The diagnostic value of the FIB-4 index for staging hepatitis B-related fibrosis: a meta-analysis.
The diagnostic value of the FIB-4 index for staging hepatitis B-related fibrosis: a meta-analysis.
复制标题
DOI：
10.1371/journal.pone.0105728
复制
发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Zhao Y
中科院分区：
文献类型：
--
作者：
Li Y;Chen Y;Zhao Y
肝纤维化分期是决定B型肝炎病毒（HBV）感染患者预后和是否需要治疗的重要因素。肝活检通常用于评估肝纤维化;然而，也开发了非侵入性替代方法，如FIB-4指数。目的探讨纤维蛋白原-4（FIB-4）在乙型肝炎肝纤维化和肝硬化诊断中的价值。使用从以下数据库检索的研究对HBV感染患者中FIB-4指数与肝活检的诊断准确性进行了荟萃分析：PubMed，奥维德，EMBASE，科克伦图书馆，中国国家知识基础设施和中国生物医学光盘。使用分层汇总受试者工作曲线模型和双变量模型生成汇总受试者工作特征曲线以及敏感性和特异性的合并估计值。采用Meta回归分析探讨其异质性。发表偏倚采用Egger检验和修剪填充法进行检测。12项研究（N = 1，908）和10项研究（N = 2，105）分别被纳入显著纤维化和肝硬化的荟萃分析。 对于显著纤维化，分层汇总接受者操作曲线下面积（AUHSROC）为0.78（95% CI = 0.74-0.81）。 推荐的临界值为1.45 - 1.62，AUHSROC、汇总敏感性和特异性分别为0.78（95%CI = 0.74-0.81）、0.65（95%CI = 0.56-0.73）和0.77（95%CI = 0.7-0.83）。 对于肝硬化，AUHSROC为0.89（95% CI = 0.85-0.91）。 推荐的临界值为2.9 - 3.6，AUHSROC、汇总敏感性和特异性分别为0.96（95%CI = 0.92-1.00）、0.42（95%CI = 0.36-0.48）和0.96（95%CI = 0.95-0.97）。 未发现发表偏倚。FIB-4指数对于检测HBV感染患者的显著纤维化和肝硬化是有价值的，但在排除纤维化和肝硬化方面的准确性欠佳。
Liver fibrosis stage is an important factor in determining prognosis and need for treatment in patients infected with hepatitis B virus (HBV). Liver biopsies are typically used to assess liver fibrosis; however, noninvasive alternatives such as the FIB-4 index have also been developed. To quantify the accuracy of the FIB-4 index in the diagnosis of HBV related fibrosis and cirrhosis. A meta-analysis of studies comparing the diagnostic accuracy of the FIB-4 index vs. liver biopsy in HBV-infected patients was performed using studies retrieved from the following databases: PubMed, Ovid, EMBASE, the Cochrane Library, the Chinese National Knowledge Infrastructure and the Chinese Biology Medicine disc. A hierarchical summary receiver operating curves model and bivariate model were used to produce summary receiver operating characteristic curves and pooled estimates of sensitivity and specificity. The heterogeneity was explored with meta-regression analysis. Publication bias was detected using Egger’s test and the trim and fill method. 12 studies (N = 1,908) and 10 studies (N = 2,105) were included in the meta-analysis for significant fibrosis and cirrhosis, respectively. For significant fibrosis, the area under the hierarchical summary receiver operating curve (AUHSROC) was 0.78 (95% CI = 0.74–0.81). The recommended cutoff value was between 1.45 and 1.62, and the AUHSROC, summary sensitivity and specificity were 0.78 (95% CI = 0.74–0.81), 0.65 (95% CI = 0.56–0.73) and 0.77 (95% CI = 0.7–0.83), respectively. For cirrhosis, the AUHSROC was 0.89 (95% CI = 0.85–0.91). The recommended cutoff value was between 2.9 and 3.6, and the AUHSROC, summary sensitivity and specificity were 0.96 (95% CI = 0.92–1.00), 0.42 (95% CI = 0.36–0.48) and 0.96 (95% CI = 0.95–0.97), respectively. No publication bias was detected. The FIB-4 index is valuable for detecting significant fibrosis and cirrhosis in HBV-infected patients, but has suboptimal accuracy in excluding fibrosis and cirrhosis.
登录
查看更多内容
影响因子：
--
作者：
Friedman, Lawrence S
通讯作者：
Friedman, Lawrence S
影响因子：
13.5
作者：
Bedossa, P;Dargère, D;Paradis, V
通讯作者：
Paradis, V
影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
13.5
作者：
Bedossa, P;Poynard, T
通讯作者：
Poynard, T
影响因子：
2.4
作者：
Jin W;Lin Z;Xin Y;Jiang X;Dong Q;Xuan S
通讯作者：
Xuan S