Kronik hepatit B ile enfekte hastalarda karaciğerdeki inflamasyonun ve fibrozun tahmin edilmesinde invaziv olmayan testlerin önemi
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Tarih
2022
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Hatay Mustafa Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Özet
Amaç: Kronik hepatit B ülkemizde orta endemisiteye sahip HCC, steatohepatit ve siroz gibi tablolara neden olabilen bir hastalıktır. Son yıllarda kronik hepatit B'li hastalarda fibrozis ve inflamasyonu değerlendirmek amacıyla noninvaziv tanı yöntemleri üzerinde durulmaya başlanmıştır. Kronik Hepatit B'li hastalarda karaciğer fibrozis ve inflamasyonunun tahmin edilmesinde non invaziv testlerin önemini değerlendirmeyi amaçladık. Gereç ve yöntem: Çalışmamıza 108 KHB tanılı hasta alındı. Modifiye knodel skorlama sistemi, karaciğer iltihabı ve fibrozisi teşhisi için patolojik standart olarak kabul edildi. Hastalar inflamatuvar aktivite açısından önemli inflamasyon olan(A≥6) ve önemli inflamasyonu olmayan(A<6) olmak üzere iki gruba ayrıldı. Fibrozis açısından minimal fibrozis ve ya fibrozis yok(F<3) ve ileri fibrozis var(F≥3) olarak iki gruba ayrıldı. Hastaların demografik özellikleri ve biyokimyasal verileri incelendi. APRI, FIB-4, RPR ve GPR'nin inflamasyon ve fibrozis tahminindeki değeri ROC eğrisi altında kalan alan hesaplanarak değerlendirilmeye çalışıldı. Bulgular: Önemli inflamasyon tahmini açısından APRI, FIB-4, RPR ve GPR'nin eğri altında kalan alan sırası ile 0.77(p<0.001), 0.66(p:0.013), 0.76(p<0.001) ve 0.66(p:0.014) olarak bulundu ve istatistiksel olarak anlamlıydı. İleri fibrozis tahmini açısından APRI, FIB-4, RPR ve GPR'nin eğri altında kalan alanlar sırası ile 0.843(p<0.001), 0.844(p<0.001), 0.789(p<0.001) ve 0.777(p<0.001) idi ve istatistiksel olarak anlamlıydı. Sonuç: APRI, FIB-4, RPR ve GPR KHB hastalarında ileri evre fibrozisi ve inflamasyonu tahmin etmede yardımcı olabilir. Bu testler karaciğer biyopsisine olan ihtiyacı azaltır fakat ortadan kaldırmaz. Karaciğer biyopsisi ile beraber değerlendirilmeleri gerekir.
Objective: Chronic hepatitis B is a moderately endemic disease in our country that can cause conditions such as HCC, steatohepatitis and cirrhosis. In recent years, noninvasive diagnostic methods have been started to be focused on in order to evaluate fibrosis and inflammation in patients with chronic hepatitis B. We aimed to evaluate the importance of non-invasive tests in predicting liver fibrosis and inflammation in patients with chronic hepatitis B. Material and method: 108 patients with CHB were included in our study. The modified Knodel scoring system was accepted as the pathological standard for the diagnosis of liver inflammation and fibrosis. In terms of inflammatory activity, the patients were divided into two groups as those with significant inflammation (A≥6) and without significant inflammation (A<6). In terms of fibrosis, they were divided into two groups as minimal fibrosis or no fibrosis (F<3) and advanced fibrosis (F≥3). Demographic characteristics and biochemical data of the patients were examined. The value of APRI, FIB-4, RPR and GPR in the prediction of inflammation and fibrosis was tried to be evaluated by calculating the area under the ROC curve. Results: Area under the curve of APRI, FIB-4, RPR and GPR for predicting significant inflammation was 0.77(p<0.001), 0.66(p:0.013), 0.76(p<0.001), and 0.66(p:0.014) respectively and statistically significant. Areas under the curve of APRI, FIB-4, RPR and GPR in terms of prediction of advanced fibrosis were 0.843(p<0.001), 0.844(p<0.001), 0.789(p<0.001) and 0.777(p<0.001) respectively and statistically significant. Conclusions: APRI, FIB-4, RPR and GPR can be helpful in predicting advanced fibrosis and inflammation in CHB patients. These tests reduce but do not eliminate the need for liver biopsy. They should be evaluated together with liver biopsy Key word: Chronic hepatitis B, non-invasive test, liver inflammation, liver fibrosis
Objective: Chronic hepatitis B is a moderately endemic disease in our country that can cause conditions such as HCC, steatohepatitis and cirrhosis. In recent years, noninvasive diagnostic methods have been started to be focused on in order to evaluate fibrosis and inflammation in patients with chronic hepatitis B. We aimed to evaluate the importance of non-invasive tests in predicting liver fibrosis and inflammation in patients with chronic hepatitis B. Material and method: 108 patients with CHB were included in our study. The modified Knodel scoring system was accepted as the pathological standard for the diagnosis of liver inflammation and fibrosis. In terms of inflammatory activity, the patients were divided into two groups as those with significant inflammation (A≥6) and without significant inflammation (A<6). In terms of fibrosis, they were divided into two groups as minimal fibrosis or no fibrosis (F<3) and advanced fibrosis (F≥3). Demographic characteristics and biochemical data of the patients were examined. The value of APRI, FIB-4, RPR and GPR in the prediction of inflammation and fibrosis was tried to be evaluated by calculating the area under the ROC curve. Results: Area under the curve of APRI, FIB-4, RPR and GPR for predicting significant inflammation was 0.77(p<0.001), 0.66(p:0.013), 0.76(p<0.001), and 0.66(p:0.014) respectively and statistically significant. Areas under the curve of APRI, FIB-4, RPR and GPR in terms of prediction of advanced fibrosis were 0.843(p<0.001), 0.844(p<0.001), 0.789(p<0.001) and 0.777(p<0.001) respectively and statistically significant. Conclusions: APRI, FIB-4, RPR and GPR can be helpful in predicting advanced fibrosis and inflammation in CHB patients. These tests reduce but do not eliminate the need for liver biopsy. They should be evaluated together with liver biopsy Key word: Chronic hepatitis B, non-invasive test, liver inflammation, liver fibrosis
Açıklama
Anahtar Kelimeler
İç Hastalıkları, Internal diseases, Kronik Hepatit B, Non invaviv test, karaciğer inflamasyon, karaciğer fibrozis, Chronic hepatitis B, non-invasive test, liver inflammation, liver fibrosis
