机构：[1]Center of Therapeutic Research for Liver Cancer, Beijing 302 Hospital, Beijing, China[2]Department of Health Statistics, the Fourth Military Medical University, Xi’an, Shanxi Province, China[3]Department of Infectious and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China[4]Department of Infectious Disease, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China[5]Traditional Chinese MedicineHospital of Guangdong Province, Guangdong Province, China广东省中医院[6]Division of Gastroenterology andHepatology, University of California, Irvine, School of Medicine, Orange, California, USA[7]Fuzhou Infectious Diseases Hospital, Fuzhou, Fujian Province, China[8]Liver Disease Department, Fuyang 2nd People’s Hospital, Fuyang, Anhui Province, China[9]Department of Infectious Diseases, Southwest Hospital, the Third Military Medical University, Chongqing, China[10]Therapeutic Center for Liver Disease, the 88th Hospital of PLA, Taian, Shandong Province, China中国人民解放军联勤保障部队第九六〇医院[11]Guangzhou 8th People’s Hospital, Guangzhou, Guangdong Province, China[12]Department of Hepatic Diseases, Shanghai Public Health Clinical Center, Shanghai, China[13]National Integrative Medicine Clinical Base for Infectious Diseases/Department of Infectious Diseases, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China[14]Affiliated Traditional Chinese MedicineHospital of LuzhouMedical University, Luzhou, Sichuan Province, China[15]Traditional Chinese Medicine Hospital of Chongqing, Chongqing, China[16]Tianjin Second People’s Hospital, Tianjin Institute of Hepatology, Tianjin, China[17]Center for Quantitative Biology, Peking University, Beijing, China[18]CHESS, The Fifth Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China[19]Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang, Liaoning Province, China.
Chronic hepatitis B (CHB) can progress into liver fibrosis and cirrhosis with poor outcomes. Early and accurate diagnosis of liver fibrosis/cirrhosis is important to guide the preventive strategy of their related complications.
A Chinese multicenter cross-sectional study was conducted to develop and validate a novel noninvasive program for staging liver fibrosis in untreated patients with CHB. Liver histology was evaluated independently by 2 pathologists. The alanine aminotransferase ratio, Hepascore, and aspartate aminotransferase to platelet index values were calculated. Liver stiffness measurement (LSM) and diameter of the spleen were measured. Logistic regression with ℓ1 penalty of regression coefficients was used to select the optimal predictors. The diagnostic accuracy for the stage of liver fibrosis was assessed by the area under the receiver operator characteristic curve with 95% confidence interval (CI).
A total of 1,200 patients with CHB were included, of whom 800 and 400 were in training and validation sets, respectively. LSM, platelets, age, hyaluronic acid, and diameter of the spleen were the top 5 predictors associated with any stage of liver fibrosis and integrated into a novel noninvasive program, named as the Chin-CHB score. The area under the receiver operator characteristic curve of the Chin-CHB score was 0.893 (95% CI: 0.77-0.92) for diagnosing significant fibrosis, 0.897 (95% CI: 0.85-0.95) for advanced fibrosis, and 0.909 (95% CI: 0.87-0.95) for cirrhosis. The diagnostic performance of the Chin-CHB score was similar between training and validation sets. The Chin-CHB score had better diagnostic performance than aspartate aminotransferase to platelet index, alanine aminotransferase ratio, LSM alone, and Hepascore for diagnosing any stage of liver fibrosis.
The Chin-CHB score had good diagnostic performance for any stage of liver fibrosis.
基金：
This work was supported in part by the grant from
the National Major Science and Technology Special Project of China
(2013ZX10005002)
第一作者机构：[1]Center of Therapeutic Research for Liver Cancer, Beijing 302 Hospital, Beijing, China
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Yan Chen,Yongji Wang,Yongping Chen,et al.A Novel Noninvasive Program for Staging Liver Fibrosis in Untreated Patients With Chronic Hepatitis B.[J].CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY.2019,10:1-12.doi:10.14309/ctg.0000000000000033.
APA：
Yan Chen,Yongji Wang,Yongping Chen,Zujiang Yu,Xiaoling Chi...&Yongping Yang.(2019).A Novel Noninvasive Program for Staging Liver Fibrosis in Untreated Patients With Chronic Hepatitis B..CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY,10,
MLA：
Yan Chen,et al."A Novel Noninvasive Program for Staging Liver Fibrosis in Untreated Patients With Chronic Hepatitis B.".CLINICAL AND TRANSLATIONAL GASTROENTEROLOGY 10.(2019):1-12
