Prospective Validation of ELF Test in Comparison with Fibroscan and FibroTest to Predict Liver Fibrosis in Asian Subjects with Chronic Hepatitis B 英文参考文献.docVIP

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Prospective Validation of ELF Test in Comparison with Fibroscan and FibroTest to Predict Liver Fibrosis in Asian Subjects with Chronic Hepatitis B 英文参考文献.doc

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Prospective Validation of ELF Test in Comparison with Fibroscan and FibroTest to Predict Liver Fibrosis in Asian Subjects with Chronic Hepatitis B 英文参考文献

ProspectiveValidationofELFTestinComparisonwith FibroscanandFibroTesttoPredictLiverFibrosisinAsian SubjectswithChronicHepatitisB BeomKyungKim1,5,HyonSukKim3,JunYongPark1,2,5,DoYoungKim1,2,5,SangHoonAhn1,2,5,6 ChaeYoonChon1,2,5,YoungNyunPark4,Kwang-HyubHan1,2,5,6,SeungUpKim1,2,5 , * 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea, 2Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea, 3Department of Laboratory Medicine, Yonsei University College ofMedicine, Seoul, Korea, 4Department of Pathology, Yonsei University Collegeof Medicine, Seoul,Korea,5LiverCirrhosisClinicalResearchCenter,YonseiUniversityCollegeofMedicine,Seoul,Korea,6BrainKorea21ProjectforMedicalScience,YonseiUniversity CollegeofMedicine,Seoul,Korea Abstract Background and Aims: Liver stiffness measurement (LSM) and FibroTest (FT) are frequently used as non-invasive alternativesforfibrosisstagingtoliverbiopsy.However,todate,diagnosticperformancesofEnhancedLiverFibrosis(ELF) test, which consists of hyaluronic acid, aminoterminal propeptide of procollagen type-III, and tissue inhibitor of matrix metalloproteinases-1,havenotbeencomparedtothoseofLSMandFTinAsianchronichepatitisB(CHB)patients. Methods: Between June 2010 and November 2011, we prospectively enrolled 170 CHB patients who underwent liver biopsiesalongwithLSM,FT,andELF.TheBattssystemwasusedtoassessfibrosisstages. Results: Areas under receiver operating characteristic curves (AUROCs) to predict significant fibrosis (F$2), advanced fibrosis(F$3),andcirrhosis(F=4)were0.901,0.860,and0.862forELF,respectively;0.937,0.956,and0.963forLSM;and 0.896,0.921,and0.881forFT.AUROCstopredictF$2weresimilarbetweeneachother,whereasLSMandFThadbetter AUROCsthanELFforpredictingF$3(bothp,0.05),andLSMpredictedF4moreaccuratelythanELF(p,0.05).Optimized cutoffsofELFtomaximizesumofsensitivityandspecificitywere8.5,9.4,and10.1forF$2,F$3,andF=4,respectively. UsingsuggestedELF,LSMandFTcutoffstodiagnoseF1,F2,F3,and