Diagnostic value of FibroTest combined with FibroScan for liver fibrosis in patients with chronic hepatitis B
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摘要:
目的探讨FibroTest联合FibroScan对慢性乙型肝炎肝纤维化的诊断价值。方法留取2011年8月至2013年7月天津市第二人民医院的99例行肝活组织检查的慢性乙型肝炎患者的血清,检测α2-巨球蛋白(α2-MG)、结合珠蛋白(HP)和载脂蛋白A1(apoAⅠ),记录TBil和GGT的数值,并根据其结果结合患者的年龄和性别计算出FibroTest的数值。并对99例慢性乙型肝炎患者用FibroScan测定肝脏硬度值。根据Scheuer肝纤维化分期标准设定2个判定点,分别为显著肝纤维化(S2S4期),严重肝纤维化(S3S4期)[1]。以肝活组织检查病理结果为金标准绘制出FibroTest及FibroScan的受试者工作特征曲线下面积(AUROC)。评价两者对慢性乙型肝炎肝纤维化的诊断价值,并应用Logistic逐步回归分析方法探讨联合诊断价值。结果 FibroTest与FibroScan对S2S4期的AUROC分别0.805(95%CI:0.7130.897,P<0.001),0.896(95...
Abstract:Objective To investigate the diagnostic value of FibroTest combined with FibroScan for liver fibrosis in patients with chronic hepatitis B ( CHB) . Methods Serum samples were collected from 99 CHB patients who underwent liver biopsy in Tianjin Second People's Hospital from August 2011 to July 2013. Serum levels of α2- macroglobulin, haptoglobin, apolipoprotein AI, total bilirubin, and gamma-glutamyl transpeptidase were measured, and FibroTest scores were calculated according to the measurement results, as well as the age and sex of patients. In addition, all patients underwent liver stiffness measurement by FibroScan. According to the Scheuer system, liver fibrosis was staged as significant fibrosis ( S2- S4) and severe fibrosis ( S3- S4) . With liver biopsy as the gold standard, the areas under the receiver operating characteristic curves ( AUCs) of FibroTest and FibroScan were determined. The diagnostic values of FibroTest and FibroScan for liver fibrosis in CHB patients were evaluated accordingly, and their combined diagnostic value was determined by logistic stepwise regression analysis. Results The AUCs of FibroTest and FibroScan for the prediction of significant fibrosis ( S2- S4) were 0. 805 ( 95% CI: 0. 713- 0. 897, P < 0. 001) and 0. 896 ( 95% CI: 0. 833- 0. 959, P < 0. 001) , respectively, and their AUCs for the prediction of severe fibrosis ( S3- S4) were 0. 834 ( 95% CI: 0. 741- 0. 928, P < 0. 001) and 0. 945 ( 95% CI: 0. 891- 0. 999, P < 0. 001) , respectively. Their combined AUC for the prediction of significant fibrosis ( S2- S4) was 0. 911 ( 95% CI: 0. 854- 0. 967, P < 0. 001) . Conclusion The combination of FibroTest and FibroScan can evaluate the liver fibrosis in CHB patients more accurately, and it not only improves diagnostic specificity, but also ensures high diagnostic accuracy, providing guidance for the prognostic evaluation and treatment of CHB.
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Key words:
- liver cirrhosis /
- biopsy, needle /
- FibroTest /
- FibroScan
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