Risk assessment of hepatocellular carcinoma in chronic hepatitis C patients by transient elastography
Risk assessment of hepatocellular carcinoma in chronic hepatitis C patients by transient elastography
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DOI：
10.1097/mcg.0b013e318050074f
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发表时间：
2008-08-01
影响因子：
2.9
通讯作者：
Omata, Masao
中科院分区：
文献类型：
--
作者：
Masuzaki, Ryota;Tateishi, Ryosuke;Omata, Masao
目的：肝纤维化程度是肝细胞癌（HCC）发生的最强危险性指标。最近开发的瞬时弹性成像（Fibroscan，Echosens，France）非侵入性地测量肝脏硬度，并且硬度和肝纤维化阶段之间的相关性已经被验证。在这项横断面研究中，我们调查了肝硬度和HCC presentation.Methods之间的关系：肝硬度测定慢性丙型肝炎患者（85与HCC和180没有）通过瞬态弹性成像。应用多变量logistic回归分析评估与HCC存在的相关性。我们计算了关于HCC存在预测的受试者工作特征（ROC）曲线，并比较了ROC曲线下面积（AUROC）。结果：多变量分析显示肝细胞癌的存在与肝硬度显著相关（P < 0.0001），沿着有年龄、男性和甲胎蛋白浓度。肝硬度、甲胎蛋白、白蛋白、凝血酶原活性、AST-血小板比率指数和血小板计数的AUROC分别为0.805、0.741、0.714、0.673、0.670和0.654。其他参数显示AUROC较小。肝硬度对HCC存在的SSLR为0.22（95%置信区间：0.11-0.42）< 10 kPa时，0.73（0.39至1.39）在10.1至15 kPa，1.30（0.80至2.12），15.1至25 kPa，和5.0（2.96 ~ 8.47）in > 25 kPa.通过瞬时弹性成像测量的肝硬度可用于区分HCC高风险的慢性丙型肝炎患者，需要经常进行影像学检查的患者。
Objective: The degree of liver fibrosis is the strongest indicator of risk for hepatocellular carcinoma (HCC) development. Recently developed transient elastography (Fibroscan, Echosens, France) noninvasively measures liver stiffness, and the correlation between the stiffness and liver fibrosis stage has been validated. In this cross-sectional study, we investigated the relationship between liver stiffness and HCC presence.Methods: Liver stiffness was measured in chronic hepatitis C patients (85 with HCC and 180 without) by transient elastography. Multivariate logistic regression was applied to assess the association with HCC presence. We computed the receiver operating characteristics (ROC) curves concerning the prediction of HCC presence and compared the areas under ROC curve (AUROC). We also calculated stratum-specific likelihood ratios (SSLR).Results: Multivariate analysis showed that HCC presence was significantly associated with liver stiffness (P < 0.0001) along with age, male, and alpha-fetoprotein concentration. AUROC was 0.805, 0.741, 0.714, 0.673, 0.670, and 0.654 for liver stiffness, alpha-fetoprotein, albumin, prothrombin activity, AST-platelet ratio index, and platelet count, respectively. Other parameters showed smaller AUROC. SSLR for HCC presence by liver stiffness was 0.22 (95% confidence interval: 0.11-0.42) in < 10 kPa, 0.73 (0.39 to 1.39) in 10.1 to 15 kPa, 1.30 (0.80 to 2.12) in 15.1 to 25 kPa, and 5.0 (2.96 to 8.47) in > 25 kPa.Conclusions: Liver stiffness measured by transient elastography is useful in demarcating chronic hepatitis C patients at a high risk for HCC, who require frequent check-up by imaging examinations.