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Assessment of liver fibrosis by transient elastography in young children with chronic hepatitis B virus infection
Hepatology International ( IF 6.6 ) Pub Date : 2021-07-09 , DOI: 10.1007/s12072-021-10194-7
Zhiqiang Xu 1, 2 , Jinfang Zhao 3 , Jiaye Liu 3 , Yi Dong 2 , Fuchuan Wang 2 , Jianguo Yan 2 , Lili Cao 2 , Pu Wang 2 , Aiqin Li 2 , Jing Li 3 , Shishu Zhu 2 , Yanwei Zhong 2 , Min Zhang 2 , Fu-Sheng Wang 1, 3
Affiliation  

Background

This study aimed to compare the diagnostic accuracy of transient elastography (TE) and biopsy for the detection of liver fibrosis in children with chronic hepatitis B (CHB).

Methods

This single-center prospective study included 157 CHB children aged 0–6 years. All patients underwent liver stiffness measurement (LSM) by TE and liver biopsy, separated by an interval of less than 1 week.

Results

The LSM, aspartate aminotransferase-platelet ratio index (APRI), and fibrosis-4 index (FIB-4) were positively correlated with activity grade and fibrosis stage in CHB children. The areas under the receiver operating characteristic curves (AUCs) of LSM for identifying significant (F ≥ 2) and advanced (F ≥ 3) fibrosis were 0.732 and 0.941, respectively. The cut-off values, specificity, and sensitivity for significant fibrosis were 5.6 kPa, 75.7%, and 67.4%, respectively; the corresponding values for advanced fibrosis were 6.9 kPa, 91.5%, and 81.3%, respectively. Compared to LSM, the overall diagnostic performances of APRI and FIB-4 for significant and advanced fibrosis were suboptimal, with low AUCs and sensitivity. Since LSM, platelet, and Log10 (hepatitis B surface antigen) were independent factors associated with the fibrosis stage (F < 2 and F ≥ 2), they were used to formulate the “LPS” index for the prediction of F ≥ 2. The AUC of LPS (for F ≥ 2) was higher than that of LSM (0.792 vs. 0.732, p < 0.05), and had an improved sensitivity (76.6% vs. 67.4%).

Conclusions

TE is a promising technology for the diagnosis of advanced fibrosis in CHB children aged 0–6 years.



中文翻译:

瞬时弹性成像评估慢性乙型肝炎病毒感染幼儿肝纤维化

背景

本研究旨在比较瞬时弹性成像 (TE) 和活检在检测慢性乙型肝炎 (CHB) 儿童肝纤维化方面的诊断准确性。

方法

这项单中心前瞻性研究包括 157 名 0-6 岁的 CHB 儿童。所有患者均通过 TE 和肝活检进行了肝脏硬度测量 (LSM),间隔小于 1 周。

结果

LSM、天冬氨酸转氨酶-血小板比率指数(APRI)和纤维化4指数(FIB-4)与CHB儿童的活动度和纤维化分期呈正相关。LSM 用于识别显着 (F ≥ 2) 和晚期 (F ≥ 3) 纤维化的受试者工作特征曲线 (AUC) 下面积分别为 0.732 和 0.941。显着纤维化的临界值、特异性和敏感性分别为 5.6 kPa、75.7% 和 67.4%;晚期纤维化的相应值分别为 6.9 kPa、91.5% 和 81.3%。与 LSM 相比,APRI 和 FIB-4 对显着和晚期纤维化的整体诊断性能欠佳,AUC 和灵敏度较低。由于 LSM、血小板和 Log 10(乙肝表面抗原)是与纤维化阶段相关的独立因素(F < 2 和 F ≥ 2),它们被用来制定预测 F ≥ 2 的“LPS”指数。 LPS 的 AUC(对于 F ≥ 2) 高于 LSM (0.792 vs. 0.732, p  < 0.05),并且灵敏度提高(76.6% vs. 67.4%)。

结论

TE 是一种很有前景的技术,可用于诊断 0-6 岁 CHB 儿童的晚期纤维化。

更新日期:2021-07-09
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