Ensemble for evaluating diagnostic efficacy of non-invasive indices in predicting liver fibrosis in untreated hepatitis C virus population.

Navneet Kaur, Gitanjali Goyal, Ravinder Garg, Chaitanya Tapasvi, Umit Demirbaga
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Abstract

Background: Hepatitis C virus (HCV) infection progresses through various phases, starting with inflammation and ending with hepatocellular carcinoma. There are several invasive and non-invasive methods to diagnose chronic HCV infection. The invasive methods have their benefits but are linked to morbidity and complications. Thus, it is important to analyze the potential of non-invasive methods as an alternative. Shear wave elastography (SWE) is a non-invasive imaging tool widely validated in clinical and research studies as a surrogate marker of liver fibrosis. Liver fibrosis determination by invasive liver biopsy and non-invasive SWE agree closely in clinical studies and therefore both are gold standards.

Aim: To analyzed the diagnostic efficacy of non-invasive indices [serum fibronectin, aspartate aminotransferase to platelet ratio index (APRI), alanine aminotransferase ratio (AAR), and fibrosis-4 (FIB-4)] in relation to SWE. We have used an Artificial Intelligence method to predict the severity of liver fibrosis and uncover the complex relationship between non-invasive indices and fibrosis severity.

Methods: We have conducted a hospital-based study considering 100 untreated patients detected as HCV positive using a quantitative Real-Time Polymerase Chain Reaction assay. We performed statistical and probabilistic analyses to determine the relationship between non-invasive indices and the severity of fibrosis. We also used standard diagnostic methods to measure the diagnostic accuracy for all the subjects.

Results: The results of our study showed that fibronectin is a highly accurate diagnostic tool for predicting fibrosis stages (mild, moderate, and severe). This was based on its sensitivity (100%, 92.2%, 96.2%), specificity (96%, 100%, 98.6%), Youden's index (0.960, 0.922, 0.948), area under receiver operating characteristic curve (0.999, 0.993, 0.922), and Likelihood test (LR+ > 10 and LR- < 0.1). Additionally, our Bayesian Network analysis revealed that fibronectin (> 200), AAR (> 1), APRI (> 3), and FIB-4 (> 4) were all strongly associated with patients who had severe fibrosis, with a 100% probability.

Conclusion: We have found a strong correlation between fibronectin and liver fibrosis progression in HCV patients. Additionally, we observed that the severity of liver fibrosis increases with an increase in the non-invasive indices that we investigated.

评估非侵入性指数在预测未经治疗的丙型肝炎病毒携带者肝纤维化方面的诊断效果的组合。
背景:丙型肝炎病毒(HCV)感染会经历不同阶段,从炎症开始到肝细胞癌结束。目前有多种侵入性和非侵入性方法来诊断慢性 HCV 感染。有创方法有其优点,但与发病率和并发症有关。因此,分析非侵入性方法作为替代方法的潜力非常重要。剪切波弹性成像(SWE)是一种非侵入性成像工具,作为肝纤维化的替代标志物已在临床和研究中得到广泛验证。目的:分析无创指标[血清纤维连接蛋白、天冬氨酸氨基转移酶与血小板比值指数(APRI)、丙氨酸氨基转移酶比值(AAR)和纤维化-4(FIB-4)]与剪切波弹性成像的诊断效果。我们采用人工智能方法预测肝纤维化的严重程度,并揭示非侵入性指标与肝纤维化严重程度之间的复杂关系:我们以医院为基础开展了一项研究,研究对象是使用定量实时聚合酶链反应检测法检测出的 100 名未经治疗的 HCV 阳性患者。我们进行了统计和概率分析,以确定非侵入性指标与纤维化严重程度之间的关系。我们还使用标准诊断方法来衡量所有受试者的诊断准确性:我们的研究结果表明,纤连蛋白是预测纤维化分期(轻度、中度和重度)的高度准确的诊断工具。这主要基于其灵敏度(100%、92.2%、96.2%)、特异性(96%、100%、98.6%)、尤登指数(0.960、0.922、0.948)、接收者工作特征曲线下面积(0.999、0.993、0.922)和似然比检验(LR+ > 10 和 LR- < 0.1)。此外,我们的贝叶斯网络分析显示,纤连蛋白(> 200)、AAR(> 1)、APRI(> 3)和 FIB-4(> 4)都与严重纤维化患者密切相关,相关概率为 100%:结论:我们发现纤连蛋白与 HCV 患者的肝纤维化进展密切相关。结论:我们发现纤维连接蛋白与 HCV 患者的肝纤维化进展密切相关。此外,我们还观察到,肝纤维化的严重程度会随着我们调查的非侵入性指数的增加而增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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