早期预测基因1型慢性丙型肝炎治疗应答的两种模式的建立与验证

作     者：Martnez-Bauer E. Crespo J. Romero-Gómez M. J.M.Sánchez-Tapias 陈云茹 

作者机构：Liver UnitHospital ClnicVillarroel 17008036 BarcelonaSpain 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2006年第2卷第10期

页      面：48-48页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：慢性丙型肝炎 治疗应答 预测基因 持续病毒学应答 评分模型 病毒载量 肝纤维化 预治疗 应答率 清除 

摘      要：Early prediction of response to therapy in genotype 1 chronic hepatitis C is difficult. Two predictive models, a pretreatment scoring model (PreT-SM) and a fourth week of therapy scoring model (4w-SM) were constructed in a cohort of 104 patients from a single center (estimation cohort) and validated in a cohort of 141 patients from four independent centers (validation cohort). Individual scores were calculated using variables independently associated with sustained virological response (SVR). Baseline viral load, aspartate aminotransferase/alanine amino transferase ratio, serum cholesterol, and a numerical score for noninvasive estimation of liver fibrosis were included in the PreT-SM;HCV-RNA clearance and PreT-SM scores were included in the 4w-SM. Receiver operating characteristic analysis revealed the area under the curve in the estimation cohort and in the validation cohort to be, respectively, 0.856 and 0.847 for the PreT-SM and 0.908 and 0.907 for the 4w-SM. Low scores were associated with SVR, high scores with non-SVR. The best cutoff scores from the PreT-SM (7 and 9.70) identified, respectively, 36%of patients with SVR and 41%of those with non-SVR from the validation cohort, with high accuracy (≥90%positive predictive value [PPV] and specificity). Similarly, cutoff scores of 3.20 and 5.60 from the 4w-SM identified, respectively, 71%of patients with SVR and 53%of those with non-SVR from the same cohort with high accuracy (PPV and specificity 92%). In conclusion, these models predicted response to therapy before or after 4 weeks of treatment in approximately 60%of genotype 1 patients and may be valuable for the management of this condition.