Application of the combined FibroMeter VCTE algorithm in Chinese patients with nonalcoholic fatty liver disease
Publication in refereed journal

替代計量分析
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其它資訊
摘要Background and Aim

The FibroMeter vibration-controlled transient elastography (FM VCTE) is a new formula combining the serum test FM and liver stiffness measurement (LSM) by VCTE. We tested the accuracy and utility of FM VCTE for fibrosis staging in patients with non-alcoholic fatty liver disease (NAFLD).

Methods

Two hundred fifteen NAFLD patients with LSM, FM NAFLD, FM VCTE, and other serum tests (aspartate aminotransferase-to-platelet ratio index, fibrosis-4 index, BARD score, NAFLD fibrosis score, and aspartate aminotransferase-to-alanine aminotransferase ratio) performed 1 day before liver biopsy were evaluated.

Results

Sixty-nine (32.1%) and 43 (20.0%) patients had F2-4 and F3-4, respectively. LSM had higher diagnostic accuracy (area under receiver-operating characteristics curves [AUROC] 0.851 for F2-4, 0.940 for F3-4; Obuchowski index 0.937 ± 0.007) than all evaluated serum tests, while FM NAFLD was the most accurate serum test (AUROC 0.775 and 0.774; Obuchowski index 0.891 ± 0.013). FM VCTE had similar accuracy to LSM (AUROC 0.855 and 0.901; Obuchowski index 0.927 ± 0.009). LSM had excellent negative predictive values of 92.4% and 99.2% to exclude F2-4 and F3-4, but the positive predictive values (PPV) were only 71.4% and 61.0%, respectively. In patients with high LSM, the use of FM VCTE improved the PPV from 71.4% to 84.4% for F2-4 and from 61.0% to 88.9% for F3-4. Liver biopsy could be spared in around 50–65% of patients.

Conclusions

Liver stiffness measurement alone can confidently exclude significant and advanced fibrosis in NAFLD patients. Using FM VCTE in patients with high liver stiffness can increase the positive predictive value to rule in F2-4 and F3-4.
著者Thomson Chi-Wang Loong, Jeremy Lok Wei, Jonathan Chung-Fai Leung, Grace Lai-Hung Wong, Sally She-Ting Shu,
Angel Mei-Ling Chim, Anthony Wing-Hung Chan, Paul Cheung-Lung Choi, Yee-Kit Tse, Henry Lik-Yuen Chan, Vincent Wai-Sun Wong
期刊名稱Journal of Gastroenterology and Hepatology
出版年份2017
月份7
卷號32
期次7
出版社Wiley
頁次1363 - 1369
國際標準期刊號0815-9319
語言英式英語

上次更新時間 2020-11-08 於 02:56