Comparison of noninvasive models of fibrosis in chronic hepatitis B

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• 作者：S. C. Raftopoulos (1)
  J. George (2)
  M. Bourliere (3)
  E. Rossi (4)
  W. B. de Boer (4)
  G. P. Jeffrey (1) (5)
  M. Bulsara (6)
  D. J. Speers (4)
  G. MacQuillan (1) (5)
  H. L. I. Ching (5)
  N. Kontorinis (7)
  W. Cheng (7)
  J. Flexman (4)
  S. Fermoyle (4)
  P. Rigby (8)
  L. Walsh (8)
  D. McLeod (9)
  L. A. Adams (1) (5)
  
• 关键词：Hepascore ; APRI ; Fibrotest ; Fibrosure ; Image morphometry
• 刊名：Hepatology International
• 出版年：2012
• 出版时间：April 2012
• 年：2012
• 卷：6
• 期：2
• 页码：457-467
• 全文大小：465KB
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• 作者单位：S. C. Raftopoulos (1)
  J. George (2)
  M. Bourliere (3)
  E. Rossi (4)
  W. B. de Boer (4)
  G. P. Jeffrey (1) (5)
  M. Bulsara (6)
  D. J. Speers (4)
  G. MacQuillan (1) (5)
  H. L. I. Ching (5)
  N. Kontorinis (7)
  W. Cheng (7)
  J. Flexman (4)
  S. Fermoyle (4)
  P. Rigby (8)
  L. Walsh (8)
  D. McLeod (9)
  L. A. Adams (1) (5)
  
  1. Department of Gastroenterology, Sir Charles Gairdner Hospital, Perth, Australia
  2. Storr Liver Unit, Westmead Millenium Institute, Westmead Hospital, University of Sydney, Sydney, Australia
  3. Service d’Hépato-Gastroentérologie, H?pital Saint Joseph, Marseille, France
  4. Department of Clinical Microbiology, PathWest Laboratory Medicine, Perth, Australia
  5. School of Medicine and Pharmacology, Sir Charles Gairdner Hospital, University of Western Australia, Perth, WA, 6009, Australia
  6. Department of Statistics, Notre Dame University, Fremantle, Australia
  7. Department of Gastroenterology, Royal Perth Hospital, Perth, Australia
  8. Center for Microscopy, Characterisation and Analysis, University of Western Australia, Perth, Australia
  9. Department of Anatomical Pathology, Westmead Hospital, University of Sydney, Sydney, Australia
  

文摘

Background and goals Liver fibrosis influences treatment and surveillance strategies in chronic hepatitis B (CHB). This multicenter study aimed to examine the accuracy of serum fibrosis models in CHB patients including those with low alanine aminotransferase (ALT) levels and serially in those undergoing treatment. Method We examined noninvasive fibrosis models [Hepascore, Fibrotest, APRI, hepatitis e antigen (HBeAg)-positive and -negative models] in 179 CHB patients who underwent liver biopsy and fibrosis assessment by METAVIR and image morphometry. Serial Hepascore measurements were assessed in 40 subjects for up to 8.7?years. Results Hepascore was more accurate than Fibrotest [area under the curve (AUC) 0.83 vs. 0.72, P?=?0.05] and HBeAg-positive model (AUC 0.83 vs. 72, P?=?0.03) for significant fibrosis but was not significantly different to APRI or HBeAg-negative scores. Fibrosis area assessed by morphometry was correlated with Hepascore (r?=?0.603, P?<?0.001), Fibrotest (r?=?0.392, P?=?0.03), and HBeAg-positive (r?=?0.492, P?=?0.001) scores only. Among 73 patients with an ALT <60?IU/L, noninvasive models were useful to predict fibrosis (PPV 80-0%) or exclude significant fibrosis (NPV 79-00%). Hepascore increased significantly among patients monitored without treatment and reduced among patients undergoing therapy (0.05/year?±?0.03 vs. ?.04/year?±?0.02, P?=?0.007). Conclusions Serum fibrosis models are predictive of fibrosis in CHB and assist in identifying subjects with low–normal ALT levels for treatment.