ABSTRACT
Objective To evaluate the performance of FibroTouch in combination with four hepatic fibrosis biomarkers for assessment of the degree of hepatic fibrosis among patients with chronic schistosomiasis-induced liver disorders. Methods A total of 63 patients with chronic schistosomiasis-induced liver diseases admitted to The Third People’s Hospital of Kunshan City from January to March 2021 were enrolled as the observation group, while 50 healthy volunteers receiving health examinations in the hospital during the study period were randomly selected as the control group. The liver stiffness measurement (LSM) was determined using the FibroTouch technique, and the serum levels of four hepatic fibrosis biomarkers were detected using chemilumi-nescence immunoassay, including type IV collagen (IV-C), type III procollagen (PC-III), hyaluronidase (HA) and laminin (LN). The receiver operating characteristic (ROC) curves of LSM and four hepatic fibrosis biomarkers alone and in combination for assessing the degree of hepatic fibrosis among patients with chronic schistosomiasis-induced liver disorders were plotted and the area under the ROC curve (AUC) was estimated to examine the value of LSM and four hepatic fibrosis biomarkers alone and in combination for assessing the degree of hepatic fibrosis. Results There were 63 subjects in the observation group, including 28 men and 35 women, and the participants had a mean age of (65.34 ± 12.56) years and a mean body mass index (BMI) of (24.47 ± 11.05) kg/m2. There were 50 subjects in the control group, including 22 men and 28 women, and the participants had a mean age of (64.28 ± 13.10) years and a mean BMI of (25.12 ± 11.64) kg/m2. There were no significant differences between the observation and control groups in terms of gender ratio (χ2 = 0.002, P > 0.05), age (t = 0.437, P > 0.05) or BMI (t = 0.303, P > 0.05). The LSM [(8.65 ± 5.22) vs. (3.24 ± 1.10) kPa; t = 8.013, P < 0.05], IV-C [(51.80 ± 9.45) vs. (30.10 ± 10.34) ng/L; t = 11.506, P < 0.05], PC-III [(77.28 ± 17.22) vs. (48.62 ± 9.54) ng/L; t = 11.224, P < 0.05], HA [(39.55 ± 5.32) vs. (84.89 ± 10.34) ng/L; t = 30.158, P < 0.05] and LN [(99.47 ± 7.37) vs. (61.93 ± 9.80) ng/L; t = 22.496, P < 0.05] were significantly greater in the observation group than in the control group, and Spearman correlation analysis showed that the degree of liver fibrosis positively correlated with LSM (rs = 0.675, P < 0.01), IV-C (rs = 0.421, P < 0.01), PC-III (rs = 0.517, P < 0.01), HA (rs = 0.550, P < 0.01) and LN (rs = 0.539, P < 0.01) among patients with chronic schistosomiasis-induced liver diseases. ROC curve analysis revealed that the AUC of LSM for assessment of the hepatic fibrosis degree was 0.884 (P < 0.001), and the LSM cutoff, sensitivity and specificity were 11.75 kPa, 71.43% and 84.00% at the highest Youden index, respectively. In addition, the AUC of four hepatic fibrosis biomarkers for assessment of the hepatic fibrosis degree was 0.577 to 0.670, with 70.174 to 115.237 ng/L cutoff values, 17.46% to 68.25% sensitivity and 71.01% to 96.00% specificity. In addition, the sensitivity and specificity of LSM combined with four hepatic fibrosis biomarkers were 92.06% and 95.07% for assessment of the hepatic fibrosis degree among patients with chronic schistosomiasis-induced liver diseases. Conclusion FibroTouch in combination with detection of four hepatic fibrosis biomarkers has a high sensitivity and specificity for assessing the degree of hepatic fibrosis among patients with chronic schistosomiasis-induced liver diseases, which deserves widespread clinical uses.
ABSTRACT
ObjectiveTo investigate the stability of FibroTouch (FT) in the determination of liver stiffness measurement (LSM) and controlled attenuation parameter (CAP). MethodsA total of 309 patients with chronic hepatitis B virus (HBV) infection, nonalcoholic fatty liver disease (NAFLD), liver function abnormalities, or other diseases who underwent FT in the outpatient service of Department of Hepatology, The Second Affiliated Hospital of Anhui Medical University, were enrolled. FT was performed at three different measurement points for the same subject, and intraclass correlation coefficient (ICC) and the Bland-Altman method were used to evaluate the stability of measured values. The Kendall’s W test and pie charts were used to evaluate the stability of diagnostic results. ResultsLSM and CAP values of the three different measurement points for the same subject had an ICC of ＞0.75 in different disease groups (all P＜0.001), among which the chronic HBV infection group had the highest ICC of LSM of 0.905, the other disease group had the highest ICC of CAP of 0.805, the NAFLD group had the lowest ICC of LSM of 0.785 and the lowest ICC of CAP of 0.780. The Bland-Altman plots were generated for the three measurement points, and the dots within the limits of agreement accounted for about 95%. The diagnostic results of LSM and CAP staging of the three measurement points had a Kendall’s W coefficient of 0.825 and 0.858, respectively (all P＜0.001). The proportion of patients with consistency between the diagnostic results for F≥2 stage (LSM＞7.3 kPa) and mild (or more severe) fatty liver stage (CAP＞240 dB/m) based on mean value of measurement points and all three measurement points was ＞60%, while the proportion of patients with consistency between the diagnostic results based on mean value of measurement points and only one measurement point was ＜10%. ConclusionThe values and diagnostic results of FT measurement have good stability; however, in order to improve its stability in diagnosing F ≥2 stage and mild (or more severe) fatty liver, it is suggested to use the mean value of multiple measurement points for diagnosis.
ABSTRACT
ObjectiveTo investigate the changes in positive staining of CD34, CK7, and CK19 and amount of fibrous collagen deposition in patients with chronic hepatitis B (CHB) and the pathological basis affecting FibroTouch measurements. MethodsA retrospective analysis was performed for the clinical data of 72 CHB patients who visited Department of Liver Cirrhosis in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2015 to December 2017. The amount of positive immunohistochemical staining of CD34, CK7, and CK19 was calculated, as well as the amount of fibrous collagen deposition in Masson trichrome staining and liver stiffness measurement (LSM) by FibroTouch. The t-test was used for comparison of normally distributed continuous data between two groups. The Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data or continuous data with heterogeneity of variance between two groups. The chi-square test was used for comparison of categorical data between groups, and the Kruskal-Wallis H test was used for comparison of ranked data between multiple groups. The receiver operating characteristic (ROC) curve was used to analyze the value of LSM in the diagnosis of hepatitis B cirrhosis, and the logistic regression model was used for multivariate analysis. ResultsWith the increase in inflammation degree, there was no significant change in the amount of positive staining of CD34 (P＞0.05), while there were significant increases in the amount of positive staining of CK19 and the amount of fibrous collagen deposition (H=9.02 and 14.12, P=0011 and 0.001). With the progression of liver fibrosis, there were significant increases in the amount of positive staining of CD34 and CK7 and the amount of fibrous collagen deposition (H=10.26, 16.29, and 22.97, P=0.016, 0.001, and ＜0.001). The logistic regression analysis showed that the amount of positive staining of CK7 (Wald=4.756, P=0.029) and the amount of fibrous collagen deposition (Wald=4.757, P=0.029) were independent influencing factors for FibroTouch measurements. ConclusionIncreases in the amount of fibrous collagen deposition and the amount of positive staining of CK7 may lead to increased FibroTouch measurements.
ABSTRACT
Objective@#To explore the diagnostic values of FibroTouch and FibroScan for liver fibrosis in patients with chronic hepatitis B(CHB).@*Methods@#This study enrolled patients with CHB who was accepted liver biopsy at Beijing Friendship Hospital, Capital Medical University between March 2014 to December 2017. FibroTouch and FibroScan were performed among these patients at same time. Liver stiffness measurement(LSM), optimal cut-off value, receiver operating characteristic(ROC) were compared.@*Results@#In our 103 patients, there were no significantly different between FibroTouch and FibroScan in LSM. The threshold of the optimal cut-off value for FibroTouch and FibroScan were 5.45 versus 5.55 kPa (≥S1), 7.10 versus 6.65 kPa (≥S2), 11.05 versus 9.20 kPa (≥S3), 15.50 versus 15.45 kPa (S4), respectively. The area under the ROC curve for the prediction of the stage1, stage2, stage2, stage 4 of liver fibrosis in these patients were 0.858 versus 0.765 (P=0.54), 0.812 versus 0.801 (P=0.68), 0.863 versus 0.878 (P=0.45), and 1.0 versus 0.99 (P=0.38) respectively.@*Conclusions@#FibroTouch and FibmScan have a good consistency in the evaluation of the degree of liver fibrosis in patients with CHB.
ABSTRACT
Objective To evaluate the clinical application value of instantaneous elastic ultrasonic imaging (FibroTouch) and multiparameter model in the liver fibrosis diagnosis of the patients with chronic liver disease ,and to determine the best diagnostic cutoff point value of liver fibrosis stage diagnosed by FibroTouch .Methods Forty-eight cases of chronic liver disease conducted the liver tissue biopsy .The serological indexes of blood routine and liver function were collected .At the same time the liver stiffness measurement (LSM) was performed by using FibroTouch .The correlation between LSM and liver fibrosis was analyzed .The diag-nostic efficiencies were compared between cutoff value with APRI ,FIB-4 and FibroIndex multiparameter model .Results The liver puncture pathological results served as the gold standard .The Spearman rank correlation analysis showed that LSM ,APRI ,FIB-4 and FibroIndex multiparameter model were correlated with liver fibrosis (P<0 .05) .In the receiver operating characteristic (ROC) curve analysis ,the cutoff values of stage F1~F4 were in turn 6 .6 ,7 .7 ,10 .5 and 15 kpa respectively .The diagnostic value for diag-nosing whether having obvious fibrosis and liver cirrhosis was superior to APRI ,FIB-4 and FibroIndex multiparameter model .Con-clusion FibroTouch has a higher clinical application value in assessing liver fibrosis degree in the patients with chronic liver disease .