Cargando…
A Novel Noninvasive Program for Staging Liver Fibrosis in Untreated Patients With Chronic Hepatitis B
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. METHODS: A Chinese multicenter cross-sectional study was conducted to de...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602766/ https://www.ncbi.nlm.nih.gov/pubmed/31033506 http://dx.doi.org/10.14309/ctg.0000000000000033 |
_version_ | 1783431403277385728 |
---|---|
author | Chen, Yan Wang, Yongji Chen, Yongping Yu, Zujiang Chi, Xiaoling Hu, Ke-Qin Li, Qin Tan, Lin Xiang, Dedong Shang, Qinghua Lei, Chunliang Chen, Liang Hu, Xiaoyu Wang, Jing Liu, Huabao Lu, Wei Chi, Weilai Dong, Zheng Wang, Xiaodong Li, Zhiqin Xiao, Huanming Chen, Da Bai, Wenlin Zhang, Changjiang Xiao, Guangming Qi, Xun Chen, Jing Zhou, Li Sun, Huiwei Deng, Minghua Qi, Xiaolong Zhang, Zheng Qi, Xingshun Yang, Yongping |
author_facet | Chen, Yan Wang, Yongji Chen, Yongping Yu, Zujiang Chi, Xiaoling Hu, Ke-Qin Li, Qin Tan, Lin Xiang, Dedong Shang, Qinghua Lei, Chunliang Chen, Liang Hu, Xiaoyu Wang, Jing Liu, Huabao Lu, Wei Chi, Weilai Dong, Zheng Wang, Xiaodong Li, Zhiqin Xiao, Huanming Chen, Da Bai, Wenlin Zhang, Changjiang Xiao, Guangming Qi, Xun Chen, Jing Zhou, Li Sun, Huiwei Deng, Minghua Qi, Xiaolong Zhang, Zheng Qi, Xingshun Yang, Yongping |
author_sort | Chen, Yan |
collection | PubMed |
description | 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. METHODS: 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 ℓ(1) 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). RESULTS: 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. CONCLUSIONS: The Chin-CHB score had good diagnostic performance for any stage of liver fibrosis. |
format | Online Article Text |
id | pubmed-6602766 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer |
record_format | MEDLINE/PubMed |
spelling | pubmed-66027662019-09-11 A Novel Noninvasive Program for Staging Liver Fibrosis in Untreated Patients With Chronic Hepatitis B Chen, Yan Wang, Yongji Chen, Yongping Yu, Zujiang Chi, Xiaoling Hu, Ke-Qin Li, Qin Tan, Lin Xiang, Dedong Shang, Qinghua Lei, Chunliang Chen, Liang Hu, Xiaoyu Wang, Jing Liu, Huabao Lu, Wei Chi, Weilai Dong, Zheng Wang, Xiaodong Li, Zhiqin Xiao, Huanming Chen, Da Bai, Wenlin Zhang, Changjiang Xiao, Guangming Qi, Xun Chen, Jing Zhou, Li Sun, Huiwei Deng, Minghua Qi, Xiaolong Zhang, Zheng Qi, Xingshun Yang, Yongping Clin Transl Gastroenterol Article 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. METHODS: 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 ℓ(1) 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). RESULTS: 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. CONCLUSIONS: The Chin-CHB score had good diagnostic performance for any stage of liver fibrosis. Wolters Kluwer 2019-04-25 /pmc/articles/PMC6602766/ /pubmed/31033506 http://dx.doi.org/10.14309/ctg.0000000000000033 Text en © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Article Chen, Yan Wang, Yongji Chen, Yongping Yu, Zujiang Chi, Xiaoling Hu, Ke-Qin Li, Qin Tan, Lin Xiang, Dedong Shang, Qinghua Lei, Chunliang Chen, Liang Hu, Xiaoyu Wang, Jing Liu, Huabao Lu, Wei Chi, Weilai Dong, Zheng Wang, Xiaodong Li, Zhiqin Xiao, Huanming Chen, Da Bai, Wenlin Zhang, Changjiang Xiao, Guangming Qi, Xun Chen, Jing Zhou, Li Sun, Huiwei Deng, Minghua Qi, Xiaolong Zhang, Zheng Qi, Xingshun Yang, Yongping A Novel Noninvasive Program for Staging Liver Fibrosis in Untreated Patients With Chronic Hepatitis B |
title | A Novel Noninvasive Program for Staging Liver Fibrosis in Untreated Patients With Chronic Hepatitis B |
title_full | A Novel Noninvasive Program for Staging Liver Fibrosis in Untreated Patients With Chronic Hepatitis B |
title_fullStr | A Novel Noninvasive Program for Staging Liver Fibrosis in Untreated Patients With Chronic Hepatitis B |
title_full_unstemmed | A Novel Noninvasive Program for Staging Liver Fibrosis in Untreated Patients With Chronic Hepatitis B |
title_short | A Novel Noninvasive Program for Staging Liver Fibrosis in Untreated Patients With Chronic Hepatitis B |
title_sort | novel noninvasive program for staging liver fibrosis in untreated patients with chronic hepatitis b |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6602766/ https://www.ncbi.nlm.nih.gov/pubmed/31033506 http://dx.doi.org/10.14309/ctg.0000000000000033 |
work_keys_str_mv | AT chenyan anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT wangyongji anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chenyongping anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT yuzujiang anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chixiaoling anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT hukeqin anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT liqin anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT tanlin anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT xiangdedong anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT shangqinghua anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT leichunliang anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chenliang anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT huxiaoyu anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT wangjing anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT liuhuabao anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT luwei anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chiweilai anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT dongzheng anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT wangxiaodong anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT lizhiqin anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT xiaohuanming anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chenda anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT baiwenlin anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT zhangchangjiang anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT xiaoguangming anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT qixun anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chenjing anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT zhouli anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT sunhuiwei anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT dengminghua anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT qixiaolong anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT zhangzheng anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT qixingshun anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT yangyongping anovelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chenyan novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT wangyongji novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chenyongping novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT yuzujiang novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chixiaoling novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT hukeqin novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT liqin novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT tanlin novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT xiangdedong novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT shangqinghua novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT leichunliang novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chenliang novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT huxiaoyu novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT wangjing novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT liuhuabao novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT luwei novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chiweilai novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT dongzheng novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT wangxiaodong novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT lizhiqin novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT xiaohuanming novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chenda novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT baiwenlin novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT zhangchangjiang novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT xiaoguangming novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT qixun novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT chenjing novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT zhouli novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT sunhuiwei novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT dengminghua novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT qixiaolong novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT zhangzheng novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT qixingshun novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb AT yangyongping novelnoninvasiveprogramforstagingliverfibrosisinuntreatedpatientswithchronichepatitisb |