Controlled Attenuation Parameter (CAP) with the XL Probe of the FibroscanA®: A Comparative Study with the M Probe and Liver Biopsy
Controlled Attenuation Parameter (CAP) with the XL Probe of the FibroscanA®: A Comparative Study with the M Probe and Liver Biopsy
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DOI：
10.1007/s10620-017-4638-3
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发表时间：
2017-09-01
影响因子：
3.1
通讯作者：
Paradis, Valerie
中科院分区：
文献类型：
--
作者：
de Ledinghen, Victor;Hiriart, Jean-Baptiste;Paradis, Valerie
控制衰减参数（CAP）是诊断脂肪变性的一种新方法。到目前为止，CAP仅适用于Fibroscan的M探头。本研究的目的是以肝活检（LB）为金标准，评价使用XL探头与使用M探头的CAP的诊断性能。共有236例接受LB的慢性肝病患者在同一天使用M和XL探头进行CAP测量。所有LB均由两位经验丰富的病理学家独立分析，M和XL探头的CAP中位数分别为240.5和239.5 dB/m。对于用M和XL探针检测脂肪变性等级，S ae 1的AUROC分别为0.82/0.83，S ae 2的AUROC为0.89/0.88，S3的AUROC为0.92/0.93。S ae 1的截止值（M和XL探头）分别为246/242，S ae 2的截止值为269/267，S3的截止值为285/286 dB/m。与M和XL探头CAP显著相关的因素是脂肪变性等级。在多变量分析中，XL探头的低CAP值与腰围、甘油三酯、白蛋白和饮酒量呈负相关，与碱性磷酸酶呈正相关。在多变量分析中，XL探头的高CAP值与腰围和甘油三酯呈正相关。XL探头的CAP是诊断脂肪变性的新工具。该参数可用于肥胖患者的诊断和随访。
Controlled attenuation parameter (CAP) is a new method for the diagnosis of steatosis. Until now, CAP was available only with the M probe of the Fibroscan. The aim of this study was to evaluate the diagnostic performance of CAP with the XL probe versus CAP with the M probe, using liver biopsy (LB) as gold standard.A total of 236 patients with chronic liver disease undergoing LB had CAP measurement with M and XL probes the same day. All LB were analyzed independently by two experienced pathologists.Median CAP was 240.5 and 239.5 dB/m with the M and XL probes, respectively. For the detection of steatosis grade with the M and XL probes, AUROCs were 0.82/0.83 for S ae 1, 0.89/0.88 for S ae 2, and 0.92/0.93 for S3, respectively. Cutoffs were (M and XL probes) 246/242 for S ae 1, 269/267 for S ae 2, and 285/286 dB/m for S3, respectively. The factor significantly associated with CAP with the M and XL probes was steatosis grade. In multivariate analysis, a low CAP value with XL probe was negatively associated with waist circumference, triglycerides, albumin, and the alcohol consumption, and positively with alkaline phosphatases. In multivariate analysis, a high CAP value with the XL probe was positively associated with waist circumference and triglycerides.CAP with the XL probe is a new tool for the diagnosis of steatosis. This parameter could be useful for the diagnosis and the follow-up of obese patients.