Prospective Validation of FibroTest in Comparison with Liver Stiffness for Predicting Liver Fibrosis in Asian Subjects with Chronic Hepatitis B 英文参考文献.docVIP

Prospective Validation of FibroTest in Comparison with Liver Stiffness for Predicting Liver Fibrosis in Asian Subjects with Chronic Hepatitis B BeomKyungKim1,2,5.,SeungUpKim1,2,5.,HyonSukKim3,JunYongPark1,2,5,SangHoonAhn1,2,5,6 ChaeYoonChon1,2,5,InRaeCho1,Dong-HooJoh1,YoungNyunPark4,Kwang-HyubHan1,2,5,6 ,Do , YoungKim1,2,5,6 * 1Department ofInternal Medicine,YonseiUniversityCollegeofMedicine,Seoul,Korea, 2YonseiInstituteofGastroenterology, YonseiUniversityCollegeofMedicine, Seoul, Korea, 3Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea, 4Department of Pathology, Yonsei University College of Medicine,Seoul,Korea,5LiverCirrhosisClinicalResearchCenter,YonseiUniversityCollegeofMedicine,Seoul,Korea,6BrainKorea21ProjectforMedicalScience,Yonsei UniversityCollegeofMedicine,Seoul,Korea Abstract Background and Aims:DiagnosticvaluesofFibroTest(FT)forhepaticfibrosishaverarelybeenassessedinAsianchronic hepatitisB(CHB)patients.Weaimedtovalidateitsdiagnosticperformancesincomparisonwithliverstiffness(LS). Methods: From2008to2010,194CHBpatientswhounderwentliverbiopsiesalongwithFTandtransientelastography wereprospectivelyenrolled.FibrosisstagewasassessedaccordingtotheBattsandLudwigsystem. Results: Topredictsignificantfibrosis(F$2),advancedfibrosis(F$3),andcirrhosis(F=4),areasunderreceiveroperating characteristic curves (AUROCs) of FT were 0.903, 0.907, and 0.866, comparable to those of LS (0.873, 0.897, and 0.910, respectively).OptimizedcutoffsofFTtomaximizesumofsensitivityandspecificitywere0.32,0.52,and0.68forF$2,F$3, andF=4,whilethoseofLSwere8.8,10.2,and14.1kPa,respectively.AccordingtoFTandLScutoffs,123(63.4%)and124 (63.9%) patients were correctly classified consistent with histological fibrosis (F1, F2, F3, and F4), respectively. Overall concordancebetweeneachfibrosisstageestimatedbyFTandLSwasobservedin111patients,where88werecorrectly classified with histological results. A combination formula adding LS to FT (LS+FT