Analysis Of Factors Influencing Fibrosis In Patients With Chronic Hepatitis B By Transient Elastography (FibroTouch)

Objiectiv: The study was aim to explore the influencing factors of FibroTouch in the diagnosis of hepatic fibrosis,and to evaluate its clinical value in the diagnosis of hepatic fibrosis in patients with chronic hepatitis B.Methods: A retrospective study was conducted to collect 778 CHB patients from November 2015 to February 2017 in the outpatient(in-patient)department of liver disease,Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine.After strictly following the exclusion criteria and exclusion criteria,306 patients were enrolled in the study,109 of them underwent liver biopsy.The influence of age,disease duration,body mass index(BMI),platelet(PLT),alanine aminotransferase(ALT),aspartate aminotransferase(AST),Γ-glutamyl transpeptidase(GGT),total bilirubin(TBIL),albumin(ALB),globulin(GLO),albumin/globulin ratio(A/G),hepatitis B core antibody(Anti-HBc),spleen length,spleen thickness and portal vein width on LSM values were analyzed.Firstly,306 subjects were included to analyze the influence of serology,imaging,immunology and other indicators on LSM value by bivariate correlation statistics.Logistic binary regression analysis was used to analyze the influencing factors of mild liver fibrosis and liver fibrosis stage,cirrhosis and non-cirrhosis stage.Then 109 CHB patients who underwent both FibroTouch and liver puncture were enrolled.The correlation between LSM value and pathological stage of liver tissue was analyzed.The diagnostic efficacy of FibroTouch in diagnosis of liver fibrosis was evaluated by ROC curve,andthe clinical value of FibroTouch in diagnosis of liver fibrosis in CHB patients was confirmed.Results: 1.According to LSM value,patients were divided into mild hepatic fibrosis group,hepatic fibrosis group and cirrhosis group.It was found that there were significant differences between LSM value and age,PLT,course of disease,ALT,AST,ALB,GLO,GGT,TBIL,spleen length and spleen thickness(P < 0.05).LSM was positively correlated with age,course of disease,ALT,AST,GLO,GGT,TBIL,spleen length and thickness(r > 0),negatively correlated with ALB and PLT(r < 0).2.According to LSM value,patients were divided into mild hepatic fibrosis group and liver fibrosis,liver cirrhosis and non-liver cirrhosis.In the stage of mild liver fibrosis and liver fibrosis,the differences in disease duration,age,PLT and LSM were statistically significant(P<0.05),and their coefficients were 1.087,1.060,and 0.994,respectively.In the stage of cirrhosis and non-cirrhosis,the difference of ALT,GGT,spleen length and LSM was statistically significant(P<0.05),and the coefficients were 0.970,1.039,1.094,respectively.3.Based on the pathological staging of liver tissue,the LSM values were significantly correlated with liver histopathological staging in 109 CHB patients who underwent liver puncture(r=0.84,P<0.01).The area under the curve of FibroTouch in the diagnosis of diagnosis of mild liver fibrosis and liver fibrosis was 0.856(95% CI,0.733-0.978).When the cutoff value of LSM was 8.9 kPa,the corresponding sensitivity was 71.43%.The specificity was 92.54%;the area under the curve of FibroTouch in the diagnosis of cirrhosis and non-cirrhosis was 0.942(95% CI,0.897-0.987).When the cutoff value of LSM was 14.1 kPa,the corresponding sensitivity was 82.35% and the specificity was 94.67 %.Conclusion: The LSM values of patients with chronic hepatitis Bdiagnosed by FibroTouch may be influenced by age,course of disease,PLT,ALT,AST,ALB,GLO,GGT,TBIL,spleen length and spleen thickness;the influencing factors of LSM values in different stages of liver fibrosis in patients with chronic hepatitis B may be different;FibroTouch has high value in the diagnosis of mild liver fibrosis and cirrhosis.