Non-invasive assessment of liver fibrosis with transient elastography (FibroScan®): applying the cut-offs of M probe to XL probe.
Non-invasive assessment of liver fibrosis with transient elastography (FibroScan®): applying the cut-offs of M probe to XL probe.
复制标题
使用瞬时弹性成像 (FibroScan®) 对肝纤维化进行无创评估：将 M 探头的截止值应用于 XL 探头。
DOI：
10.1016/s1665-2681(19)31341-9
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发表时间：
2013
影响因子：
3.8
通讯作者：
V. de Lédinghen
中科院分区：
文献类型：
--
作者：
G. Wong;J. Vergniol;Peter Lo;Vincent Wai‐Sun Wong;J. Foucher;B. le Bail;P. Choi;F. Chermak;K. Leung;Wassil Merrouche;H. Chan;V. de Lédinghen
研究背景和基本原理有限的研究旨在确定XL探头在不同肝纤维化阶段的临界值（XL cut-offs），而M探头的临界值（M cut-offs）可能不适用于XL探头。我们的目标是推导出超重患者适当的XL临界值。招募了通过两种探头进行肝硬度测量（LSM）的患者。对应M临界值的XL临界值探头来自探索性队列，随后在也接受肝活检的亚组患者中进行了验证。XL截止诊断晚期fibrosis.ResultsTotal 517例患者（63%男性，平均年龄58）谁有可靠的LSM两个探头的诊断准确性被列入探索性队列。M探针的LSM（LSM-M）和XL探针的LSM（LSM-XL）之间存在强相关性（r ²= 0.89，p <0.001）。学习使用LSM-XL的决策树以预测3种LSM-M类别（<$6.0 kPa、6.0-11.9 kPa和≥ 12.0 kPa），并确定XL截止值为4.8 kPa和10.7 kPa。这些临界值随后在接受肝活检的147例患者的队列中得到验证。在62例LSM-XL <$4.8 kPa或≥ 10.7 kPa的患者中，总体准确率为89%。这些临界值可以避免体重指数（BMI）为<$25 -30 kg/m ²而非<$30 kg/m ²的患者纤维化分期不足。结论XL临界值为4.8 kPa和10.7 kPa是BMI为<$25 -30 kg/m ²的患者M探头6.0 kPa和12.0 kPa的最佳估计值。BMI> 30 kg/m ²的患者可使用M探头截止值作为XL探头。
Background and rationale for the studyLimited studies have aimed to define the cut-offs of XL probe (XL cut-offs) for different stages of liver fibrosis, whereas those of M probe (M cut-offs) may not be applicable to XL probe. We aimed to derive appropriate XL cut-offs in overweight patients. Patients with liver stiffness measurement (LSM) by both probes were recruited. XL cut-offs probe for corresponding M cut-offs were derived from an exploratory cohort, and subsequently validated in a subgroup patients also underwent liver biopsy. The diagnostic accuracy of XL cut-offs to diagnose advanced fibrosis was evaluated.ResultsTotal 517 patients (63% male, mean age 58) who had reliable LSM by both probes were included in the exploratory cohort. There was a strong correlation between the LSM by M probe (LSM-M) and LSM by XL probe (LSM-XL)(r ²= 0.89, p‹ 0.001). A decision tree using LSM-XL was learnt to predict the 3 categories of LSM-M (‹ 6.0 kPa, 6.0-11.9 kPa and≥ 12.0 kPa), and XL cut-offs at 4.8 kPa and 10.7 kPa were identified. These cut-offs were subsequently validated in a cohort of 147 patients who underwent liver biopsy. The overall accuracy was 89% among 62 patients whose LSM-XL‹ 4.8 kPa or≥ 10.7 kPa. These cut-offs would have avoided under-staging of fibrosis among patients with body mass index (BMI)› 25-30 kg/m ² but not› 30 kg/m ².ConclusionsXL cut-offs at 4.8 kPa and 10.7 kPa were the best estimates of 6.0 kPa and 12.0 kPa of M probe for patients with BMI› 25-30 kg/m ². Patients with BMI› 30 kg/m ² might use M probe cut-offs for XL probe.