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首页> 外文期刊>Gut and Liver >Simple Noninvasive Scores Are Clinically Useful to Exclude, Not Predict, Advanced Fibrosis: A Study in Turkish Patients with Biopsy-Proven Nonalcoholic Fatty Liver Disease
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Simple Noninvasive Scores Are Clinically Useful to Exclude, Not Predict, Advanced Fibrosis: A Study in Turkish Patients with Biopsy-Proven Nonalcoholic Fatty Liver Disease

机译：简单的非侵入性评分是临床上可用于排除，而不是预测，先进的纤维化：土耳其活检验证的非酒精性脂肪肝病的研究

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Background/Aims Advanced fibrosis (F≥3) indicates poor outcomes in nonalcoholic fatty liver disease (NAFLD). Here, we examined the diagnostic performance of the fibrosis-4 index (FIB-4) and NAFLD fibrosis score (NFS) for detecting (or excluding) advanced fibrosis in patients with biopsy-proven NAFLD. Methods The diagnostic performance of each noninvasive test according to previously identified cutoff points indicating low and high risk for advanced fibrosis was determined in 463 patients with NAFLD. Patients who scored &1.3 and &2.67 on the FIB-4 were considered at low and high risk for advanced fibrosis, respectively. Patients who scored &–1.455 and &0.676 on the NFS were considered at low and high risk for advanced fibrosis, respectively. Results Eighty-one patients (17.5%) had biopsy-proven advanced fibrosis (F≥3). The published FIB-4 cutoff values for low and high risk were able to exclude advanced fibrosis with negative predictive values (NPVs) of 0.907 and 0.843 and specificities of 74% and 97%, respectively. The published NFS cutoff values for low and high risk were able to exclude advanced fibrosis with NPVs of 0.913 and 0.842 and specificities of 63% and 96%, respectively. If biopsies were performed in only patients with a FIB-4 above the low cutoff point (≥1.3), 67.1% could be avoided. Conversely, if biopsies were performed in only patients with an NFS above the low cutoff point (≥–1.455), 57.0% could be avoided. Conclusions The main clinical utility of the FIB-4 and NFS in patients with NAFLD lies in the ability to exclude, not identify, advanced fibrosis.
机译：背景/ AIMS先进的纤维化（F≥3）表明非酒精性脂肪肝病（NAFLD）的结果不佳。在这里，我们研究了纤维化-4指数（FIB-4）和NAFLD纤维化评分（NFS）的诊断性能，用于检测（或排除）活组织检查验证的NAFLD患者的先进纤维化。方法在463例NAFLD患者中测定了根据先前鉴定的截止点，根据先前鉴定的截止点表明晚期纤维化的低风险和高风险的诊断性能。在纤维化的低和高风险下考虑均匀且＆ 2.67的患者。患者分别刻划的患者和＆在NFS上的低风险中均均均匀均为晚期纤维化。结果80-一名患者（17.5％）具有活组织检查验证的先进纤维化（F≥3）。公布的低风险的FIB-4截止值能够将前纤维化排除在0.907和0.843的负预测值（NPV）和74％和97％的特异性。出版的NFS截止值低和高风险的截止值能够排除高速纤维化，NPV为0.913和0.842，特异性分别为63％和96％。如果仅在低截止点（≥1.3）以上的FIB-4的患者中进行活组织检查，则可以避免67.1％。相反，如果仅在低截止点（≥1.455）高于NFS的患者中进行活组织检查，则可以避免57.0％。结论NAFLD患者FIB-4和NFS的主要临床效用位于排除，不识别，晚期纤维化的能力。

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