CAJ | 학술논문

目的探讨 FibroScan 对于原发性胆汁性肝硬化（primary biliary cirrhosis，PBC）肝纤维化诊断的准确性。方法选择2009年10月-2013年12月经肝脏穿刺病理诊断的 PBC 患者56例，进行 FibroScan 检测得到肝脏硬度测量（liver stiffness measurement，LSM）值。以肝脏活组织检查结果作为“金标准”，计算受试者工作特征曲线下面积（AUROC），评价 FibroScan 对 PBC 肝纤维化的诊断价值。结果LSM 值平均为（13．714±7．475）kPa，与肝脏病理分期呈正相关，Kendall 相关系数为0．897，P ＜0．01。FibroScan 诊断 PBC 肝纤维化≥S2期、≥S3期、S4期的 AUROC 分别为0．897、0．959、0．989。纤维化分期为≥F2、≥F3、F4时对应的最佳截断值分别为12．9、16．1和19．7 kPa。肝硬度、血清透明质酸、AST/PLT（APRI）均为肝脏病理分期独立相关因素。结论FibroScan 是一项方便、准确的用于诊断PBC 肝纤维化程度的方法。
목적탐토 FibroScan 대우원발성담즙성간경화（primary biliary cirrhosis，PBC）간섬유화진단적준학성。방법선택2009년10월-2013년12월경간장천자병리진단적 PBC 환자56례，진행 FibroScan 검측득도간장경도측량（liver stiffness measurement，LSM）치。이간장활조직검사결과작위“금표준”，계산수시자공작특정곡선하면적（AUROC），평개 FibroScan 대 PBC 간섬유화적진단개치。결과LSM 치평균위（13．714±7．475）kPa，여간장병리분기정정상관，Kendall 상관계수위0．897，P ＜0．01。FibroScan 진단 PBC 간섬유화≥S2기、≥S3기、S4기적 AUROC 분별위0．897、0．959、0．989。섬유화분기위≥F2、≥F3、F4시대응적최가절단치분별위12．9、16．1화19．7 kPa。간경도、혈청투명질산、AST/PLT（APRI）균위간장병리분기독립상관인소。결론FibroScan 시일항방편、준학적용우진단PBC 간섬유화정도적방법。
Objective To assess the diagnostic veracity of liver stiffness measurement (LSM)for liver fibrosis stage in primary biliary cirrhosis (PBC).Methods Fifty-six patients with PBC,who were diagnosed definitely,were prospectively enrolled in this study from Oct.2009 to Dec.2013.All patients underwent liver biopsy (LB)and LSM. The values of LSM were obtained by Fibroscan.Fibrosis stages were assessed based on liver biopsy (LB)by two experienced pathologists.With liver biopsy as gold standard,receiver operating characteristic (ROC)curves were drawn, and then areas under the receiver operating characteristic curves (AUROC)were calculated to evaluate diagnostic accuracy of transient elastography for liver fibrosis in patients with PBC.Results Stiffness values of the patients enrolled were (13.714±7.475)kPa.Liver stiffness was positively correlated with liver fibrosis stage with a Kendall′s coefficient of 0.897 (P <0.001).Using FibroScan for the assessment of liver fibrosis in patients with PBC,AUROC was 0.959 for the patients with ≥F2,0.989 for those with ≥F3 and 0.993 for those with F4.Optimal stiffness cutoff values for fibrosis stage ≥F2,≥F3 and F4 were 12.9 kPa,16.1 kPa,and 19.7 kPa respectively.Moreover,LSM ,serum hyaluronic acid level and APRI (ast/platelet-count)were independent parameters associated with fibrosis stage based on LB.Conclusions FibroScan is a convenient and accurate noninvasive means for assessing liver fibrosis in PBC.