FibroTouch和FibroScan检测评估慢性乙型肝炎患者肝纤维化程度的诊断价值

摘要

目的 以病理检查为金标准,评估FibroTouch与FibroScan对慢性乙型肝炎(chronic hepatitis B,CHB)患者肝纤维化分期的诊断价值.方法 纳入2014年3月至2017年12月期间于北京友谊医院行肝组织活检术的CHB患者,同时行FibroTouch和FibroScan检测,分析两种检测方法诊断CHB患者肝纤维化分期的硬度值、最佳诊断界值、曲线下面积(the area under the curve,AUC).结果 103例CHB患者,使用FibroTouch和FibroScan检测不同纤维分期的肝脏硬度值无统计学差异.此外,FibroTouch和FibroScan诊断肝纤维化分期≥SI的界值分别为5.45和5.55 kPa,≥S2的界值分别为7.10和6.65 kPa,≥S3的界值分别为11.05和9.20 kPa,≥S4的界值分别为15.50和15.45kPa.两种检测方法诊断肝纤维化分期≥S1、≥S2、≥S3、s4的AUC分别为0.858和0.765 (P=0.54)、0.812和0.801 (P =0.68)、0.863和0.878(P =0.45)和1.0和0.99 (P =0.38).结论 FibroTouch与FibroScan诊断CHB患者肝纤维化程度的诊断效能相似.%Objective To explore the diagnostic values of FibroTouch and FibroScan for liver fibrosis in patients with chronic hepatitis B(CHB).Methods This study enrolled patients with CHB who was accepted liver biopsy at Beijing Friendship Hospital,Capital Medical University between March 2014 to December 2017.FibroTouch and FibroScan were performed among these patients at same time.Liver stiffness measurement (LSM),optimal cut-off value,receiver operating characteristic (ROC) were compared.Results In our 103 patients,there were no significantly different between FibroTouch and FibroScan in LSM.The threshold of the optimal cut-off value for FibroTouch and FibroScan were 5.45 versus 5.55 kPa (≥S1),7.10 versus 6.65 kPa (≥S2),11.05 versus 9.20 kPa (≥S3),15.50 versus 15.45 kPa (S4),respectively.The area under the ROC curve for the prediction of the stagel,stage2,stage2,stage 4 of liver fibrosis in these patients were 0.858 versus 0.765 (P =0.54),0.812 versus 0.801 (P =0.68),0.863 versus0.878 (P =0.45),and 1.0 versus 0.99 (P =0.38) respectively.Conclusions FibroTouch and FibmScan have a good consistency in the evaluation of the degree of liver fibrosis in patients with CHB.