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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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Area under the curve (AUC) of the fibrosis-based activity score (F-score), Mohamadnejad et al. score (M-score), and LSM-based activity score (L-score) in differentiating significant inflammation.(A) AUC of the F-Score and M-Score for the HBeAg(+) patients in the training set; (B) AUC of the F-Score and M-Score in the HBeAg(−) patients in the training set; (C) AUC of the F-Score, M-Score, and L-Score in the HBeAg(+) patients in the validation set; (D) AUC of the F-Score, M-Score, and L-Score in the HBeAg(−) patients in the validation set.
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pone-0111641-g002: Area under the curve (AUC) of the fibrosis-based activity score (F-score), Mohamadnejad et al. score (M-score), and LSM-based activity score (L-score) in differentiating significant inflammation.(A) AUC of the F-Score and M-Score for the HBeAg(+) patients in the training set; (B) AUC of the F-Score and M-Score in the HBeAg(−) patients in the training set; (C) AUC of the F-Score, M-Score, and L-Score in the HBeAg(+) patients in the validation set; (D) AUC of the F-Score, M-Score, and L-Score in the HBeAg(−) patients in the validation set.

Mentions: A fibrosis-based prediction score was constructed according to its relative contribution, as determined by: 1/(1-AUC) (Table 3). For convenience, the factor with the lowest score was set as 10 whereas other factors were rounded to the nearest integers by calibrating their 1/(1-AUC) with the variable with the lowest 1/(1-AUC), respectively. The calculation of fibrosis-based score was shown in Table S4. Final score of each patient was the cumulative score of the respective score of enrolled independent variable in this patient. This new fibrosis-based activity score ranged from −70 to 70 in the HBeAg(+) patients, and from −93 to 93 in the HBeAg(−) patients. The AUC was 0.964 (95% confidence interval (CI), 0.940–0.987; p<0.0001; Fig. 2A) in HBeAg(+) patients and 0.971 (95% CI, 0.937–1.000; p<0.0001; Fig. 2B) in HBeAg(−) patients.


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 fibrosis-based activity score (F-score), Mohamadnejad et al. score (M-score), and LSM-based activity score (L-score) in differentiating significant inflammation.(A) AUC of the F-Score and M-Score for the HBeAg(+) patients in the training set; (B) AUC of the F-Score and M-Score in the HBeAg(−) patients in the training set; (C) AUC of the F-Score, M-Score, and L-Score in the HBeAg(+) patients in the validation set; (D) AUC of the F-Score, M-Score, and L-Score in the HBeAg(−) patients in the validation set.
© Copyright Policy
Related In: Results  -  Collection

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

pone-0111641-g002: Area under the curve (AUC) of the fibrosis-based activity score (F-score), Mohamadnejad et al. score (M-score), and LSM-based activity score (L-score) in differentiating significant inflammation.(A) AUC of the F-Score and M-Score for the HBeAg(+) patients in the training set; (B) AUC of the F-Score and M-Score in the HBeAg(−) patients in the training set; (C) AUC of the F-Score, M-Score, and L-Score in the HBeAg(+) patients in the validation set; (D) AUC of the F-Score, M-Score, and L-Score in the HBeAg(−) patients in the validation set.
Mentions: A fibrosis-based prediction score was constructed according to its relative contribution, as determined by: 1/(1-AUC) (Table 3). For convenience, the factor with the lowest score was set as 10 whereas other factors were rounded to the nearest integers by calibrating their 1/(1-AUC) with the variable with the lowest 1/(1-AUC), respectively. The calculation of fibrosis-based score was shown in Table S4. Final score of each patient was the cumulative score of the respective score of enrolled independent variable in this patient. This new fibrosis-based activity score ranged from −70 to 70 in the HBeAg(+) patients, and from −93 to 93 in the HBeAg(−) patients. The AUC was 0.964 (95% confidence interval (CI), 0.940–0.987; p<0.0001; Fig. 2A) in HBeAg(+) patients and 0.971 (95% CI, 0.937–1.000; p<0.0001; Fig. 2B) in HBeAg(−) patients.

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