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A new index for non-invasive assessment of liver fibrosis

World Journal of Gastroenterology 2010年第38期16卷 4809-4816页

作者： Naohiro Ichino Keisuke Osakabe Toru Nishikawa Hiroko Sugiyama Miho Kato Shiho Kitahara Senju Hashimoto Naoto Kawabe Masao Harata Yoshifumi Nitta Michihito Murao Takuji Nakano Yuko Arima hiroaki shimazaki Koji Suzuki Kentaro Yoshioka Faculty of Medical Technology School of Health SciencesFujita Health UniversityToyoakeAichi 470-1192Japan Department of Clinical Laboratory Fujita Health University Hospital Department of Liver Biliary Tract and Pancreas DiseasesFujita Health University

AIM:To construct and evaluate a new non-invasive fibrosis index for assessment of the stage of liver f ibrosis. METHODS:A new f ibrosis index (Fibro-Stiffness index) was developed in 165 of 285 patients with chronic hepatitis C, and was validated in the other 120 patients where liver biopsy was performed. Its usefulness was compared with liver stiffness (LS) measured by FibroScan, the aminotransferase-to-platelet ratio index, the Forns index and the FibroIndex. RESULTS: The Fibro-Stiffness index consists of LS,platelet count and prothrombin time. The values of the Fibro-Stiffness index differed signif icantly between neighboring f ibrosis stages except F0-F1. The area under the receiver operating characteristics curves of the Fibro-Stiffness index for prediction of F≥2 (0.90), F≥ 3 (0.90) and F= 4(0.92) in the estimation group and those for F≥ 3 (0.93) and F =4 (0.97) in the validation group were the highest among the 5 methods examined. The accuracy of the Fibro-Stiffness index had highest values for F≥2, F≥3 and F=4 in both the estimation and validation groups. The diagnostic performance for F= 4 was improved by a combination of the Fibro-Stiffness index with serum hyaluronic acid level. CONCLUSION: The Fibro-Stiffness index was constructed and validated. It showed superior diagnostic performance to other indices for F ≥ 2,3 and 4.

关键词： Non-invasive fi brosis index Fibro-Stiffness index Chronic hepatitis C Liver stiffness Liver fi brosis

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Factors correlating with acoustic radiation force impulse elastography in chronic hepatitis C

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World Journal of Gastroenterology 2014年第5期20卷 1289-1297页

作者： Toru Nishikawa Senju Hashimoto Naoto Kawabe Masao Harata Yoshifumi Nitta Michihito Murao Takuji Nakano Yuko Mizuno hiroaki shimazaki Toshiki Kan Kazunori Nakaoka Yuka Takagawa Masashi Ohki Naohiro Ichino Keisuke Osakabe Kentaro Yoshioka Department of Liver Biliary Tract and Pancreas Diseases Fujita Health University Faculty of Medical Technology School of Health Sciences Fujita Health University

AIM: To investigate the factors other than fibrosis stage correlating with acoustic radiation force impulse(ARFI) elastograpy in chronic hepatitis C. METHODS: ARFI elastograpy was performed in 108 consecutive patients with chronic hepatitis C who underwent a liver biopsy. The proportion of fibrosis area in the biopsy specimens was measured by computerassisted morphometric image analysis. RESULTS: ARFI correlated significantly with fibrosis stage(β = 0.1865, P < 0.0001) and hyaluronic acid levels(β = 0.0008, P = 0.0039) in all patients by multiple regression analysis. Fibrosis area correlated significantly with ARFI by Spearman's rank correlation test but not by multiple regression analysis. ARFI correlated significantly with body mass index(BMI)(β =-0.0334, P = 0.0001) in F 0 or F 1, with γ-glutamyltranspeptidase levels(β = 0.0048, P = 0.0012) in F 2, and with fibrosis stage(β = 0.2921, P = 0.0044) and hyaluronic acid levels(β = 0.0012, P = 0.0025) in F 3 or F 4. The ARFI cutoff value was 1.28 m/s for F ≥ 2, 1.44 m/s for F ≥ 3, and 1.73 m/s for F 4. CONCLUSION: ARFI correlated with fibrosis stage and hyaluronic acid but not with inflammation. ARFI was affected by BMI, γ-glutamyltranspeptidase, and hyaluronic acid in each fibrosis stage.

关键词： Acoustic radiation force impulse Body mass index C

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Vitamin E reduces liver stiffness in nonalcoholic fatty liver disease

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World Journal of Hepatology 2015年第27期7卷 2749-2756页

作者： Aiko Fukui Naoto Kawabe Senju Hashimoto Michihito Murao Takuji Nakano hiroaki shimazaki Toshiki Kan Kazunori Nakaoka Masashi Ohki Yuka Takagawa Tomoki Takamura Hiroyuki Kamei Kentaro Yoshioka Department of Liver Biliary Tract and Pancreas Diseases Fujita Health University Department of Clinical Pharmacy Practice and Health Care Management Faculty of PharmacyMeijo University

AIM: To evaluate the efficacy of vitamin E treatment on liver stiffness in nonalcoholic fatty liver disease(NAFLD).METHODS: Thirty-eight NAFLD patients were administered vitamin E for > 1 year. The doses of vitamin E were 150, 300, or 600 mg; three times per day after each meal. Responses were assessed by liver enzyme levels [aspartate aminotransferase(AST), alanine aminotranferease(ALT), and γ-glutamyl transpeptidase(γ-GTP)], noninvasive scoring systems of hepatic fibrosis-4 [FIB-4 index and aspartate aminotransferaseto-platelet index(APRI)], and liver stiffness [velocity of shear wave(Vs)] measured by acoustic radiation force impulse elastography. Vs measurements were performed at baseline and 12 mo after baseline. The patients were genotyped for the patatin-like phospholipase domain containing 3(PNPLA3) polymorphisms and then divided into either the CC/CG or GG group to examine each group's responses to vitamin E treatment. RESULTS: We found marked differences in the platelet count, serum albumin levels, alkaline phosphatase levels, FIB-4 index, APRI, and Vs at baseline depending on the PNPLA3 polymorphism. AST, ALT, and γ-GTP levels(all P < 0.001); FIB-4 index(P = 0.035); APRI(P < 0.001); and Vs(P < 0.001) significantly decreased from baseline to 12 mo in the analysis of all patients. In the subset analyses of PNPLA3 genotypes, AST levels(P = 0.011), ALT levels(P < 0.001), γ-GTP levels(P = 0.005), APRI(P = 0.036), and Vs(P = 0.029) in genotype GG patients significantly improved, and AST and ALT levels(both P < 0.001), γ-GTP levels(P = 0.003), FIB-4 index(P = 0.017), and APRI(P < 0.001) in genotype CC/CG patients. CONCLUSION: One year of vitamin E treatment improved noninvasive fibrosis scores and liver stiffness in NAFLD patients. The responses were similar between different PNPLA3 genotypes.

关键词： Vitamin E Acoustic radiation force impulse Nonalco

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Changes of shear-wave velocity by interferon-based therapy in chronic hepatitis C

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World Journal of Gastroenterology 2015年第35期21卷 10215-10223页

作者： Keisuke Osakabe Naohiro Ichino Toru Nishikawa Hiroko Sugiyama Miho Kato Ai Shibata Wakana Asada Naoto Kawabe Senju Hashimoto Michihito Murao Takuji Nakano hiroaki shimazaki Toshiki Kan Kazunori Nakaoka Yuka Takagawa Masashi Ohki Takamitsu Kurashita Tomoki Takamura Kentaro Yoshioka Faculty of Medical Technology School of Health SciencesFujita Health University Center of Ultrasound Diagnosis Fujita Health University Hospital Department of Liver Biliary Tract and Pancreas DiseasesFujita Health University

AIM: To evaluate the changes of shear-wave velocity(Vs) by acoustic radiation force impulse after treatment in chronic hepatitis ***: Eighty-seven patients with chronic hepatitis C were consecutively treated with combinations of interferon(IFN) plus ribavirin(RBV). Vs value(m/s) was measured with acoustic radiation force impulse before treatment, at end of treatment(EOT), 1 year after EOT, and 2 years after ***: In patients with a sustained virological response(SVR)(n = 41), Vs significantly decreased at EOT [1.19(1.07-1.37), P = 0.0004], 1 year after EOT [1.10(1.00-1.22), P = 0.0001], and 2 years after EOT [1.05(0.95-1.16), P < 0.0001] compared with baseline [1.27(1.11-1.49)]. In patients with a relapse(n = 26), Vs did not significantly decrease at EOT [1.23(1.12-1.55)], 1 year after EOT [1.20(1.12-1.80)], and 2 years after EOT [1.41(1.08-2.01)] compared with baseline [1.39(1.15-1.57)]. In patients with a nonvirological response(n = 20), Vs did not significantly decrease at EOT [1.64(1.43-2.06)], 1 year after EOT [1.66(1.30-1.95)], and 2 years after EOT [1.61(1.36-2.37)] compared with baseline [1.80(1.54-2.01)]. Among genotype 1 patients, baseline Vs was significantly lower in SVR patients [1.28(1.04-1.40)] than in non-SVR patients [1.56(1.20-1.83)](P = 0.0142).CONCLUSION: Reduction of Vs values was shown in SVR patients after IFN-plus-RBV therapy by acoustic radiation force impulse.

关键词： Hepatitis C virus Fibrosis Interferon and ribaviri

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