| Objective: Investigate the diagnostic efficiency of FibroTouch for hepatic fibrosis in patients with autoimmune liver disease(AILD).Compare the accuracy of FibroTouch and liver fibrosis serological models in the diagnosis of AILD liver fibrosis.Compare FibroTouch and noninvasive serological models for the diagnosis of fibrosis in AILD patients.Analyze the factors affecting liver stiffness measurement when FibroTouch is used in AILD.Explore the influencing factors of FibroTouch in the diagnosis of hepatic fibrosis in AILD patients.Methods: Seventy-five patients with AILD were enrolled,including twenty-six cases of autoimmune hepatitis(AIH),thirty cases of primary biliary cholangitis(PBC),and nineteen cases of AIH-PBC Overl Syndrome(OS).The correlation of variables were estimated by the Spearman’s correlation coefficient(r).The area under the receiver operating characteristic curve(AUROC)was used to evaluate the diagnostic accuracy of FibroTouch and serological models.The simple linear regression analysis and multiple linear regression methods were used to analysis the influence factors of LSM,and the regression equation was established after multiple linear regression analysis.Results:1.LSM was correlated with liver fibrosis of AILD patients(r = 0.48,P < 0.001):AIH group(r = 0.622,P = 0.001),OS group(r = 0.462,P = 0.046)and PBC group(r =0.230,P = 0.222),respectively.When PBC patients were removed,the correlation was significantly enhanced(r = 0.617,P < 0.001).2.In all patients,FibroTouch has high diagnostic efficiency for liver fibrosis,specially for early cirrhosis.AUROC values of LSM for stages≥S2,≥S3,and S4 were0.723,0.778,and 0.980,respectively.The optimal cut-off values of LSM for fibrosis stages ≥S2,≥S3,and S4 were 5.9,10.6,and 23.3k Pa,respectively.In AIH patients,AUROC values of LSM for stages ≥S2 and ≥S3 were 0.768 and 0.942.Diagnostic thresholds of LSM in discriminating fibrosis stages ≥ S2 and ≥S3 were 12.2 and 14.9 k Pa,respectively.In PBC group,FibroTouch has good diagnostic efficiency only for patients with stage S4(AUROC 0.946).In OS group,FibroTouch has no diagnostic efficiency for patients with S≥ 3(P = 0.188),while it has high diagnostic efficiency for patients with early cirrhosis(AUROC 0.971).Due to the small number of patients,we cannot determine the diagnostic of FibroTouch for patients with S≥ 2 in OS.3.Among the three serological models of APRI,FIB-4 and Forns index,only Forns index has diagnostic efficiency for liver fibrosis in AILD patients(P<0.05).AUROC values of LSM for stages S≥ 2,S≥ 3,and S4 were 0.687,0.709,and 0.794(P<0.05).The diagnostic efficiency of Forns index was comparable to Fibrotouch.4.Univariate analysis showed LSM value was positively related to age,liver inflammation,albumin(ALB),total bilirubin(TBi L),direct bilirubin(DBi L),total bile acid(TBA),platelet(PLT),prothrombin time(PT),international normalized ratio(INR),fibrinogen(FIB),serum immunoglobulin G(Ig G),and serum immunoglobulin A(P <0.05).The regression equation established after multiple linear regression analysis was LSM = 0.224+0.194*TBA(umol/L)+ 67.749*INR+0.293*age(years)-2.874*FIB(g/l)-5.027*PT(s),F(5,64)= 14.05,P < 0.001,adjusted R2 = 0.486.Conclusion:1.FibroTouch is an accurate and reliable noninvasive tool in assessing liver fibrosis in AILD,especially for early cirrhosis.2.Fibrotouch has good diagnostic accuracy for the stage of liver fibrosis in AIH patients.And the performance and applicability in patients with PBC and AIH-PBC overlap syndrome remains questionable.3.Compared with currently widely used noninvasive serological methods,FibroTouch was comparable to Forns index in detecting hepatic fibrosis in AILD(P>0.18),and APRI and FIB-4 had no diagnostic value for AILD patients.4.In AILD patients,age,TBA,INR,FIB,and PT affected the diagnostic accuracy of FbiroTouch.Age,TBA,INR,FIB,and PT affected the diagnostic accuracy of FbiroTouch for AILD patients. |
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