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Eur J Gastroenterol Hepatol:简单无创性检测系统对进展期肝纤维化的诊断性能较差

2017-09-27 MedSci MedSci原创

结论:由于这些无创检测系统用于诊断CHB患者进展期肝纤维化的性能较差,并且错误率较高。因此,其临床效果并不可靠。

背景和目的:该研究旨在分析简单非侵入性检测诊断慢性乙型肝炎(CHB)患者进展期纤维化的诊断性能和临床效果。

患者和方法:该研究回顾性分析了德国一家三级转诊中心的239例接受肝活检的CHB成人患者。记录患者人口统计学、乙型肝炎病毒肝炎标志物、抗病毒治疗情况、实验室参数、肝脏影像学及肝组织学结果。使用基于4因素的肝纤维化指数(FIB-4)、天冬氨酸氨基转移酶/丙氨酸氨基转移酶比率指数(AAR)、天冬氨酸氨基转移酶/血小板比率指数(APRI)和年龄-血小板指数等无创性诊断系统对进展期肝纤维化的的敏感度、特异性、阳性预测值和阴性预测值以及受试者工作特征曲线下面积(AUROC)进行评估。

结果:CHB感染的中位持续时间为31个月(范围: 6-340个月);86%的患者是白种人,71%的患者是男性。无创肝纤维化检测指标FIB-4, APRI, AAR,和年龄-血小板指数评估进展期肝纤维化的受试者工作特征曲线下面积分别是0.75 [95% 可信区间: 0.67-0.82], 0.72 (95% 可信区间: 0.64-0.80), 0.48 (95% 可信区间: 0.39-0.56)和0.73 (95%可信区间: 0.66-0.81)。进展期肝纤维化患者被误诊为轻度纤维化的比例为35%(APRI)至82% (AAR)。

结论:由于这些无创检测系统用于诊断CHB患者进展期肝纤维化的性能较差,并且错误率较高。因此,其临床效果并不可靠。

原始出处:

Lang S, Kutting F, Staub A, et al. Performance of simple noninvasive scoring systems for the prediction of advanced fibrosis in patients with chronic hepatitis B. Eur J Gastroenterol Hepatol, 2017, Sep 6. doi: 10.1097/MEG.0000000000000977.

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    2017-10-25 许安
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    2017-12-23 swallow
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  6. [GetPortalCommentsPageByObjectIdResponse(id=1814032, encodeId=17a3181403245, content=<a href='/topic/show?id=edff943e88a' target=_blank style='color:#2F92EE;'>#进展期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94378, encryptionId=edff943e88a, topicName=进展期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fca128, createdName=licz0423, createdTime=Fri Mar 23 01:31:00 CST 2018, time=2018-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711206, encodeId=e93d1e1120685, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Fri Nov 03 12:31:00 CST 2017, time=2017-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071915, encodeId=69aa20e191584, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Oct 25 22:31:00 CST 2017, time=2017-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026265, encodeId=32f820262650c, content=<a href='/topic/show?id=6cbc915966c' target=_blank style='color:#2F92EE;'>#诊断性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91596, encryptionId=6cbc915966c, topicName=诊断性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=83a4244, createdName=swallow, createdTime=Sat Dec 23 09:31:00 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064202, encodeId=35972064202d5, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Nov 16 11:31:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808160, encodeId=913018081601f, content=<a href='/topic/show?id=f94d81342e5' target=_blank style='color:#2F92EE;'>#肝纤维#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81342, encryptionId=f94d81342e5, topicName=肝纤维)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sat Mar 10 14:31:00 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426850, encodeId=7e4614268508e, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Fri Sep 29 02:31:00 CST 2017, time=2017-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=248181, encodeId=6029248181ea, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Sep 27 12:36:12 CST 2017, time=2017-09-27, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1814032, encodeId=17a3181403245, content=<a href='/topic/show?id=edff943e88a' target=_blank style='color:#2F92EE;'>#进展期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94378, encryptionId=edff943e88a, topicName=进展期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fca128, createdName=licz0423, createdTime=Fri Mar 23 01:31:00 CST 2018, time=2018-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711206, encodeId=e93d1e1120685, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Fri Nov 03 12:31:00 CST 2017, time=2017-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071915, encodeId=69aa20e191584, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Oct 25 22:31:00 CST 2017, time=2017-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026265, encodeId=32f820262650c, content=<a href='/topic/show?id=6cbc915966c' target=_blank style='color:#2F92EE;'>#诊断性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91596, encryptionId=6cbc915966c, topicName=诊断性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=83a4244, createdName=swallow, createdTime=Sat Dec 23 09:31:00 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064202, encodeId=35972064202d5, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Nov 16 11:31:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808160, encodeId=913018081601f, content=<a href='/topic/show?id=f94d81342e5' target=_blank style='color:#2F92EE;'>#肝纤维#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81342, encryptionId=f94d81342e5, topicName=肝纤维)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sat Mar 10 14:31:00 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426850, encodeId=7e4614268508e, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Fri Sep 29 02:31:00 CST 2017, time=2017-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=248181, encodeId=6029248181ea, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Sep 27 12:36:12 CST 2017, time=2017-09-27, status=1, ipAttribution=)]
    2017-09-29 gwc384
  8. [GetPortalCommentsPageByObjectIdResponse(id=1814032, encodeId=17a3181403245, content=<a href='/topic/show?id=edff943e88a' target=_blank style='color:#2F92EE;'>#进展期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94378, encryptionId=edff943e88a, topicName=进展期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5fca128, createdName=licz0423, createdTime=Fri Mar 23 01:31:00 CST 2018, time=2018-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711206, encodeId=e93d1e1120685, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Fri Nov 03 12:31:00 CST 2017, time=2017-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2071915, encodeId=69aa20e191584, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Oct 25 22:31:00 CST 2017, time=2017-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026265, encodeId=32f820262650c, content=<a href='/topic/show?id=6cbc915966c' target=_blank style='color:#2F92EE;'>#诊断性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=91596, encryptionId=6cbc915966c, topicName=诊断性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=83a4244, createdName=swallow, createdTime=Sat Dec 23 09:31:00 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064202, encodeId=35972064202d5, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Nov 16 11:31:00 CST 2017, time=2017-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1808160, encodeId=913018081601f, content=<a href='/topic/show?id=f94d81342e5' target=_blank style='color:#2F92EE;'>#肝纤维#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81342, encryptionId=f94d81342e5, topicName=肝纤维)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Sat Mar 10 14:31:00 CST 2018, time=2018-03-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1426850, encodeId=7e4614268508e, content=<a href='/topic/show?id=221d685172' target=_blank style='color:#2F92EE;'>#EPA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6851, encryptionId=221d685172, topicName=EPA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4a9b4077760, createdName=gwc384, createdTime=Fri Sep 29 02:31:00 CST 2017, time=2017-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=248181, encodeId=6029248181ea, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Wed Sep 27 12:36:12 CST 2017, time=2017-09-27, status=1, ipAttribution=)]
    2017-09-27 Y—xianghai

    学习了新知识

    0

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