摘要
目的探讨瞬时弹性成像(transient elastography,TE)技术在非病毒性肝病肝纤维化无创诊断中的应用价值。方法收集2015年1月至2016年7月于首都医科大学附属北京地坛医院经肝组织活检诊断为非病毒性肝病患者的临床及病理资料进行回顾性研究。肝组织活检纤维化程度F0～F1为无显著肝纤维化,F2～F4为显著肝纤维化,分析LSM值与肝组织活检纤维化分期的相关性,绘制ROC曲线,计算LSM值诊断显著肝纤维化的AUROC、敏感性和特异度等。结果共纳入96例符合条件的患者,其中无显著肝纤维化者58例(60.42%),显著肝纤维化者38例(39.58%)。LSM值与肝组织活检纤维化分期间相关系数r=0.500(P <0.001)。LSM值诊断显著肝纤维化的AUROC为0.795(P <0.05);当Cut-off值为11.45 kPa时,敏感性为60.5%、特异度为89.7%,阳性预测值为79.3%,阴性预测值为77.6%。结论 LSM值与非病毒性肝病患者肝纤维化分期间有较好的相关性;TE对于非病毒性肝病引起的肝纤维化有较高的诊断价值,可用于评估肝纤维化程度,动态监测肝纤维化进展。
Objective To investigate the value of transient elastography(TE)on non-invasive diagnosis of liver fibrosis in patients with non-viral liver diseases.Methods Clinical and pathological data of patients who underwent liver biopsy and diagnosed as non-viral liver diseases in Beijing Ditan Hospital,Capital Medical University from January 2005 to July 2016 were collected and analyzed,retrospectively.Fibrosis stage of F0~F1 were defined as non-significant liver fibrosis while the stage of F2~F4 were defined as significant liver fibrosis.The correlation between liver stiffness measurement(LSM)value and the degree of liver fibrosis determined by histopathological was analyzed.The ROC curve was plotted,the AUROC,sensitivity and specificity of diagnosis for significant liver fibrosis by LSM value were calculated.Results The clinical and pathological data of 96 patients with non-viral liver diseases were collected,58 cases(60.42%)were in the stage of non-significant liver fibrosis,while 38 cases(39.58%)were in the stage of significant liver fibrosis.The correlation coefficient between LSM value of patients with non-viral liver diseases and histopathological degree of liver fibrosis was 0.500(P<0.001).The AUROC of significant liver fibrosis diagnosed by LSM value was 0.795(P<0.05).When the Cut-off value was 11.45 kPa,the sensitivity was 60.5%,the specificity was 89.7%,the positive predictive value was 79.3%,and the negative predictive value was 77.6%.Conclusions There is a good correlation between LSM value and the stage of liver fibrosis in patients with non-viral liver diseases.TE technology has a good value in diagnosing significant liver fibrosis caused by non-viral liver diseases,which can be used to assess the stage of liver fibrosis and dynamically monitor liver fibrosis progression.
作者
程丹颖
王笑梅
欧蔚妮
孙磊
万钢
纪世博
刘聪
邢卉春
CHENG Dan-ying;WANG Xiao-mei;OU Wei-ni;SUN Lei;WAN Gang;JI Shi-bo;LIU Cong;XING Hui-chun(Center of Hepatology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Department of Pathology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Cases Statistics Section,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)
出处
《中国肝脏病杂志（电子版）》
CAS
2019年第1期37-41,共5页
Chinese Journal of Liver Diseases：Electronic Version
基金
首都卫生发展科研专项(首发2018-2-2173)
吴阶平医学基金会肝病医学部肝硬化门脉高压并发症科研项目(LDWJPMF-MMGY-2016002)
北京市医院管理局扬帆计划(xmlx201837)
关键词
瞬时弹性成像技术
非病毒性肝病
肝纤维化
无创诊断
Transient elastography
Non-viral liver diseases
Liver fibrosis
Non-invasive diagnosis
