FibroTouch、FibroScan与原发性胆汁性肝硬化分期的相关性分析

Correlation of FibroTouch and FibroScan with the stage of primary biliary cirrhosis

目的明确FibroTouch与FibroScan对原发性胆汁性肝硬化（PBC）分期的诊断价值。方法病例选自2014年1月至2016年3月就诊的PBC患者66例，均进行肝穿刺活组织学检查，同步行FibroTouch和FibroScan检测，以肝脏硬度值（LSM）表示肝纤维化程度，并应用受试者工作特征曲线对比分析两种检测方法诊断PBC肝纤维化分期的各期截值、灵敏度及特异度。两种检测值之间的相关性采用Spearman秩相关检验。结果FibroTouch、FibroScan测定值与肝穿刺组织病理学纤维化分期的相关系数分别为0．904与0．880（P值均〈0．01）；诊断PBC肝纤维化分期≥S1、≥S2、≥S3、≥S4的FibroTouch截值依次为6．25、9．05、11．75kPa和18．95kPa，灵敏度依次为89．7％、94．7％、80．0％和80．0%，特异度依次为100．0%、100．0%、87．0％和100．0％；FibroScan截值依次为6．05、8．85、12．40kPa和16．20kPa，灵敏度依次为96．4％、88．6％、76．2％和100．0％，特异度为77．8％、100.0％、86．4％和93．0％，两种检测方法诊断PBC肝纤维化分期[≥S1（P=0．109）、≥S2（P=0．853）、≥S3（P=0．387）、≥S4（P=0．224）]的诊断效能差异无统计学意义。结论FibroTouch与FibroScan均可作为PBC肝纤维化分期及疾病进展监测的无创性诊断方法，灵敏度、特异度良好。

Objective To investigate the diagnostic value of FibroTouch and FibroScan for the stage of primary biliary cirrhosis （PBC）. Methods A total of 66 PBC patients who visited our hospital from January 2014 to March 2016 were enrolled, and all the patients underwent liver biopsy and FibroTouch and FibroScan tests. Liver stiffness measurement （LSM） was used to assess fibrosis degree, and the receiver operating characteristic （ROC） curve was used to compare the cut-off values, sensitivities, and specificities of these two methods in determining fibrosis stage. The Spearman rank correlation test was used to investigate the correlation between FibroTouch and FibroScan values. Results The correlation coefficients between FibroTouch or FibroScan values and fibrosis stage determined by liver biopsy were 0.904 and 0.880, respectively （both P 〈 0.01）. The cut-off values of FibroTouch in the diagnosis of PBC with fibrosis stages of ≥ S1, ≥ S2, ≥S3, and ≥S4 were 6.25 kPa, 9.05 kPa, 11.75 kPa, and 18.95 kPa, respectively, with sensitivities of 89.7%, 94.7%, 80.0%, and 80.0% and specificities of 100%, 100%, 87.0%, and 100%, respectively; the cut-offvalues of FibroScan were 6.05 kPa, 8.85 kPa, 12.40 kPa, and 16.20 kPa, respectively, with sensitivities of 96.4%, 88.6%, 76.2%, and 100% and specificities of 77.8%, 100%, 86.4%, and 93.0%, respectively. There were no significant differences in the diagnostic performance between FibroTouch and FibroScan in determining fibrosis stage [≥ S1 （P = 0.109）, ≥S2 （P = 0.853）, ≥ S3 （P = 0.387）, ≥ S4 （P = 0.224）]. Conclusion FibroTouch and FibroScan can be used as noninvasive diagnostic tools for the determination of fibrosis stage and the monitoring of disease progression in PBC patients and have good sensitivity and specificity.