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Liver stiffness measurement-based scoring system for significant inflammation related to chronic hepatitis B.

Hong MZ, Zhang RM, Chen GL, Huang WQ, Min F, Chen T, Xu JC, Pan JS - PLoS ONE (2014)

Bottom Line: An inflammation activity scoring system for significant inflammation was constructed.In the validation set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.971, 90.5%, and 92.5% in the HBeAg(+) patients and 0.977, 95.2%, and 95.8% in the HBeAg(-) patients.Significant inflammation can be accurately predicted by this novel method.

View Article: PubMed Central - PubMed

Affiliation: Department of Infectious Diseases, Chenggong Hospital affiliated to Xiamen University (the 174th Hospital of PLA), Xiamen, Fujian, China.

ABSTRACT

Objectives: Liver biopsy is indispensable because liver stiffness measurement alone cannot provide information on intrahepatic inflammation. However, the presence of fibrosis highly correlates with inflammation. We constructed a noninvasive model to determine significant inflammation in chronic hepatitis B patients by using liver stiffness measurement and serum markers.

Methods: The training set included chronic hepatitis B patients (n = 327), and the validation set included 106 patients; liver biopsies were performed, liver histology was scored, and serum markers were investigated. All patients underwent liver stiffness measurement.

Results: An inflammation activity scoring system for significant inflammation was constructed. In the training set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.964, 91.9%, and 90.8% in the HBeAg(+) patients and 0.978, 85.0%, and 94.0% in the HBeAg(-) patients, respectively. In the validation set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.971, 90.5%, and 92.5% in the HBeAg(+) patients and 0.977, 95.2%, and 95.8% in the HBeAg(-) patients. The liver stiffness measurement-based activity score was comparable to that of the fibrosis-based activity score in both HBeAg(+) and HBeAg(-) patients for recognizing significant inflammation (G ≥3).

Conclusions: Significant inflammation can be accurately predicted by this novel method. The liver stiffness measurement-based scoring system can be used without the aid of computers and provides a noninvasive alternative for the prediction of chronic hepatitis B-related significant inflammation.

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Related in: MedlinePlus

Area under the curve (AUC) of the enrolled variables in differentiating significant inflammation in the training set.(A) AUC of γ-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and fibrosis (S) in the HBeAg(+) patients; (B) AUC of albumin (ALB), cholinesterase (CHE), and pre-albumin (Pre-ALB) in the HBeAg(+) patients; (C) AUC of GGT, ALT, AST, and fibrosis (S) in the HBeAg(−) patients; (D) AUC of ALB, CHE, and Pre-ALB in the HBeAg(−) patients.
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pone-0111641-g001: Area under the curve (AUC) of the enrolled variables in differentiating significant inflammation in the training set.(A) AUC of γ-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and fibrosis (S) in the HBeAg(+) patients; (B) AUC of albumin (ALB), cholinesterase (CHE), and pre-albumin (Pre-ALB) in the HBeAg(+) patients; (C) AUC of GGT, ALT, AST, and fibrosis (S) in the HBeAg(−) patients; (D) AUC of ALB, CHE, and Pre-ALB in the HBeAg(−) patients.

Mentions: We performed AUC analysis to indicate the efficacy of the associated factors on the prediction of significant inflammation. As shown in Table 2, both in the HBeAg(+) and HBeAg(−) patients, the stage of fibrosis had the greatest AUC. Contributions of other associated factors were shown in Table 2 and Fig. 1A∼1D. The ranking of associated factors listed by AUC from highest to lowest was in accordance to the sequence of associated factors listed by Gini index (Table S3). By performing AUC analysis, we also confirmed the optimal cut-off value of each associated factor (Table 2). The prediction performance of each cut-off value was also calculated (Table 2).


Liver stiffness measurement-based scoring system for significant inflammation related to chronic hepatitis B.

Hong MZ, Zhang RM, Chen GL, Huang WQ, Min F, Chen T, Xu JC, Pan JS - PLoS ONE (2014)

Area under the curve (AUC) of the enrolled variables in differentiating significant inflammation in the training set.(A) AUC of γ-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and fibrosis (S) in the HBeAg(+) patients; (B) AUC of albumin (ALB), cholinesterase (CHE), and pre-albumin (Pre-ALB) in the HBeAg(+) patients; (C) AUC of GGT, ALT, AST, and fibrosis (S) in the HBeAg(−) patients; (D) AUC of ALB, CHE, and Pre-ALB in the HBeAg(−) patients.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4216134&req=5

pone-0111641-g001: Area under the curve (AUC) of the enrolled variables in differentiating significant inflammation in the training set.(A) AUC of γ-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and fibrosis (S) in the HBeAg(+) patients; (B) AUC of albumin (ALB), cholinesterase (CHE), and pre-albumin (Pre-ALB) in the HBeAg(+) patients; (C) AUC of GGT, ALT, AST, and fibrosis (S) in the HBeAg(−) patients; (D) AUC of ALB, CHE, and Pre-ALB in the HBeAg(−) patients.
Mentions: We performed AUC analysis to indicate the efficacy of the associated factors on the prediction of significant inflammation. As shown in Table 2, both in the HBeAg(+) and HBeAg(−) patients, the stage of fibrosis had the greatest AUC. Contributions of other associated factors were shown in Table 2 and Fig. 1A∼1D. The ranking of associated factors listed by AUC from highest to lowest was in accordance to the sequence of associated factors listed by Gini index (Table S3). By performing AUC analysis, we also confirmed the optimal cut-off value of each associated factor (Table 2). The prediction performance of each cut-off value was also calculated (Table 2).

Bottom Line: An inflammation activity scoring system for significant inflammation was constructed.In the validation set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.971, 90.5%, and 92.5% in the HBeAg(+) patients and 0.977, 95.2%, and 95.8% in the HBeAg(-) patients.Significant inflammation can be accurately predicted by this novel method.

View Article: PubMed Central - PubMed

Affiliation: Department of Infectious Diseases, Chenggong Hospital affiliated to Xiamen University (the 174th Hospital of PLA), Xiamen, Fujian, China.

ABSTRACT

Objectives: Liver biopsy is indispensable because liver stiffness measurement alone cannot provide information on intrahepatic inflammation. However, the presence of fibrosis highly correlates with inflammation. We constructed a noninvasive model to determine significant inflammation in chronic hepatitis B patients by using liver stiffness measurement and serum markers.

Methods: The training set included chronic hepatitis B patients (n = 327), and the validation set included 106 patients; liver biopsies were performed, liver histology was scored, and serum markers were investigated. All patients underwent liver stiffness measurement.

Results: An inflammation activity scoring system for significant inflammation was constructed. In the training set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.964, 91.9%, and 90.8% in the HBeAg(+) patients and 0.978, 85.0%, and 94.0% in the HBeAg(-) patients, respectively. In the validation set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.971, 90.5%, and 92.5% in the HBeAg(+) patients and 0.977, 95.2%, and 95.8% in the HBeAg(-) patients. The liver stiffness measurement-based activity score was comparable to that of the fibrosis-based activity score in both HBeAg(+) and HBeAg(-) patients for recognizing significant inflammation (G ≥3).

Conclusions: Significant inflammation can be accurately predicted by this novel method. The liver stiffness measurement-based scoring system can be used without the aid of computers and provides a noninvasive alternative for the prediction of chronic hepatitis B-related significant inflammation.

Show MeSH
Related in: MedlinePlus