Clinical Value Of Diagnosing The Hepatic Fibrosis Degree Of Patients With Chronic HBV Using FibroTouch Transient Elastography Non-invasively

Objective Through discussing the sensitivity and specificity of diagnosing hepatic fibrosis degree of patients with Hepatitis B virus(HBV) using Fibro Touch transient elastography, observe the influence of different alanine aminotransferase(ALT) levels on the non-invasive diagnosis accuracy of liver stiffness in hepatic fibrosis and liver cirrhosis using Fibro Touch(FT), so as to further clarify the clinical application value of diagnosing the hepatic fibrosis degree of patients with chronic HBV using Fibro Touch transient elastography non-invasively.Methods Selected 187 patients with chronic HBV receiving liver biopsy in the Second Affiliated Hospital of Anhui Medical University from March 2014 to September 2015;the liver stiffness measurement(LSM) of all patients was tested through Fibro Touch; at the same time, tested the blood routine, liver function and hepatitis B five indicators and other serological indicators. The liver biopsy result was the gold standard, drew the LSM receiver operating characteristics(ROC) curve, calculated the area under the receiver operating characteristic curve(AUROC), 95% confidence interval(95% CI),specificity(Se), sensitivity(Sp), positive predictive value(PPV), negative predictive value(NPV) and coincidence rate, etc, in order to clarify the clinical application value of diagnosing the hepatic fibrosis degree of patients with chronic HBV using Fibro Touch non-invasively. In addition, selected 145 patients with ALT < twice of normal value, and conducted the statistical calculation in the same way. Compared the two results, and evaluated the influence of ALT level on diagnosing the hepatic fibrosis degree of patients with chronic HBV using Fibro Touch non-invasively(namely the significant hepatic fibrosis group, severe hepatic fibrosis group, liver cirrhosis group).Results1. LSM increases as the hepatic fibrosis gets worse, positively related to the hepatic fibrosis staging(rs=0.678, P<0.01).2. LSM has certain correlation with albumi(ALB), globulin(GLB), alanine transaminase(ALT), aspartate aminotransferase(AST), γ-glutamic acid transpeptidase(GGT), prothrombin time(PT), platelet(PLT) and hepatitis B surface antigen(HBs Ag)(P<0.05).3. In the case group not excluding ALT≥2×upper limit of normal(ULN), AUROC of diagnosing significant hepatic fibrosis(≥S2 stage), severe hepatic fibrosis(≥S3 stage)and liver cirrhosis(S4 stage) of patients with chronic HBV using Fibro Touch is 0.815,0.884, 0.920; the optimal corresponding cutoff value is 7.55 k Pa, 10.15 k Pa, 15.25 k Pa;the sensitivity is 79.2%, 83.3%, 90.5%; the specificity is 74.7%, 87.2%, 89.2%; and the coincidence rate is 77.0%, 86.1%, 89.3%. In the ALT<2×ULN case group, AUROC of diagnosing significant hepatic fibrosis(≥S2 stage), severe hepatic fibrosis(≥S3 stage)and liver cirrhosis(S4 stage) of patients with chronic HBV using Fibro Touch is 0.829,0.899, 0.963; the optimal corresponding cutoff value is 7.55 k Pa, 10.10 k Pa, 15.25 k Pa;the sensitivity is 79.4%, 83.5%, 93.3%; the specificity is 77.8%, 89.6%, 91.6%; and the coincidence rate is 78.5%, 86.0%, 91.9%. There is no significant difference in the sensitivity and specificity between it and the patient group.Conclusion Fibro Touch has good sensitivity and specificity to non-invasively diagnose the hepatic fibrosis degree of patients with chronic HBV, and ALT level may have no significant effect on Fibro Touch non-invasive diagnosis accuracy. And it is simple, safe and noninvasive, helps most patients with chronic HBV avoid the liver biopsy, so it is worth clinical promoting.