Norifumi Kawada  11 , Shuichi Kaneko  3 , Shuhei Nishiguchi  12 , Kazuaki Chayama  13 , Junko Tanaka  14 , Namiki Izumi  1 , Tatsuya Kanto  15
Affiliations
Affiliations

    1
    Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.
    2
    Department of Gastroenterology and Hepatology, Kumamoto Rosai Hospital, Yatsushiro, Japan.
    3
    Department of Gastroenterology, Saga Medical Center Kouseikan, Saga, Japan.
    4
    Department of Molecular Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan.
    5
    Department of Liver Disease, Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba, Tokyo, 272-8516, Japan.
    6
    Department of Gastroenterology and Hepatology, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan.
    7
    Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.
    8
    Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
    9
    First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.
    10
    Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan.
    11
    Department of Hepatology, Graduate School of Medicine, Osaka City University, Osaka, Japan.
    12
    Department of Internal Medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan.
    13
    Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
    14
    Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
    15
    Department of Liver Disease, Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, 1-7-1 Kohnodai, Ichikawa, Chiba, Tokyo, 272-8516, Japan. [email protected].

    PMID: 33791882 DOI: 10.1007/s00535-021-01782-3

Abstract

Background and aims: The usefulness of APRI or FIB-4 is well established as a non-invasive liver fibrosis marker at a point of diagnosis in patients with chronic liver disease. However, their applicability for the monitoring of progression of liver fibrosis over time is yet to be determined. We aimed to clarify the feasibility of APRI and FIB-4 for the longitudinal evaluation of liver fibrosis in patients with chronic hepatitis B and C.

Methods: This is a multi-center retrospective and prospective cohort study, enrolling 1029 patients with HCV and 384 patients with HBV who were histologically diagnosed by liver biopsy. The observation period of retrospective and prospective study was 14 and 12 years, respectively. The APRI and FIB-4 were traced back in cases of histologically diagnosed cirrhosis, and those were prospectively analyzed after biopsy in cases diagnosed as F3 of METAVIR score, respectively.

Results: The averaged APRI and FIB-4 exhibited time-dependent increase in the retrospective study of hepatitis C patients (increase by 0.09/year in APRI and 0.29/year in FIB-4). In the prospective study of untreated hepatitis C patients, such increases were 0.14/year in APRI and 0.40/year in FIB-4, respectively. Neither the average of APRI nor FIB-4 showed a specific tendency with hepatitis B patients and treatment-experienced hepatitis C patients.

Conclusion: The APRI and FIB-4 may serve as a transition indicator of liver fibrosis in anti-viral treatment-naïve patients with chronic hepatitis C.

Keywords: APRI; FIB-4; HBV; HCV; Longitudinal change.

StephenW

APRI和FIB-4作為慢性病毒性肝炎患者肝纖維化轉變指標的適用性
板倉淳1，黑崎昌行1，瀨戶廣博2，瀨尾哲郎3，大澤紀子4，千葉正明5，田中元彥6，富田拓二7，坂本直矢8，江本伸行9，上野佳之10，川田伸史11 3，西口樹平12，茶山一昭13，田中淳子14，泉南木1，關東達也15
隸屬關係
隸屬關係

    1個
    日本東京武藏野紅十字醫院消化內科和肝病科。
    2個
    日本八代市熊本Rosai醫院消化內科和肝病科。
    3
    日本佐賀市佐賀醫學中心佐賀醫學中心消化內科。
    4
    金澤大學癌症研究所分子腫瘤學系，日本金澤。
    5
    日本國立全球衛生醫學中心肝炎和免疫學研究中心肝病科，東京都千葉市市川市1-7-1 Kohnodai，日本272-8516。
    6
    日本熊本大學熊本大學醫學研究生院胃腸病學和肝病學系。
    7
    日本久留米大學久留米大學醫學院醫學部消化內科。
    8
    日本北海道大學醫學研究生院胃腸病學和肝病學系。
    9
    日本山梨大學山梨大學醫學院內科第一系。
    10
    日本山形大學山形大學醫學部消化內科。
    11
    日本大阪市立大學醫學研究生院肝病學系。
    12
    日本西宮市兵庫醫學院消化內科和消化內科。
    13
    廣島大學生物醫學與健康科學研究生院胃腸病學和代謝系，日本廣島。
    14
    廣島大學生物醫學與健康科學研究院流行病學，傳染病控制與預防系，日本廣島。
    15
    日本國立全球衛生醫學中心肝炎和免疫學研究中心肝病科，東京都千葉市市川市1-7-1 Kohnodai，日本272-8516。 [email protected]。

    PMID：33791882 DOI：10.1007 / s00535-021-01782-3

抽象的

背景和目的：在慢性肝病患者的診斷點，APRI或FIB-4的用途已被公認是一種非侵入性肝纖維化標記物。然而，它們是否適用於隨時間推移監測肝纖維化進展尚待確定。我們旨在闡明APRI和FIB-4在縱向評估慢性乙型和丙型肝炎患者肝纖維化中的可行性。

方法：這是一項多中心回顧性和前瞻性隊列研究，招募了1029例經肝活檢組織學診斷為HCV的患者和384例HBV的患者。回顧性研究和前瞻性研究的觀察期分別為14年和12年。在組織學診斷為肝硬化的病例中追溯到APRI和FIB-4，在診斷為METAVIR分數為F3的病例中進行活檢後進行前瞻性分析。

結果：在回顧性研究中，丙型肝炎患者的平均APRI和FIB-4呈時間依賴性增加（APRI增加0.09 /年，FIB-4增加0.29 /年）。在未經治療的丙型肝炎患者的前瞻性研究中，APRI和FIB-4的增加分別為0.14 /年和0.40 /年。對於乙型肝炎患者和有治療經驗的丙型肝炎患者，APRI和FIB-4的平均值均未顯示出特定趨勢。

結論：APRI和FIB-4可以作為未接受過抗病毒治療的慢性丙型肝炎患者肝纖維化的過渡指標。

關鍵字：APRI； FIB-4；乙肝病毒;丙型肝炎病毒；縱向變化。