FIB-4联合血清PCⅢ、ⅣC评估乙型肝炎病毒相关肝纤维化

Assessment of hepatitis B virus associated liver fibrosis by FIB-4 combined with serum PCIII, IVC

目的建立一种新的无创乙型肝炎病毒(hepatitis B virus,HBV)相关肝纤维化诊断模型。方法回顾性分析我院332例行肝组织活检的慢性乙型病毒性肝炎患者,根据纤维化分期,分为轻度肝纤维化组(S<2)以及中重度肝纤维化组(S≥2)。检测患者肝纤维化血清学指标以及FIB-4指数,根据ROC曲线评价FIB-4与肝纤维化指标联合诊断肝纤维化的特异性及敏感度。结果重度肝纤维化组患者FIB-4、血清PCⅢ及ⅣC水平均较轻度肝纤维化组高(p<0.01),FIB-4、血清Ⅲ型前胶原(typeⅢprocdlagen,PCⅢ)及Ⅳ型胶原(typeⅣcollagen,ⅣC)三者联合ROC曲线下面积为0.782,诊断中重度肝纤维化的灵敏度为71.5%,特异性为89.8%。结论FIB-4与血清PCⅢ、ⅣC联合诊断HBV相关S2期以上肝纤维化分期具有较好的评估价值。联合FIB-4和血清PCⅢ、ⅣC可作为评估肝纤维化的一种无创检测方法。

Objective To establish a new noninvasive diagnosis model for HBV associated liver fibrosis.Methods The data of 332 patients with chronic hepatitis B who received liver biopsy in our hospital were analyzed retrospectively.Based on liver histopathological results,the patients were divided into two groups:mild fibrosis group(S<2)and medium to severe group(S≥2).The serum markers of liver fibrosis and fibrosis-4(FIB-4)score were tested and the diagnosis sensitivity and specificity of FIB-4 combined with markers of liver fibrosis were assessed by the ROC curve.Results FIB-4 score,serum type III procollagen(PCIII)and type IV collagen(IVC)in the medium to severe group were statistically higher than those in the mild group(P<0.01).The area under curve(AUC)of ROC by FIB-4 score combined with serum PCIII and IVC was 0.782.The sensitivity of this combined assessment in the medium to severe fibrosis cases was 71.5%with the specificity of 89.8%.Conclusions FIB-4 score combined with serum PCIII and IVC showed diagnostic value in assessing the HBV associated fibrosis at stage 2 and above.The model of FIB-4 combined with serum PCIII and IVC could be a promising noninvasive method to assess liver fibrosis.