[Effectiveness of FibroTouch combined with four hepatic fibrosis biomarkers for evaluation of the liver fibrosis degree among patients with chronic schistosomiasis-induced liver disorders]

Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2022 Jan 11;33(6):629-633. doi: 10.16250/j.32.1374.2021268.
[Article in Chinese]

Abstract
in English, Chinese

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.

Conclusions: 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.

［摘要］ 目的 评价联合使用 FibroTouch 技术及肝纤维化四项生化指标检测对慢性血吸虫病肝病患者肝纤维化程度的 效果。方法 以 2021 年 1—3 月昆山市第三人民医院收治的 63 例慢性血吸虫病肝病患者作为观察组, 另选择同期在该 院进行健康体检的 50 例健康志愿者作为对照组。用 FibroTouch 技术检测两组研究对象肝脏硬度值 (LSM), 用化学发光 法检测两组研究对象肝纤维化四项生化指标。绘制 LSM、肝纤维化四项指标单独及联合应用诊断慢性血吸虫病肝病患 者肝纤维化程度的受试者工作特征 (ROC) 曲线, 计算曲线下面积 (AUC), 评价单独及联合使用两种方法诊断肝纤维化程 度的价值。结果 观察组共 63 例患者, 其中男性 28 例、女性 35 例, 平均年龄 (65.34 ± 12.56) 岁, 平均体质指数 (24.47 ± 11.05) kg/m2; 对照组共 50 例, 其中男性 22 例、女性 28 例, 平均年龄 (64.28 ±13.10) 岁, 平均体质指数 (25.12±11.64) kg/m2。两组研究对象性别构成比 (χ2 = 0.002, P>0.05)、年龄 (t = 0.437, P>0.05)、体质指数 (t = 0.303, P>0.05) 差异均无统计学 意义。观察组和对照组患者 LSM ([8.65 ± 5.22) vs. (3.24 ± 1.10) kPa; t = 8.013, P < 0.05]、IV 型胶原 (IV-C) ([51.80 ± 9.45) vs. (30.10 ± 10.34) ng/L; t = 11.506, P < 0.05]、III 型前胶原 (PC-III) ([77.28 ± 17.22) vs (48.62 ± 9.54) ng/L; t = 11.224, P < 0.05]、透明质酸酶 (HA) ([39.55 ± 5.32) vs. (84.89 ± 10.34) ng/L; t = 30.158, P < 0.05] 和层黏连蛋白 (LN) ([99.47 ± 7.37) vs. (61.93 ± 9.80) ng/L; t = 22.496, P < 0.05] 水平差异均有统计学意义, 前者均高于后者。Spearman 相关 分析显示, 慢性血吸虫病肝病患者肝纤维化程度与LSM、IV-C、PC-III、HA、LN 水平均呈正相关 (rs = 0.675、0.421、0.517、0.550、0.539, P 均 < 0.01)。ROC 曲线分析显示, LSM 预测慢性血吸虫病肝病肝纤维化程度的AUC值为 0.864 (P < 0.001), 当约登指数最大时, LSM 截断值为 11.75 kPa, 灵敏度为 71.43%, 特异度为 84.00%; 肝纤维化四项指标预测慢性血吸虫病 肝病肝纤维化程度的 AUC 值为 0.577~0.670, 截断值为 70.174~115.237 ng/L, 灵敏度为 17.46%~68.25%, 特异度为 71.01%~96.00%; 两者联合应用诊断慢性血吸虫病肝病肝纤维化程度的灵敏度为 92.06%, 特异度为 95.07%。结论 联 合应用 FibroTouch 和肝纤维化四项指标检测诊断慢性血吸虫病肝纤维化灵敏度、特异度高, 值得临床推广应用。.

Keywords: Chronic schistosomiasis; Diagnostic efficiency; FibroTouch; Hyaluronidase; Laminin; Liver fibrosis; Type III procollagen; Type IV collagen.

MeSH terms

  • Aged
  • Biomarkers
  • Case-Control Studies
  • Female
  • Humans
  • Liver / diagnostic imaging
  • Liver / pathology
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / pathology
  • Male
  • Middle Aged
  • ROC Curve
  • Schistosomiasis* / complications
  • Schistosomiasis* / diagnosis
  • Schistosomiasis* / pathology

Substances

  • Biomarkers