A noninvasive model to predict liver histology for antiviral therapy decision in chronic hepatitis B with alanine aminotransferase < 2 upper limit of normal.
A noninvasive model to predict liver histology for antiviral therapy decision in chronic hepatitis B with alanine aminotransferase < 2 upper limit of normal.
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DOI：
10.1186/s12876-020-01576-6
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发表时间：
2021-01-06
影响因子：
2.4
通讯作者：
Huang W
中科院分区：
文献类型：
--
作者：
Chen S;Huang H;Huang W
目前，大多数肝纤维化分期评估主要集中在非侵入性诊断方法上。本研究旨在构建一个无创模型来预测丙氨酸转氨酶（ALT）<正常上限（ULN）2倍的慢性乙型肝炎（CHB）抗病毒治疗的肝脏组织学。我们回顾性分析了 577 例接受肝活检且 ALT 低于 2 ULN 的 CHB 患者。然后他们被随机分为训练组和验证组。通过逻辑回归分析，在训练组中构建了一种新的预测模型来预测肝脏组织学的显着变化[坏死性炎症活动度（G）≥ 2或纤维化阶段（S）≥ 2]，然后在验证组中进行验证。如果肝活检显示中度或重度炎症或明显纤维化，建议进行抗病毒治疗。天冬氨酸转氨酶 (AST)、抗乙型肝炎病毒核心抗体 (抗 HBC) 和谷氨酰胺转肽酶 (GGT) 被确定为抗病毒治疗的独立预测因子，ROC 曲线下面积 (AUROC) 分别为 0.649、0.647 和 0.616。我们的新模型指数结合了 AST、抗 HBC 和 GGT，训练集和验证集的 AUROC 分别为 0.700 和 0.742。本研究建立了一种无创模型来预测肝脏组织学，以帮助 ALT < 2 ULN 的 CHB 患者做出抗病毒治疗决策，从而减少临床肝活检的需要。
At present, most assessments of liver fibrosis staging mainly focus on non-invasive diagnostic methods. This study aims to construct a noninvasive model to predict liver histology for antiviral therapy in chronic hepatitis B (CHB) with alanine aminotransferase (ALT) < 2 times upper limit of normal (ULN). We retrospectively analyzed 577 patients with CHB who received liver biopsy and whose ALT was less than 2 ULN. Then they were randomly divided into a training group and a validation group. Through logistic regression analysis, a novel predictive model was constructed in the training group to predict significant changes in liver histology [necro-inflammatory activity grade (G) ≥ 2 or fibrosis stage (S) ≥ 2] and then validated in the validation group. If liver biopsy showed moderate or severe inflammation or significant fibrosis, antiviral treatment was recommended. Aspartate aminotransferase (AST), anti-hepatitis B virus core antibody (anti-HBC) and glutamine transpeptidase (GGT) were identified as independent predictors for antiviral therapy, with area under the ROC curve (AUROC) of 0.649, 0.647 and 0.616, respectively. Our novel model index, which combined AST, anti- HBC and GGT with AUROC of 0.700 and 0.742 in training set and validation set. This study established a noninvasive model to predict liver histology for antiviral treatment decision in patients with CHB with ALT < 2 ULN, which can reduce the clinical needs of liver biopsy.
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定量乙型肝炎核心抗体水平在预测丙氨酸转氨酶水平正常或接近正常的慢性乙型肝炎患者显着肝脏炎症中的作用
影响因子：
4.2
作者：
Li, Jing;Zhang, Tian-Ying;Xia, Ning-Shao
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Xia, Ning-Shao
影响因子：
6.7
作者：
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Lok, ASF;Ghany, MG;Morishima, C
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Morishima, C
影响因子：
13.5
作者：
KAMIMOTO, Y;HORIUCHI, S;MORINO, Y
通讯作者：
MORINO, Y
影响因子：
24.5
作者：
Lemoine M;Shimakawa Y;Nayagam S;Khalil M;Suso P;Lloyd J;Goldin R;Njai HF;Ndow G;Taal M;Cooke G;D'Alessandro U;Vray M;Mbaye PS;Njie R;Mallet V;Thursz M
通讯作者：
Thursz M