机构地区:[1]Department of Gastroenterology,Internal Medicine,Kitasato University School of Medicine,Sagamihara,Kanagawa 252-0375,Japan [2]Department of Hepatopancreatobiliary Medic [3]Department of Gastroenterology,Shonan Kamakura General Hospital,Kamakura,Kanagawa 247-8533,Japan [4]Division of Gastroenterology and Hepatology,Graduate School of Medical and Dental Sciences,Niigata University,Niigata 951-8510,Japan [5]Department of Internal Medicine,Division of Gastroenterology,Nippon Medical School Chiba Hokusoh Hospital,Chiba 270-1694,Japan [6]Department of Internal Medicine,Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo 113-8603,Japan [7]Department of Gastroenterology and Hepatology,Tokyo Medical University Hospital,Shinjuku,Tokyo 113-8510,Japan [8]Division of Gastroenterology and Hepatology,Department of Internal Medicine,Tokai University School of Medicine,Kanagawa 259-1193,Japan
出 处:《World Journal of Gastroenterology》2020年第1期97-108,共12页世界胃肠病学杂志(英文版)
摘 要:BACKGROUND Autotaxin(ATX)has been reported as a direct biomarker for estimating the evaluation of liver fibrosis.But available data on ATX as a useful biomarker for the complications of liver cirrhosis(LC)are scant.AIM To assess the clinical usefulness of ATX for assessing the complications of LC.METHODS This multicenter,retrospective study was conducted at six locations in Japan.We include patients with LC,n=400.The ATX level was evaluated separately in men and women because of its high level in female patients.To assess the clinical usefulness of ATX for the complications of LC,the area under the curve(AUC)of ATX assessing for the severe complications was analyzed in comparison with the model for end-stage liver disease score,albumin-bilirubin(ALBI)score,fibrosis-4 index,and aspartate aminotransferase-to-platelet ratio index.RESULTS The mean age was 68.4±11.4 years,240 patients(60.0%)were male.A total of 213(53.3%)and 187(46.8%)patients were compensated and decompensated,respectively.The numbers of patients with varix rupture,hepatic ascites,and hepatic encephalopathy were 35(8.8%),131(32.8%),and 103(25.8%),respectively.The AUCs of ATX in men for hepatic encephalopathy,hepatic ascites,and varix ruptures were 0.853,0.816,and 0.706,respectively.The AUCs of ATX in women for hepatic encephalopathy,hepatic ascites,and varix rupture were 0.759,0.717,and 0.697,respectively.The AUCs of ATX in men were higher than those in women,as were all the other biomarkers used to detect encephalopathy and varix ruptures.However,for detecting ascites,the AUC of ALBI in men was more effective than using ATX.CONCLUSION ATX in men was more effective than any other biomarkers for detecting hepatic encephalopathy and varix ruptures.BACKGROUND Autotaxin(ATX) has been reported as a direct biomarker for estimating the evaluation of liver fibrosis. But available data on ATX as a useful biomarker for the complications of liver cirrhosis(LC) are scant.AIM To assess the clinical usefulness of ATX for assessing the complications of LC.METHODS This multicenter, retrospective study was conducted at six locations in Japan. We include patients with LC, n = 400. The ATX level was evaluated separately in men and women because of its high level in female patients. To assess the clinical usefulness of ATX for the complications of LC, the area under the curve(AUC) of ATX assessing for the severe complications was analyzed in comparison with the model for end-stage liver disease score, albumin-bilirubin(ALBI) score, fibrosis-4 index, and aspartate aminotransferase-to-platelet ratio index.RESULTS The mean age was 68.4 ± 11.4 years, 240 patients(60.0%) were male. A total of 213(53.3%) and 187(46.8%) patients were compensated and decompensated,respectively. The numbers of patients with varix rupture, hepatic ascites, and hepatic encephalopathy were 35(8.8%), 131(32.8%), and 103(25.8%),respectively. The AUCs of ATX in men for hepatic encephalopathy, hepatic ascites, and varix ruptures were 0.853, 0.816, and 0.706, respectively. The AUCs of ATX in women for hepatic encephalopathy, hepatic ascites, and varix rupture were 0.759, 0.717, and 0.697, respectively. The AUCs of ATX in men were higher than those in women, as were all the other biomarkers used to detect encephalopathy and varix ruptures. However, for detecting ascites, the AUC of ALBI in men was more effective than using ATX.CONCLUSION ATX in men was more effective than any other biomarkers for detecting hepatic encephalopathy and varix ruptures.
关 键 词:AUTOTAXIN Hepatic encephalopathy Hepatic ascites Liver fibrosis Biomarker
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