간질환 종류에 따른 비침습적 간섬유화 평가법의 유용성 분석 : C형 간염 보균자 중심으로
Analysis on Usefulness of Non-invasive Liver Fibrosis Evaluation Method according to the Liver Disease : Focused on H ep atitis C p atients
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초록
Liver biopsy is the gold standard for diagnosing liver fibrosis, but it is invasive and has a risk for complications. For this reason, recently, study has been actively conducted on non-invasive liver fibrosis evaluation method. But, there is no established standard for the type of diffuse liver disease. Therefore, this study was suggest the usefulness and cut-off values of Fibroscan, FIB-4, APRI and AAR of patients with hepatitis C in Korea. According to the diagnosis, 240 people in hepatitis C are classified into fatty liver, chronic hepatitis, and liver cirrhosis. The statistical analysis was performed by ANOVA to verify difference between groups. The ROC curve was analyzed to determine the usefulness and practical cut-off value. A s a result, for all diseases, the AUC value for Fibroscan was 0 .8 o ver a nd t he APRI was 0 .7 o ver. Cut-off value of serum based liver fibrosis markers was increased in order of fatty liver, chronic hepatitis and liver cirrhosis. If Fibroscan and serological liver fibrosis markers are applied to predict liver fibrosis, it is expected that excessive liver biopsy can be reduced.
Abstract
Liver biopsy is the gold standard for diagnosing liver fibrosis, but it is invasive and has a risk for complications. For this reason, recently, study has been actively conducted on non-invasive liver fibrosis evaluation method. But, there is no established standard for the type of diffuse liver disease. Therefore, this study was suggest the usefulness and cut-off values of Fibroscan, FIB-4, APRI and AAR of patients with hepatitis C in Korea. According to the diagnosis, 240 people in hepatitis C are classified into fatty liver, chronic hepatitis, and liver cirrhosis. The statistical analysis was performed by ANOVA to verify difference between groups. The ROC curve was analyzed to determine the usefulness and practical cut-off value. A s a result, for all diseases, the AUC value for Fibroscan was 0 .8 o ver a nd t he APRI was 0 .7 o ver. Cut-off value of serum based liver fibrosis markers was increased in order of fatty liver, chronic hepatitis and liver cirrhosis. If Fibroscan and serological liver fibrosis markers are applied to predict liver fibrosis, it is expected that excessive liver biopsy can be reduced.
참고문헌 (16)
- Statistics Korea, "Causes of Death Statistics", Statistics Korea, ~ (2017)
- Kim BH, "Temporal improvement in survival of patients with hepatocellular carcinoma in a hepatitis B virus-endemic population", J Gastroenterol Hepatol, 33(2), pp.475~483 (2018)
- 정숙향, "Current status of hepatitis C virus infection and countermeasures in South Korea", Epidemiology and Health, 39, pp.1~7 (2017), 한국역학회[DOI]
- Wai CT, "A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C", J Hepatol, 38(2), pp.518~526 (2003)
- Piccinino F, "Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276biopsies", J Hepatol, 2(2), pp.165~173 (1986)
- Regev A, "Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection", Am J Gastroenterol, 97(10), pp.2614~2618 (2002)
- 안현, "복부 초음파검사에서 영상 점수 시스템 분류에 따른 간 섬유화 평가의 유용성", 방사선기술과학, 42(3), pp.187~194 (2019), 대한방사선과학회
- Fraquelli M, "Reproducibility of transient elastography in the evaluation of liver fibrosis in patients with chronic liver disease", Gut, 56(7), pp.968~973 (2007)
- Castera L, "Non-invasive evaluation of liver fibrosis using transient elastography", J Hepatol, 48(5), pp.835~847 (2008)
- Vallet-Pichard A, "FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest", J Hepatol, 46(1), pp.32~36 (2007)
- 심성준, "만성 B형 간염 환자에서 중증 간 섬유화 및 간경변의 예측 지표로써 AST", 혈소판 비의 유용성, 2005, pp.45(5), 340~347[DOI]
- 박수영, "임상적으로 간경변증의 증후가 없는 만성 B형 간염에서 간섬유화의 지표로서 AST", ALT 비와 혈소판 수치의 임상적 유용성, 2004, pp.43(4), 246~251[DOI]
- 배락천, "만성 간질환 환자에서 순간탄성측정법(transient elastography, FibroscanⓇ)에 의한 간탄력도에 영향을 줄 수 있는 임상요소", Clinical and Molecular Hepatology, 16(2), pp.123~130 (2010), 대한간학회
- 천해경, "초음파상 지방간과 혈액학적 검사 및 체지방률과의 상관관계", 방사선기술과학, 32(4), pp.437~444 (2009), 대한방사선과학회
- Zhu X, "Prospective evaluation of FibroScan for the diagnosis of hepatic fibrosis compared with liver biopsy", AST platelet ratio index and FIB-4 in patients with chronic HBV infection, 2011, pp.56(9), 2742~2749
- Kim SE, "Optimal Evaluation of the Results of Liver Function Tests", Korean J Med, 94(1), pp.89~95 (2019)