FibroScan与FibroTouch对肝纤维化程度诊断价值的比较分析

摘要

目的：比较FibroScan与FibroTouch对肝纤维化程度的诊断价值。方法收集2013年9月－2014年3月就诊于吉林大学第一医院肝胆胰内科的患者962例，同时行FibroScan和FibroTouch检测。其中33例有肝穿刺病理分期，66例可计算天冬氨酸转氨酶与血小板比值指数（APRI）（53例慢性乙型肝炎，13例慢性丙型肝炎）。2种检测值之间的相关性采用Spearman秩相关检验。利用受试者工作特征曲线（ROC）分析2种检测方法对肝纤维化程度的诊断价值，并进行比较。结果对所有患者FibroScan与Fib-roTouch的测量值进行分析，FibroScan与FibroTouch的相关系数为0．866（P＜0．05，n＝962），与APRI 的相关系数分别为0．58、0．63（P＜0．05，n＝66），与肝穿刺病理分期的相关系数分别为0．67、0．74（P＜0．05，n＝33）。对于慢性乙型肝炎患者，FibroScan与FibroTouch诊断APRI分期≥2的ROC曲线下面积（AUC）分别为0．761和0．728，两者差异无统计学意义（P＝0．61）；对于慢性丙型肝炎患者，两者诊断APRI分期≥1的AUC 分别为0．810和0．893，两者差异亦无统计学意义（P＝0．38）。FibroScan 与Fibro-Touch诊断肝脏病理分期≥S1、≥S2、≥S3、≥S4的AUC 分别为0．830 vs 0．889（P＝0．15）、0．841 vs 0．835（P＝0．90）、0．888 vs 0.920（P＝0．43）和0．964 vs 0.979（P＝0．45）。结论 FibroScan与FibroTouch检测对肝纤维化程度的诊断价值相似，但本研究肝穿刺病例数较少，有待扩大样本进一步研究。%Objective To compare the diagnostic values of FibroScan and FibroTouch for liver fibrosis.Methods A total of 962 patients who visited Department of Hepatology,The First Hospital of Jilin University from September 2013 to March 2014 were enrolled.FibroScan and FibroTouch were performed among these patients.Thirty-three cases underwent liver biopsy,and Aspartate aminotransferase -to -platelet ratio index (APRI)was calculated in 66 patients (chronic hepatitis B (CHB):53 cases;chronic hepatitis C (CHC):13 cases). Spearman rank correlation test was used to analyze the correlation between the results measured by FibroScan and FibroTouch.The diagnostic values of FibroScan and FibroTouch for liver fibrosis were analyzed and compared by receiver operating characteristic (ROC)curve.Results The analysis of liver stiffness measured by FibroScan and FibroTouch among all patients showed that the correlation coefficient between Fi-broScan and FibroTouch was 0.866 (P<0.05,n=962).FibroScan and FibroTouch were significantly correlated with APRI (r=0.58 and 0.63,P<0.05,n=66)and pathological stage determined by liver biopsy (r=0.67 and 0.74,P<0.05,n=33).Among patients with CHB,for the diagnosis of APRI≥2 (liver cirrhosis),the areas under the ROC curve (AUCs)of FibroScan and FibroTouch were 0.761 vs 0.728 (P=0.61);among patients with CHC,for the diagnosis of APRI≥1 (liver cirrhosis),the AUCs of FibroScan and FibroTouch were 0.810 vs 0.893 (P=0.38).For pathological stages≥S1,≥S2,≥S3,and≥S4,the AUCs of FibroScan and FibroTouch were 0.830 vs 0.889 (P=0.15),0.841 vs 0.835 (P=0.90),0.888 vs 0.920 (P=0.43),and 0.964 vs 0.979 (P=0.45),respectively.Conclu-sion FibroScan and FibroTouch have comparable diagnostic values for liver fibrosis.However,the number of cases undergoing liver biopsy in this study was relatively small,and investigation of more cases is needed to make further confirmation.