| FibroTouch诊断乙型肝炎病毒携带者肝纤维化价值研究* |
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| 引用本文： | 莫金英,余希,余雪平,吴丽华,瞿志军.FibroTouch诊断乙型肝炎病毒携带者肝纤维化价值研究*[J].实用肝脏病杂志,2022,25(4):480-483. |
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| 作者姓名： | 莫金英 余希 余雪平 吴丽华 瞿志军 |
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| 作者单位： | 518116 广东省深圳市龙岗中心医院感染病科(莫金英,余希,吴丽华,瞿志军);福建医科大学附属泉州第一医院感染病科(余雪平) |
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| 基金项目： | *国家自然科学基金资助项目(编号:81400625);广东省医学科学技术研究基金资助项目(编号:A2013624);深圳市龙岗区经济与科技发展专项资金-医疗卫生科技计划项目(编号:LGKCYLWS2019000121) |
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| 摘 要： | 目的 探讨使用FibroTouch无创检测诊断乙型肝炎病毒(HBV)携带者肝纤维化程度的效能。方法 2017年7月～2019年12月在深圳市龙岗中心医院感染病科住院的HBV携带者66例,所有患者均接受肝脏穿刺活检术。使用FibroTouch行肝脏硬度检测(LSM),常规计算基于4因子(FIB-4)指数,应用MedCalc软件绘制ROC曲线。结果 肝组织病理学检查提示,无显著肝纤维化(S0～S1)24例、进展期肝纤维化(S2～S3)27例和肝硬化(S4)15例;无显著肝纤维化组LSM为(7.8±1.8) kPa,显著低于进展期肝纤维化组【(11.4±3.1)kPa,P＜0.01】或肝硬化组【(18.2±6.2)kPa,P＜0.01】患者,无显著肝纤维化组FBI-4指数为(1.0±0.5),与进展期肝纤维化组的(1.2±0.5)比,无显著性差异(P>0.05),但这两组FIB-4均显著低于肝硬化组(2.0±1.0,P<0.01];LSM独立诊断S2、S3和S4期肝纤维化的AUC分别为0.856(其敏感性为83.7%,特异性为52.6%)、0.938(其敏感性为92.3%,特异性为90.0%)和0.963(其敏感性为100.0%,特异性为90.2%),均显著高于FBI-4诊断的AUC(P<0.05),LSM联合FIB-4均不能提高诊断肝纤维化的效能(P>0.05)。结论 使用FibroTouch诊断乙型肝炎毒携带者肝纤维化有很大的临床应用价值,可无创检测,方便动态检测,定期复查。
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| 关 键 词： | 乙型肝炎病毒携带者 瞬时弹性成像技术 肝纤维化 基于4因子的指数 诊断 |
| 收稿时间： | 2022-03-31 |
Diagnostic performance of FibroTouch scan in identifying liver fibrosis in hepatitis B virus carriers |
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| Mo Jinying,Yu Xi,Yu Xueping,et al.Diagnostic performance of FibroTouch scan in identifying liver fibrosis in hepatitis B virus carriers[J].Journal of Clinical Hepatology,2022,25(4):480-483. |
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| Authors: | Mo Jinying Yu Xi Yu Xueping |
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| Affiliation: | Department of Infectious Diseases, Longgang Central Hospital, Shenzhen 518116, Guangdong Province, China |
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| Abstract: | Objective The aim of this study was to investigate the diagnostic performance of FibroTouch scan in predicting liver fibrosis in chronic hepatitis B virus (HBV) carriers. Methods 66 HBV carriers were encountered in Longgang Central Hospital, Shenzhen, between July 2017 and December 2019, and all underwent liver biopsy. The liver fibrosis based on four factors (FIB-4) was calculated routinely, and the liver stiffness measurement (LSM) was detected by FibroTouch. The ROC was drawn by MedCalc software. Results The liver histopathological examination showed S0-S1 in 24 cases, S2-S3 in 27 cases and liver cirrhosis (S4) in 15 cases in our series; the LSM in carriers with S0-1 was (7.8±1.8) kPa, significantly lower than (11.4±3.1)kPa, P＜0.01] in those with progressive liver fibrosis or (18.2±6.2)kPa, P＜0.01] in patients with liver cirrhosis, and the FBI-4 in carriers with S0-1 was (1.0±0.5), in those with S2-3 was (1.2±0.5), not significantly different between them (P>0.05), while both significantly lower than (2.0±1.0, P<0.01] in patients with liver cirrhosis; the AUCs by LSM in predicting S2, S3 and S4 were 0.856 with sensitivity (Se) of 83.7% and specificity (Sp) of 52.6%, 0.938( Se of 92.3% and Sp of 90.0%, and 0.963(Se of 100.0% and Sp of 90.2%), all significantly higher than by FBI-4 (P<0.05), while the combination of LSM and FIB-4 didn’t improve the diagnostic performance (P>0.05). Conclusion The non-invasive diagnosis of liver fibrosis by FibroTouch detection in chronic HBV carriers is efficacious, and warrants further clinical investigation. |
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| Keywords: | Hepatitis B viral carriers Transient elastic imaging Liver fibrosis FIB-4 index Diagnosis |
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