APRI和FIB-4作为慢性病毒性肝炎患者肝纤维化转变指标的适用

StephenW

Applicability of APRI and FIB-4 as a transition indicator of liver fibrosis in patients with chronic viral hepatitis

    Jun Itakura, Masayuki Kurosaki, Hiroko Setoyama, Tetsuro Simakami, Noriko Oza, Masaaki Korenaga, Motohiko Tanaka, Takuji Torimura, Naoya Sakamoto, Nobuyuki Enomoto, Yoshiyuki Ueno, Norifumi Kawada, Shuichi Kaneko, Shuhei Nishiguchi, Kazuaki Chayama, Junko Tanaka, Namiki Izumi & Tatsuya Kanto

Journal of Gastroenterology volume 56, pages470–478(2021)Cite this article

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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.

StephenW

APRI和FIB-4作为慢性病毒性肝炎患者肝纤维化转变指标的适用性

    板仓淳，黑崎昌行，濑户广博，司马哲郎，小泽纪子，小田正明，田中元彦，田村拓司，坂本直矢，江本信行，上野义行，川田佳夫，川中修一，中山顺平，中口顺史＆关东达也

胃肠病学杂志第56卷，第470–478页（2021）

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抽象的
背景和目标

在慢性肝病患者的诊断点，APRI或FIB-4的用途已被确立为无创性肝纤维化标记物。然而，它们是否适用于随时间推移监测肝纤维化进展尚待确定。我们旨在阐明APRI和FIB-4在纵向评估慢性乙型和丙型肝炎患者肝纤维化中的可行性。
方法

这是一项多中心回顾性和前瞻性队列研究，纳入了1029例经肝活检组织学诊断为HCV的患者和384例HBV的患者。回顾性研究和前瞻性研究的观察期分别为14年和12年。在组织学诊断为肝硬化的病例中追溯到APRI和FIB-4，在诊断为METAVIR分数为F3的病例中进行活检后进行前瞻性分析。
结果

在丙型肝炎患者的回顾性研究中，平均APRI和FIB-4呈时间依赖性增加（APRI增加0.09 /年，FIB-4增加0.29年）。在未经治疗的丙型肝炎患者的前瞻性研究中，APRI和FIB-4的增加分别为0.14 /年和0.40 /年。对于乙型肝炎患者和有治疗经验的丙型肝炎患者，APRI和FIB-4的平均值均未显示出特定趋势。
结论

APRI和FIB-4可以作为未经抗病毒治疗的慢性丙型肝炎患者肝纤维化的过渡指标。