The usefulness of liver stiffness measurement using FibroScan in chronic hepatitis C in South Korea: A multicenter, prospective study
The usefulness of liver stiffness measurement using FibroScan in chronic hepatitis C in South Korea: A multicenter, prospective study
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DOI：
10.1111/j.1440-1746.2010.06385.x
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发表时间：
2011-01-01
影响因子：
4.1
通讯作者：
Han, Kwang-Hyub
中科院分区：
文献类型：
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作者：
Kim, Seung Up;Jang, Hui Won;Han, Kwang-Hyub
目的：在韩国进行一项多中心前瞻性研究，探讨慢性丙型肝炎(CHC)肝脏硬度测定(LSM)的准确性。方法：2005年6月至2009年7月，91例慢性丙型肝炎(CHC)患者，无抗病毒治疗史、肝硬化史、合并其他病毒感染、大量饮酒，丙氨酸氨基转移酶(ALT)和lt；5倍正常上限，总胆红素和lt；1.5 mg/dL，足够的肝活检质量(>；=15 mm和超过6个门脉)，四分位数与肝脏硬度(LS)值的中位数比率和lt；0.21，并招募了10多个有效测量。采用BATTS和Ludwig评分系统进行组织学评价。计算年龄-血小板指数(API)、天冬氨酸氨基转移酶(AST)-血小板比率指数(APRI)和年龄-脾-血小板比率指数(Aspri)。采用受试者工作特征曲线下面积(AUROC)评价LSM模型与其他无创模型的性能。结果：LSM模型的平均年龄为47.9岁，平均LS值为7.7kPa.LS值与纤维化分期高度相关(r=0.835，P<；0.001)。LSM对>；=F2、>；=F3和F=4的AUROC分别为0.909、0.993和0.970，优于API(分别为0.72、0.858和0.948)、APRI(分别为0.780、0.887和0.904)和Aspri(分别为0.713、0.862和0.957)。结论：LSM能准确评估慢性丙型肝炎患者的肝纤维化程度，值得推广应用。
Aim:We investigated the accuracy of liver stiffness measurement (LSM) in chronic hepatitis C (CHC) in a multicenter, prospective study in South Korea.Methods:Between June 2005 and July 2009, 91 CHC patients without a previous history of antiviral treatment, clinical evidences of cirrhosis, coinfection with other viruses, and heavy alcohol consumption and with alanine aminotransferase (ALT) < 5x upper limit of normal, total bilirubin < 1.5 mg/dL, sufficient liver biopsy quality (>= 15 mm and more than six portal tracts), interquartile range to median liver stiffness (LS) value ratio < 0.21, and more than 10 valid measurements, were recruited. The Batts and Ludwig scoring system was used for histologic assessment. Age-platelet index (API), aspartate aminotransferase (AST)-to-platelet ratio index (APRI), and age-spleen-platelet ratio index (ASPRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used to evaluate the performance of LSM and other noninvasive models.Results:The mean age was 47.9 years, and the mean LS value was 7.7 kPa (44 men and 47 women). LS value was highly correlated to the fibrosis stages (r = 0.835, P < 0.001). The AUROCs of LSM were 0.909 for >= F2, 0.993 for >= F3, and 0.970 for F = 4 and were superior to those of API (0.72, 0.858, and 0.948, respectively), APRI (0.780, 0.887, and 0.904, respectively), and ASPRI (0.713, 0.862, and 0.957, respectively). The optimal cutoff LS values were 6.2 kPa for >= F2, 7.7 kPa for >= F3, and 11.0 kPa for F = 4.Conclusions:Our data suggest that LSM can accurately assess liver fibrosis in patients with CHC and be applied in South Korea.