FibroBox: a novel noninvasive tool for predicting significant liver fibrosis and cirrhosis in HBV infected patients.
FibroBox: a novel noninvasive tool for predicting significant liver fibrosis and cirrhosis in HBV infected patients.
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FibroBox：一种新型非侵入性工具，用于预测 HBV 感染患者的严重肝纤维化和肝硬化
DOI：
10.1186/s40364-020-00215-2
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发表时间：
2020
影响因子：
11.1
通讯作者：
Li XH
中科院分区：
文献类型：
--
作者：
Lu XJ;Yang XJ;Sun JY;Zhang X;Yuan ZX;Li XH
背景：中国是慢性乙型肝炎（CHB）的高发地区。现有的非侵入性生物标志物TE、APRI和FIB-4对中国队列纤维化分期的准确性不够高。方法以肝活检为金标准，利用实验室检查、超声测量和肝脏硬度测量，结合机器学习技术，开发了一种新的无创指标，用于预测中国北部和东部CHB患者的显著纤维化和肝硬化。我们回顾性评估了新型指标FibroBox、Fibroscan、天冬氨酸转氨酶与血小板比值指数（APRI）和纤维化-4指数（FIB-4）在吉林和淮安CHB患者（训练集）以及安徽和北京队列（验证集）中的诊断性能。结果1289例有肝脏组织学资料的HBV患者中，63.2%有明显纤维化，22.5%有肝硬化。采用LASSO logistic回归和过滤方法，最终选择纤维扫描结果、血小板计数、丙氨酸转氨酶（ALT）、凝血酶原时间（PT）、III型前胶原氨基末端肽（PIIINP）、IV型胶原、层粘连蛋白、透明质酸（HA）和脾静脉直径作为纤维盒的输入变量。因此，开发了FibroBox，其受试者工作特征曲线下面积（AUROC）显著高于TE、APRI和FIB-4，用于预测明显的纤维化和肝硬化。在安徽和北京的队列中，纤维化显著的AUROC分别为0.88 （95% CI, 0.72-0.82）和0.87 (95% CI, 0.83-0.91)，肝硬化的AUROC分别为0.87 （95% CI, 0.82-0.92）和0.90 （95% CI, 0.85-0.94）。在验证队列中，FibroBox准确诊断出81%的显著纤维化和84%的肝硬化。结论fibrobox在预测中国慢性乙型肝炎患者肝纤维化方面有较好的效果，可作为肝活检的可行替代方法。
BackgroundChina is a highly endemic area of chronic hepatitis B (CHB). The accuracy of existed noninvasive biomarkers including TE, APRI and FIB-4 for staging fibrosis is not high enough in Chinese cohort.MethodsUsing liver biopsy as a gold standard, a novel noninvasive indicator was developed using laboratory tests, ultrasound measurements and liver stiffness measurements with machine learning techniques to predict significant fibrosis and cirrhosis in CHB patients in north and east part of China. We retrospectively evaluated the diagnostic performance of the novel indicator named FibroBox, Fibroscan, aspartate transaminase-to-platelet ratio index (APRI), and fibrosis-4 index (FIB-4) in CHB patients from Jilin and Huai’an (training sets) and also in Anhui and Beijing cohorts (validation sets).ResultsOf 1289 eligible HBV patients who had liver histological data, 63.2% had significant fibrosis and 22.5% had cirrhosis. In LASSO logistic regression and filter methods, fibroscan results, platelet count, alanine transaminase (ALT), prothrombin time (PT), type III procollagen aminoterminal peptide (PIIINP), type IV collagen, laminin, hyaluronic acid (HA) and diameter of spleen vein were finally selected as input variables in FibroBox. Consequently, FibroBox was developed of which the area under the receiver operating characteristic curve (AUROC) was significantly higher than that of TE, APRI and FIB-4 to predicting significant fibrosis and cirrhosis. In the Anhui and Beijing cohort, the AUROC of FibroBox was 0.88 (95% CI, 0.72–0.82) and 0.87 (95% CI, 0.83–0.91) for significant fibrosis and 0.87 (95% CI, 0.82–0.92) and 0.90 (95% CI, 0.85–0.94) for cirrhosis. In the validation cohorts, FibroBox accurately diagnosed 81% of significant fibrosis and 84% of cirrhosis.ConclusionsFibroBox has a better performance in predicting liver fibrosis in Chinese cohorts with CHB, which may serve as a feasible alternative to liver biopsy.
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DOI：
10.1097/meg.0000000000001437
发表时间：
2019-11-01
影响因子：
2.1
作者：
Yuan, Xiaoling;Duan, Sheng-Zhong;Zhang, Lanjing
通讯作者：
Zhang, Lanjing
影响因子：
9.8
作者：
Regev, A;Berho, M;Schiff, ER
通讯作者：
Schiff, ER
影响因子：
13.5
作者：
Bedossa, P;Poynard, T
通讯作者：
Poynard, T
影响因子：
168.9
作者：
Schweitzer, Aparna;Horn, Johannes;Ott, Joerdis J.
通讯作者：
Ott, Joerdis J.
影响因子：
7.6
作者：
Castera, L.;Bernard, P. -H.;de Ledinghen, V.
通讯作者：
de Ledinghen, V.