内窥镜超声应变弹性成像测量肝脏硬度的有效性和血细胞角蛋白18水平作为纤维化替代标志物的作用。

IF 1.6 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY
Deniz Guney Duman, Yesim Ozen Alahdab, Coskun Ozer Demirtas, Yusuf Yılmaz, Feyza Dilber, Filiz Ture Ozdemir, Caglayan Keklikkiran, Haluk Tarik Kani, Umut Emre Aykut, Osman Cavit Ozdogan
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Fibrosis-4 (FIB-4) and aspartate aminotransferase (AST)-to-Platelet Ratio Index (APRI) scores were recorded, and blood cytokeratin-18 (CK-18) levels were measured to assess hepatic fibrosis. A clinical evaluation was also conducted. Results: One hundred participants (control: 49, CLD: 33, cirrhotic: 18) were included. The SR and liver parenchyma strains in cirrhotics were significantly higher than those in the CLD (P < .001) and control (P < .001) groups. Strain ratio threshold set at 5.67 had a sensitivity of 94.4% and a specificity of 95.9% to differentiate cirrhotics from control patients. An SR threshold of 10.65 had a sensitivity of 94.4% and a specificity of 84.8% in differentiating cirrhotics from CLD patients. The SR showed a strong positive correlation with FIB-4 and APRI scores, but not with CK-18 levels. 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引用次数: 0

摘要

背景/目的:实时内镜超声应变弹性成像(EUS-E)半定量应变比(SR)在慢性肝病(CLD)和肝硬化中的作用尚不明确。在此,目的是评估EUS-E检测CLD和肝硬化的有效性。材料和方法:前瞻性纳入肝硬化和非肝硬化CLD患者。对照组为无肝脏疾病且行EUS非肝指征检查的患者。根据肝静脉和肝实质的应变计算应变比。记录纤维化-4 (FIB-4)和天冬氨酸转氨酶(AST)与血小板比值指数(APRI)评分,并测定血细胞角蛋白-18 (CK-18)水平以评估肝纤维化。并进行了临床评价。结果:纳入100例受试者(对照组49例,慢性肝病33例,肝硬化18例)。肝硬化组SR和肝实质菌群显著高于CLD组(P < 0.001)和对照组(P < 0.001)。应变比阈值设定为5.67,区分肝硬化与对照患者的敏感性为94.4%,特异性为95.9%。SR阈值为10.65,区分肝硬化和CLD患者的敏感性为94.4%,特异性为84.8%。SR与FIB-4和APRI评分呈显著正相关,与CK-18无显著正相关。结论:EUS-E获得的应变比阈值分别为5.67和10.65,可用于区分肝硬化与非肝硬化CLD患者和无肝脏疾病患者。这项试点研究是第一个评估EUS-E在肝脏疾病中的作用的研究,未来的研究将涉及具有特定病因的CLD患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Usefulness of Endoscopic Ultrasound Strain Elastography for Measuring Liver Stiffness and the Role of Blood Cytokeratin 18 Levels as a Surrogate Marker of Fibrosis.

Usefulness of Endoscopic Ultrasound Strain Elastography for Measuring Liver Stiffness and the Role of Blood Cytokeratin 18 Levels as a Surrogate Marker of Fibrosis.

Usefulness of Endoscopic Ultrasound Strain Elastography for Measuring Liver Stiffness and the Role of Blood Cytokeratin 18 Levels as a Surrogate Marker of Fibrosis.

Usefulness of Endoscopic Ultrasound Strain Elastography for Measuring Liver Stiffness and the Role of Blood Cytokeratin 18 Levels as a Surrogate Marker of Fibrosis.

Background/Aims: The role of semi-quantitative strain ratio (SR) using real-time endoscopic ultrasound strain elastography (EUS-E) in chronic liver disease (CLD) and cirrhosis is yet to be determined. Herein, the aim was to assess the usefulness of EUS-E to detect CLD and cirrhosis. Materials and Methods: Patients with cirrhosis and non-cirrhotic CLD were enrolled prospectively. Patients without liver disease and undergoing EUS examinations for non-hepatic indications were taken as control group. Strain ratio was calculated from strains of hepatic vein and liver parenchyma. Fibrosis-4 (FIB-4) and aspartate aminotransferase (AST)-to-Platelet Ratio Index (APRI) scores were recorded, and blood cytokeratin-18 (CK-18) levels were measured to assess hepatic fibrosis. A clinical evaluation was also conducted. Results: One hundred participants (control: 49, CLD: 33, cirrhotic: 18) were included. The SR and liver parenchyma strains in cirrhotics were significantly higher than those in the CLD (P < .001) and control (P < .001) groups. Strain ratio threshold set at 5.67 had a sensitivity of 94.4% and a specificity of 95.9% to differentiate cirrhotics from control patients. An SR threshold of 10.65 had a sensitivity of 94.4% and a specificity of 84.8% in differentiating cirrhotics from CLD patients. The SR showed a strong positive correlation with FIB-4 and APRI scores, but not with CK-18 levels. Conclusions: Strain ratio thresholds of 5.67 and 10.65 obtained by EUS-E are useful to differentiate cirrhotics from non-cirrhotic CLD patients and liver-disease-free subjects, respectively. This pilot study is the first one evaluating the role of EUS-E in liver diseases, and future studies involving patients having CLD of specific etiologies are warranted.

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来源期刊
Turkish Journal of Gastroenterology
Turkish Journal of Gastroenterology 医学-胃肠肝病学
CiteScore
1.90
自引率
0.00%
发文量
127
审稿时长
6 months
期刊介绍: The Turkish Journal of Gastroenterology (Turk J Gastroenterol) is the double-blind peer-reviewed, open access, international publication organ of the Turkish Society of Gastroenterology. The journal is a bimonthly publication, published on January, March, May, July, September, November and its publication language is English. The Turkish Journal of Gastroenterology aims to publish international at the highest clinical and scientific level on original issues of gastroenterology and hepatology. The journal publishes original papers, review articles, case reports and letters to the editor on clinical and experimental gastroenterology and hepatology.
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