Utility of FibroScan-based scoring systems to narrow the risk group of nonalcoholic fatty liver disease with comorbidities  

作　　者：Kouichi Miura Hiroshi Maeda Naoki Morimoto Shunji Watanabe Mamiko Tsukui Yoshinari Takaoka Hiroaki Nomoto Rie Goka Kazuhiko Kotani Hironori Yamamoto 

机构地区：[1]Department of Medicine,Division of Gastroenterology,Jichi Medical University School of Medicine,3311-1 Yakushiji,Shimotsuke 329-0498,Tochigi,Japan [2]Division of Community and Family Medicine,Center for Community Medicine,Jichi Medical University,3311-1 Yakushiji,Shimotsuke 329-0498,Japan

出　　处：《World Journal of Gastrointestinal Pathophysiology》2022年第3期96-106,共11页世界胃肠病理生理学杂志（英文版）（电子版）

摘　　要：BACKGROUND Vibration-controlled transient elastography(VCTE)is proposed as a second step of examination to assess liver fibrosis in patients with nonalcoholic fatty liver disease(NAFLD)after triaging by the fibrosis-4(FIB-4)index.Recently,VCTEbased scoring systems,including FibroScan-AST(FAST),Agile 3+,and Agile 4,emerged to determine the status of NAFLD.However,the significance of these scoring systems remains unknown in narrowing the high-risk group of NAFLD patients with comorbidities,including hepatocellular carcinoma(HCC)and esophagogastric varices(EGV).AIM To clarify the significance of VCTE-based scoring systems to narrow the high-risk group of NAFLD patients with comorbidities.METHODS We performed a cross-sectional study to investigate the usefulness of VCTE-based scoring systems and other fibrosis markers to narrow the high-risk group of patients with NAFLD.FIB-4 index was used for the first triage.Risk groups of FAST,Agile 3+,and Agile 4 were stratified according to the published data.Among the 191 patients with NAFLD,there were 26(14%)and 25 patients(13%)with HCC and EGV,respectively.RESULTS When 1.3 was used as a cutoff value,the FIB-4 index narrowed the risk group to 120 patients,in which all patients with HCC and/or EGV were included.High risk group of Agile 3+could subsequently narrow the risk group.The prevalence of HCC and EGV at this step were 33%(26/80)and 31%(25/80),respectively.In further narrowing of EGV,Agile 4 aggregated the patients with EGV into 43 patients,of whom 23(53%)had EGV.FAST failed to narrow the risk group of patients with comorbidities.When 2.6 was used as a cutoff value of the FIB-4 index,three patients with HCC and two patients with EGV were missed at the first triage.CONCLUSION Agile 3+and Agile 4 are useful to narrow the NAFLD patient group,in which patients may have HCC and/or EGV.

关 键 词：Nonalcoholic fatty liver disease Vibration controlled transient elastography Non-invasive test Hepatocellular carcinoma VARIX 

分 类 号：R575[医药卫生—消化系统]