自身免疫性肝炎肝纤维化的无创血液检测:在特定患者中的应用提高了准确性

IF 1.5 Q3 GASTROENTEROLOGY & HEPATOLOGY
M. Ferronato, M. Lenzi, P. Muratori, L. Muratori
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引用次数: 2

摘要

背景。肝纤维化评估对指导自身免疫性肝炎(AIH)的治疗至关重要,但非侵入性检查(NITs)的准确性较差。我们的研究旨在评估nit在不同AIH表现中的表现。方法。122例AIH患者的单中心回顾性研究。将NITs与肝纤维化的组织学分级进行比较。我们对急性(黄疸和/或转氨酶上限为正常的10倍)和非急性患者进行了准确性分析。结果。各Ishak分期NIT值分布的差异有显著性:脾直径-血小板计数比(SD/PC) (p < 0.001)、纤维化-4评分(FIB-4) (p = 0.002)、ast - alt比(AAR) (p = 0.002)、红细胞宽度-分布-血小板计数比(RDW/PC) (p = 0.008)和ast -血小板计数比(APRI) (p = 0.029)。SD/PC、FIB-4、RDW/PC、APRI、AAR的晚期纤维化AUC分别为0.814、0.770、0.768、0.708、0.694。非急性亚组SD/PC、FIB-4、APRI AUC分别为0.902、0.834、0.758,急性亚组分别为0.754、0.724、0.716。RDW/PC和AAR在两个亚组间无显著差异。结论。对于SD/PC、FIB-4和APRI,非急性表现的患者诊断准确性更高。在这种情况下,SD/PC和FIB-4显示了与其他非侵入性技术一起在临床实践中可能感兴趣的整体性能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Blood-Based Non-Invasive Tests of Hepatic Fibrosis in Autoimmune Hepatitis: Application among Selected Patients Leads to Higher Accuracy
Background. Assessment of liver fibrosis is essential to guide treatment in autoimmune hepatitis (AIH), but non-invasive tests (NITs) showed poor accuracy. Our study aims to evaluate the performance of NITs among different AIH presentations. Methods. Monocentric retrospective study among 122 AIH patients. NITs were compared to histological grading of liver fibrosis. We performed an accuracy analysis among acute (jaundice and/or transaminases > 10 times upper limit of normal) and non-acute patients. Results. A significant difference in the distribution of NIT values for each Ishak stage was found for spleen-diameter-to-platelet-count ratio (SD/PC) (p < 0.001), fibrosis-4-score (FIB-4) (p = 0.002), AST-to-ALT ratio (AAR) (p = 0.002), red-blood-cell-width-distribution-to-platelet-count ratio (RDW/PC) (p = 0.008) and AST-to-platelet-count ratio (APRI) (p = 0.029). The AUC for advanced fibrosis of SD/PC, FIB-4, RDW/PC, APRI and AAR were, respectively, 0.814, 0.770, 0.768, 0.708 and 0.694. The AUC of SD/PC, FIB-4 and APRI in non-acute subgroup were 0.902, 0.834 and 0.758, while in acute patients they were 0.754, 0.724 and 0.716. RDW/PC and AAR weren’t different among the two subgroups. Conclusions. For SD/PC, FIB-4 and APRI, diagnostic accuracy is higher in patients with non-acute presentation. In this context, SD/PC and FIB-4 showed an overall performance that could be of interest in clinical practice alongside other non-invasive techniques.
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来源期刊
Gastroenterology Insights
Gastroenterology Insights GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.80
自引率
3.40%
发文量
35
审稿时长
10 weeks
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