AIM:To evaluate the efficacy of 6 noninvasive liver fibrosis models and to identify the most valuable model for the prediction of liver fibrosis stage in chronic hepatitis B(CHB) patients.METHODS:Seventy-eight CHB pat...AIM:To evaluate the efficacy of 6 noninvasive liver fibrosis models and to identify the most valuable model for the prediction of liver fibrosis stage in chronic hepatitis B(CHB) patients.METHODS:Seventy-eight CHB patients were consecutively enrolled in this study.Liver biopsy was performed and blood serum was obtained at admission.Histological diagnosis was made according to the METAVIR system.Significant fibrosis was defined as stage score ≥ 2,severe fibrosis as stage score ≥ 3.The diagnostic accuracy of 6 noninvasive liver fibrosis models,including serum aspartate aminotransferase(AST) to platelet ratio index(APRI),FIB-4,Forn's index,Fibrometer,Hepascore,and Shanghai Liver Fibrosis Group's index(SLFG),was investigated.RESULTS:The APRI,FIB-4 and Forn's index under receiver operating characteristic curve(AUROC) for sig-nificant fibrosis were 0.71,0.75 and 0.79,respectively,with a diagnosis accuracy of 67%,77% and 80%,respectively,and 0.80,0.87 and 0.86,respectively,under the AUROC for severe fibrosis.The Hepascore,SLFG,and Fibrometer were 0.80,0.83 and 0.85,respectively under the AUROC for significant fibrosis(P < 0.01).The diagnosis accuracy of Hepascore and SLFG was 86% and 88%,respectively.The Hepascore,SLFG,and Fibrometer were 0.95,0.93,and 0.94,respectively,under the AUROC for severe fibrosis(P < 0.01).CONCLUSION:The models containing direct serum markers have a better diagnostic value than those not containing direct serum markers.展开更多
目的了解河南省城乡1~74岁人群乙型肝炎病毒(hepatitis B virus,HBV)血清标志物的流行状况,评价乙型肝炎(hepatitis B)防控效果,为河南省疾病预防控制部门未来制定防治策略提供依据。方法采用多阶段随机抽样方法,在全省随机抽取30个县区...目的了解河南省城乡1~74岁人群乙型肝炎病毒(hepatitis B virus,HBV)血清标志物的流行状况,评价乙型肝炎(hepatitis B)防控效果,为河南省疾病预防控制部门未来制定防治策略提供依据。方法采用多阶段随机抽样方法,在全省随机抽取30个县区中60个居委会/行政村。根据乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)感染率估算预期调查人数为30300人(实际调查人数32077人);采用流行病学调查方法,使用ELISA对HBV血清标志物进行检验;采用EPIdate 3.1软件建立数据库,用SPSS 13.0统计软件进行数据的统计分析。结果全省1~74岁人群HBsAg、HBsAb和HBcAb流行率分别为3.26%、46.56%和21.75%。HBsAg流行率1~4岁最低为0.35%,1~24岁人群流行率随年龄增加,不同年龄组差异有统计学意义(χ^(2)=308.540,P<0.05)。HBsAb流行率不同年龄组差异有统计学意义(χ^(2)=114.887,P<0.05)。HBcAb流行率1~4岁组最低为2.22%,不同年龄组差异有统计学意义(χ^(2)=2993.071,P<0.05)。城市人群HBsAg流行率为2.70%,农村为3.62%,城市低于农村,差异有统计学意义(χ^(2)=22.404,P<0.05);城市人群HBsAb流行率为49.08%,农村为44.98%,城市高于农村,差异有统计学意义(χ^(2)=55.606,P<0.05);城市人群HBcAb流行率为20.21%,农村为23.11%,城市低于农村,差异有统计学意义(χ^(2)=48.248,P<0.05)。男女性别分布,男女HBsAg流行率分别为4.03%、2.64%,男性高于女性,差异有统计学意义(χ^(2)=17.082,P<0.05)。职业情况,农民HBsAg阳性率最高为4.35%,医护人员最低为2.21%。文化程度,小学以下的HBsAg阳性率最高为5.29%,本科及以上学历人员最低为2.04%。结论河南省乙肝防控成就显著,乙肝病毒感染率显著降低,特别是保护了小年龄组人群免受乙肝病毒的危害。保持新生儿乙肝疫苗首针、及时接种率和全程接种率;加大在农村、偏远等重点地区乙肝疫苗接种的防控工作及知识宣传;加强农民、工人等重点人群�展开更多
Alcoholic liver disease(ALD)is the most common liver disease in the Western world.For many reasons,it isunderestimated and underdiagnosed.An early diagnosis is absolutely essential since it(1)helps to identify patient...Alcoholic liver disease(ALD)is the most common liver disease in the Western world.For many reasons,it isunderestimated and underdiagnosed.An early diagnosis is absolutely essential since it(1)helps to identify patients at genetic risk for ALD;(2)can trigger efficient abstinence namely in non-addicted patients;and(3)initiate screening programs to prevent life-threateningcomplications such as bleeding from varices,spontaneous bacterial peritonitis or hepatocellular cancer.The two major end points of ALD are alcoholic liver cirrhosis and the rare and clinically-defined alcoholic hepatitis(AH).The prediction and early diagnosis of both entities is still insufficiently solved and usually relies on acombination of laboratory,clinical and imaging findings.It is not widely conceived that conventional screeningtools for ALD such as ultrasound imaging or routine laboratory testing can easily overlook ca.40%of manifest alcoholic liver cirrhosis.Non-invasive methods such as transient elastography(Fibroscan),acoustic radiation force impulse imaging or shear wave elastography have significantly improved the early diagnosis of alcoholiccirrhosis.Present algorithms allow either the exclusion or the exact definition of advanced fibrosis stages in ca.95%of patients.The correct interpretation of liver stiffness requires a timely abdominal ultrasound and actual transaminase levels.Other non-invasive methods such as controlled attenuation parameter,serum levels of M30 or M65,susceptometry or breath tests are under current evaluation to assess the degree of steatosis,apoptosis and iron overload in these patients.Liver biopsy still remains an important option to rule out comorbidities and to confirm the prognosis namely for patients with AH.展开更多
AIM:To determine whether serum interleukin-18 (IL-18) levels correlated with clinicopathologic features and prognosis in patients with hepatocellular carcinoma (HCC). METHODS:Serum IL-18,IL-6 and IL-12 levels were mea...AIM:To determine whether serum interleukin-18 (IL-18) levels correlated with clinicopathologic features and prognosis in patients with hepatocellular carcinoma (HCC). METHODS:Serum IL-18,IL-6 and IL-12 levels were measured by enzyme-linked immunosorbent assay (ELISA) from 70 patients with HCC and 10 healthy controls. RESULTS:Serum IL-18,IL-6 and IL-12 levels of patients with HCC were significantly higher that those of the controls. The levels of IL-18 correlated significantly with the presence of venous invasion and advanced tumor stages classified by Okuda's criteria. Patients with high serum IL-18 levels (≥ 105 pg/mL) had a poorer survival than those with low serum IL-18 levels (< 105 pg/mL) (4 and 11 mo,respectively,P = 0.015). Multivariate analyses showed that serum IL-18 level,but not IL-6 and IL-12 levels,was a significant and independent prognostic factor of survival. CONCLUSION:These findings demonstrate that serum IL-8 may a useful biological marker of tumor invasiveness and an independent prognostic factor of survival for patients with HCC. Thus,the detailed mechanisms of IL-18 involving in tumor progression should be further investigated.展开更多
基金Supported by Grant for Master Degree Students of Fudan University
文摘AIM:To evaluate the efficacy of 6 noninvasive liver fibrosis models and to identify the most valuable model for the prediction of liver fibrosis stage in chronic hepatitis B(CHB) patients.METHODS:Seventy-eight CHB patients were consecutively enrolled in this study.Liver biopsy was performed and blood serum was obtained at admission.Histological diagnosis was made according to the METAVIR system.Significant fibrosis was defined as stage score ≥ 2,severe fibrosis as stage score ≥ 3.The diagnostic accuracy of 6 noninvasive liver fibrosis models,including serum aspartate aminotransferase(AST) to platelet ratio index(APRI),FIB-4,Forn's index,Fibrometer,Hepascore,and Shanghai Liver Fibrosis Group's index(SLFG),was investigated.RESULTS:The APRI,FIB-4 and Forn's index under receiver operating characteristic curve(AUROC) for sig-nificant fibrosis were 0.71,0.75 and 0.79,respectively,with a diagnosis accuracy of 67%,77% and 80%,respectively,and 0.80,0.87 and 0.86,respectively,under the AUROC for severe fibrosis.The Hepascore,SLFG,and Fibrometer were 0.80,0.83 and 0.85,respectively under the AUROC for significant fibrosis(P < 0.01).The diagnosis accuracy of Hepascore and SLFG was 86% and 88%,respectively.The Hepascore,SLFG,and Fibrometer were 0.95,0.93,and 0.94,respectively,under the AUROC for severe fibrosis(P < 0.01).CONCLUSION:The models containing direct serum markers have a better diagnostic value than those not containing direct serum markers.
文摘目的了解河南省城乡1~74岁人群乙型肝炎病毒(hepatitis B virus,HBV)血清标志物的流行状况,评价乙型肝炎(hepatitis B)防控效果,为河南省疾病预防控制部门未来制定防治策略提供依据。方法采用多阶段随机抽样方法,在全省随机抽取30个县区中60个居委会/行政村。根据乙型肝炎表面抗原(hepatitis B surface antigen,HBsAg)感染率估算预期调查人数为30300人(实际调查人数32077人);采用流行病学调查方法,使用ELISA对HBV血清标志物进行检验;采用EPIdate 3.1软件建立数据库,用SPSS 13.0统计软件进行数据的统计分析。结果全省1~74岁人群HBsAg、HBsAb和HBcAb流行率分别为3.26%、46.56%和21.75%。HBsAg流行率1~4岁最低为0.35%,1~24岁人群流行率随年龄增加,不同年龄组差异有统计学意义(χ^(2)=308.540,P<0.05)。HBsAb流行率不同年龄组差异有统计学意义(χ^(2)=114.887,P<0.05)。HBcAb流行率1~4岁组最低为2.22%,不同年龄组差异有统计学意义(χ^(2)=2993.071,P<0.05)。城市人群HBsAg流行率为2.70%,农村为3.62%,城市低于农村,差异有统计学意义(χ^(2)=22.404,P<0.05);城市人群HBsAb流行率为49.08%,农村为44.98%,城市高于农村,差异有统计学意义(χ^(2)=55.606,P<0.05);城市人群HBcAb流行率为20.21%,农村为23.11%,城市低于农村,差异有统计学意义(χ^(2)=48.248,P<0.05)。男女性别分布,男女HBsAg流行率分别为4.03%、2.64%,男性高于女性,差异有统计学意义(χ^(2)=17.082,P<0.05)。职业情况,农民HBsAg阳性率最高为4.35%,医护人员最低为2.21%。文化程度,小学以下的HBsAg阳性率最高为5.29%,本科及以上学历人员最低为2.04%。结论河南省乙肝防控成就显著,乙肝病毒感染率显著降低,特别是保护了小年龄组人群免受乙肝病毒的危害。保持新生儿乙肝疫苗首针、及时接种率和全程接种率;加大在农村、偏远等重点地区乙肝疫苗接种的防控工作及知识宣传;加强农民、工人等重点人群�
文摘Alcoholic liver disease(ALD)is the most common liver disease in the Western world.For many reasons,it isunderestimated and underdiagnosed.An early diagnosis is absolutely essential since it(1)helps to identify patients at genetic risk for ALD;(2)can trigger efficient abstinence namely in non-addicted patients;and(3)initiate screening programs to prevent life-threateningcomplications such as bleeding from varices,spontaneous bacterial peritonitis or hepatocellular cancer.The two major end points of ALD are alcoholic liver cirrhosis and the rare and clinically-defined alcoholic hepatitis(AH).The prediction and early diagnosis of both entities is still insufficiently solved and usually relies on acombination of laboratory,clinical and imaging findings.It is not widely conceived that conventional screeningtools for ALD such as ultrasound imaging or routine laboratory testing can easily overlook ca.40%of manifest alcoholic liver cirrhosis.Non-invasive methods such as transient elastography(Fibroscan),acoustic radiation force impulse imaging or shear wave elastography have significantly improved the early diagnosis of alcoholiccirrhosis.Present algorithms allow either the exclusion or the exact definition of advanced fibrosis stages in ca.95%of patients.The correct interpretation of liver stiffness requires a timely abdominal ultrasound and actual transaminase levels.Other non-invasive methods such as controlled attenuation parameter,serum levels of M30 or M65,susceptometry or breath tests are under current evaluation to assess the degree of steatosis,apoptosis and iron overload in these patients.Liver biopsy still remains an important option to rule out comorbidities and to confirm the prognosis namely for patients with AH.
基金Supported by the Rajadapiseksompoj research grant,Faculty of Medicine,Chulalongkorn University
文摘AIM:To determine whether serum interleukin-18 (IL-18) levels correlated with clinicopathologic features and prognosis in patients with hepatocellular carcinoma (HCC). METHODS:Serum IL-18,IL-6 and IL-12 levels were measured by enzyme-linked immunosorbent assay (ELISA) from 70 patients with HCC and 10 healthy controls. RESULTS:Serum IL-18,IL-6 and IL-12 levels of patients with HCC were significantly higher that those of the controls. The levels of IL-18 correlated significantly with the presence of venous invasion and advanced tumor stages classified by Okuda's criteria. Patients with high serum IL-18 levels (≥ 105 pg/mL) had a poorer survival than those with low serum IL-18 levels (< 105 pg/mL) (4 and 11 mo,respectively,P = 0.015). Multivariate analyses showed that serum IL-18 level,but not IL-6 and IL-12 levels,was a significant and independent prognostic factor of survival. CONCLUSION:These findings demonstrate that serum IL-8 may a useful biological marker of tumor invasiveness and an independent prognostic factor of survival for patients with HCC. Thus,the detailed mechanisms of IL-18 involving in tumor progression should be further investigated.
