FibroTouch诊断乙型肝炎病毒携带者肝纤维化价值研究*

doi:10.3969/j.issn.1672-5069.2022.04.007

实用肝脏病杂志 ›› 2022, Vol. 25 ›› Issue (4): 480-483.doi: 10.3969/j.issn.1672-5069.2022.04.007

FibroTouch诊断乙型肝炎病毒携带者肝纤维化价值研究^*

莫金英, 余希, 余雪平, 吴丽华, 瞿志军

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)

收稿日期:2022-03-31 出版日期:2022-07-10 发布日期:2022-07-14
通讯作者: 瞿志军,E-mail:quzhijun1971@163.com
作者简介:莫金英,女,38岁,医学硕士,主治医师。E-mail:mjy1456639105@163.com
基金资助:
^*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)

Diagnostic performance of FibroTouch scan in identifying liver fibrosis in hepatitis B virus carriers

Mo Jinying, Yu Xi, Yu Xueping, et al

Department of Infectious Diseases, Longgang Central Hospital, Shenzhen 518116, Guangdong Province, China

Received:2022-03-31 Online:2022-07-10 Published:2022-07-14

摘要/Abstract

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。

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

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 S_0-1 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 S_0-1 was (1.0±0.5), in those with S_2-3 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.

Key words: Hepatitis B viral carriers, Transient elastic imaging, Liver fibrosis, FIB-4 index, Diagnosis

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.

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 Practical Hepatology, 2022, 25(4): 480-483.

参考文献

[1] Lampertico P, Agarwal K, Berg T, et al. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol,2017,67(2):370-398.
[2] Yan H, Zhong GC, Xu GW, et al. Sodium taurocholate cotransporting polypeptide is a functional receptor for human hepatitis B and D virus.J Hepatol, 2013,58(6):e00049.
[3] Wang H, Xue L, Yan R, et al. Comparison of histologic characteristics of Chinese chronic hepatitis B patients with persistently normal or mildly elevated ALT.PLoS One,2013,8(11):e80585.
[4] Hosseini SY, Sanaei N, Fattahi MR, et al. Association of HBsAg mutation patterns with hepatitis B infection outcome: Asymptomatic carriers versus HCC/cirrhotic patients.J Ann Hepatol,2019,18(4):640-645.
[5] Tada T, Kumada T, Toyoda H, et al.Hepatitis B virus core-related antigen levels predict progression to liver cirrhosis in hepatitis B carriers.J Gastroenterol Hepatol,2018,33(4):918-925.
[6] Lei J, Xiao Y, Si W, et al. Lnc-TCL6 is a potential biomarker for early diagnosis and grade in liver-cirrhosis patients.J Gastroenterol Rep,2019,7(6):434-443.
[7] Xz A, Ph A, Xw A, et al. Development and validation of a non-invasive model for diagnosing HBV-related liver cirrhosis.J Clin Chim Acta,2021,5(23):525-531.
[8] Su CW, Chiou YW, Tsai YH, et al. The influence of hepatitis B viral load and pre-S deletion mutations on post-operative recurrence of hepatocellular carcinoma and the tertiary preventive effects by anti-viral therapy.Plos One,2013,8(6):e66457.
[9] Vallet P, Mallet V, Nalpas B, et al. FIB-4: An inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest. Hepatology,2007,46(1):32-36.
[10] Kleef L, Sonneveld MJ, Man R, et al.Poor performance of FIB-4 in elderly individuals at risk for chronic liver disease - implications for the clinical utility of the EASL NIT guideline.J Hepatol,2022,76(1):245-246.
[11] Martin J, Khatri G, Gopal P, et al. Accuracy of ultrasound and noninvasive markers of fibrosis to identify patients with cirrhosis.Dig Dis Sci,2015,60(6):1841-1847.
[12] Dana J, Girard M, Franchi AS,et al.Comparison of transient elastography, shear wave elastography, magnetic resonance elastography and fibroTest as routine diagnostic markers for assessing liver fibrosis in children with cystic fibrosis.Clin Res Hepatol Gastroenterol,2022,46(3):101855.
[13] Kim D, Cholankeril G, Loomba R, et al. Prevalence of fatty liver disease and fibrosis detected by FibroScan in adults in the United States, 2017-2018. Clin Gastroenterol Hepatol,2021,19(7):1499-1501.
[14] Xu Y, Liu Y, Cao Z, et al. Comparison of FibroTouch and FibroScan for staging fibrosis in chronic liver disease: Single-center prospective study. Dig Liver Dis, 2019,51(9):1323-1329.
[15] 冷雪君,颜学兵. FibroTouch无创肝脏硬度测定值与血清标志物对慢性乙型肝炎患者肝纤维化程度评估的相关性分析. 世界华人消化杂志,2018,26(12):707-715.
[16] 王贵强, 段钟平, 王福生,等. 慢性乙型肝炎防治指南(2019年版).实用肝脏病杂志, 2020,23(1):9-32.
[17] Peng X, Tian A, Li J, et al. Diagnostic value of FibroTouch and non-invasive fibrosis indexes in hepatic fibrosis with different aetiologies. Dig Dis Sci,2021(45):1-10.
[18] Tan YW, Zhou XB, Ye Y, et al. Diagnostic value of FIB-4, aspartate aminotransferaseto-platelet ratio index and liver stiffness measurement in hepatitis B virus-infected patients with persistently normal alanine aminotransferase.World J Gastroenterol,2017,23(31):5746-5754.

FibroTouch诊断乙型肝炎病毒携带者肝纤维化价值研究^*

Diagnostic performance of FibroTouch scan in identifying liver fibrosis in hepatitis B virus carriers

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	熊霞鹂, 魏宏, 朱云霞, 段钟平. 富马酸替诺福韦二吡呋酯对HBV感染孕妇肾功能和胎儿生长发育的安全性研究^*[J]. 实用肝脏病杂志, 2022, 25(4): 484-487.
[2]	罗真真, 田海英, 葛建华, 纪元. 慢性丙型肝炎患者血清N-寡糖和胆汁酸水平变化判断肝纤维化临床价值分析^*[J]. 实用肝脏病杂志, 2022, 25(4): 504-507.
[3]	付丽红, 高月求, 王晓琳, 刘坤, 李曼, 黄凌鹰. 38例药物性肝损伤患者肝组织病理学特征分析^*[J]. 实用肝脏病杂志, 2022, 25(4): 512-516.
[4]	汤磊, 彭蕾, 叶珺, 张振华, 邹桂舟. 影响慢性乙型肝炎患者进展为肝硬化的多因素分析^*[J]. 实用肝脏病杂志, 2022, 25(4): 538-541.
[5]	李芳, 王衍森, 翁璐昕. 高频超声肝实质纹理特征定量联合血清AFP-L3水平评估乙型肝炎肝硬化患者肝功能分级价值研究^*[J]. 实用肝脏病杂志, 2022, 25(4): 542-545.
[6]	郑丽雅, 田澄, 李娜. 剪切波弹性成像技术联合多参数评估肝硬化患者食管静脉曲张价值研究^*[J]. 实用肝脏病杂志, 2022, 25(4): 546-549.
[7]	王宝锋, 马彦高, 李义, 曾宪强, 周进学. 增强MRI扫描在乙型肝炎肝硬化背景下对原发性肝癌的诊断价值分析^*[J]. 实用肝脏病杂志, 2022, 25(4): 554-557.
[8]	王晶, 张洁, 赵静. 超声造影联合声触诊组织量化技术鉴别肝血管瘤与肝细胞癌价值研究^*[J]. 实用肝脏病杂志, 2022, 25(4): 575-578.
[9]	孙向征, 卢微, 李若曼. 多层螺旋CT增强扫描诊断肝血管瘤与肝转移癌价值分析^*[J]. 实用肝脏病杂志, 2022, 25(4): 579-582.
[10]	宗金娟, 周明, 史家乐. 应用CTA技术和超声评估肝移植术患者术前肝脏血供状态研究^*[J]. 实用肝脏病杂志, 2022, 25(4): 583-586.
[11]	金盼盼, 张岭漪. PIVKA-II:一种新型乙型肝炎相关肝癌诊断标记物研究进展[J]. 实用肝脏病杂志, 2022, 25(4): 605-608.
[12]	郭悦承, 陆伦根. 肝纤维化临床诊断与治疗研究进展[J]. 实用肝脏病杂志, 2022, 25(3): 305-308.
[13]	韩冰, 涂传涛. NASH患者肝巨噬细胞在肝纤维化形成过程中的作用及其临床转化研究进展^*[J]. 实用肝脏病杂志, 2022, 25(3): 309-313.
[14]	严兆兰, 祖红梅, 蔡长霞, 魏巍. 血清低水平丙氨酸氨基转移酶的HBV感染者临床特征分析^*[J]. 实用肝脏病杂志, 2022, 25(3): 343-346.
[15]	李春花, 李忠新, 张春雷, 曾学辉, 陈甜甜, 宋林立. 不同肝纤维化程度的慢性乙型肝炎患者血清FGF-21、PDGF-BB和FBRS水平变化及其临床意义探讨^*[J]. 实用肝脏病杂志, 2022, 25(3): 347-350.