Retrospective study of FibroScan®, APRI, FIB-4 and FORNS indexes compared with liver biopsy in the evaluation of liver fibrosis in patients with chronic hepatitis C monoinfection and HIV coinfection
Retrospective study of FibroScan®, APRI, FIB-4 and FORNS indexes compared with liver biopsy in the evaluation of liver fibrosis in patients with chronic hepatitis C monoinfection and HIV coinfection
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DOI：
10.1016/j.gastrohep.2010.02.005
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发表时间：
2010-06-01
影响因子：
1.9
通讯作者：
del Pozo Perez, Miguel Angel
中科院分区：
文献类型：
--
作者：
Gonzalez Guilabert, Maria Isabel;Hinojosa Mena-Bernal, Carmen;del Pozo Perez, Miguel Angel
目的：以肝活检为金标准，评价FibroScan（R）（FS）、APRI、FIB-4和FORNS指标预测肝纤维化（LE）的能力。Fibroscan（R）测量和血液样本与活检同时采集。使用ROC曲线和一致性，敏感性，特异性和预测值和likelihood ratios.Results：显着较高的LF阶段被发现在老年患者和HIV合并感染的测试进行了评估。FS和FIB-4能够预测显著的LF >= 1，超过94%的FS > 6.7 kPas或FIB-4 > 1.3的患者在肝活检中LF >= 1，敏感性较低（63%FS; 56%FIB-4）。对于LF >= 2的检测，所有试验均具有显著的预测能力，在FS > 6.8kPas、APRI > 0.6、FIB-4 > 1.4和FORNS > 5.6的患者中，77%至86%的患者具有LF >= 2，具有低敏感性（70%FS; 54%APRI; 59%FIB-4; 54%FORNS）。结论：所有检测方法均能较好地预测轻度肝纤维化（LF ≥ 2）和晚期肝纤维化（LF = 2）。然而，与肝活检的低或中度一致性以及检测轻度纤维化的低灵敏度表明，当其他方法的结果不一致或不确定时，仍需要肝活检。(C)2009 Elsevier Espana，S.L. All rights reserved.
Objective: To assess the ability of FibroScan(R) (FS) and the APRI, FIB-4 and FORNS indexes to predict liver fibrosis (LE), using liver biopsy as the gold standard.Methods: LF stage was determined in 154 patients with chronic hepatitis C virus infection using the METAVIR system. Fibroscan(R) measurements and blood samples were taken simultaneously with biopsy. The tests were evaluated using ROC curves and the concordance, sensitivity, specificity and predictive values and likelihood ratios.Results: Significantly higher LF stages were found in older patients and in those with HIV coinfection. FS and FIB-4 were able to predict significant LF >= 1 and more than 94% of patients with FS > 6.7 kPas or FIB-4 > 1.3 had LF >= 1 in liver biopsy, with low sensitivities (63% FS; 56% Fib-4). For the detection of LF >= 2, all the tests had significant predictive capacity and between 77% and 86% of the patients with FS > 6.8kPas, APRI > 0.6, FIB-4 > 1.4 and FORNS > 5.6 had LF >= 2, with low sensitivities (70%FS; 54%APRI; 59%FIB-4; 54%FORNS). All tests had high negative predictive values (91-92%) and specificities (86-92%) in the detection of advanced fibrosis (FH = 4).Conclusion: All tests were acceptable in predicting the presence or absence of mild fibrosis (LF >= 2) and the absence of advanced fibrosis (LF = 2). However, the low or moderate agreement with liver biopsy and low sensitivities in the detection of mild fibrosis indicate that liver biopsy continues to be required when the results of other methods are discordant or indeterminate. (C) 2009 Elsevier Espana, S.L. All rights reserved.