2024-03-28T11:59:24Z
https://niigata-u.repo.nii.ac.jp/oai
oai:niigata-u.repo.nii.ac.jp:02000283
2022-12-15T04:28:43Z
453:455
471:561:562
Screening and follow-up of chronic liver diseases with understanding their etiology in clinics and hospitals
1次医療機関や専門医療機関での、病因に基づいた慢性肝疾患のスクリーニングとフォローアップ
Ogawa, Masahiro
小川, 雅裕
open access
【○!C】 2020 The Authors. JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd
Creative Commons Attribution 4.0 International
autotaxin
fibrosis-4 index
hepatocellular carcinoma
Mac-2-binding protein glycosylation isomer
magnetic resonance elastography
Background and Aim: Considering the increasing prevalence of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis (NASH), the development of an effective screening and follow-up system that enables the recognition of etiological changes by primary physicians in clinics and specialists in hospitals is required. Methods: Chronic hepatitis B (HBV) and C (HCV), NASH, and alcoholic steatohepatitis (ASH) patients who were assayed for Mac-2-binding protein glycosylation isomer (M2BPGi) (n = 272) and underwent magnetic resonance elastography (MRE) (n = 119) were enrolled. Patients who underwent MRE were also tested by ultrasound elastography (USE) (n = 80) and for M2BPGi (n = 97), autotaxin (ATX) (n = 62), and platelet count (n = 119), and their fibrosis-4 (FIB-4) index was calculated (n = 119). Results: FIB-4 index >2, excluding HBV-infected patients, M2BPGi >0.5, ATX >0.5, and platelet count <20×10^4/μL were the benchmark indices, and we took into consideration other risk factors, such as diabetes mellitus and age, to recommend further examinations, such as USE, based on the local situation to avoid overlooking hepatocellular carcinoma (HCC) in the clinic. During specialty care in the hospital, MRE exhibited high diagnostic ability for fibrosis stages >F3 or F4; it could efficiently predict collateral circulation with high sensitivity, which can replace USE. We also identified etiological features and found that collateral circulation in NASH/ASH patients tended to exceed high-risk levels; moreover, these patients exhibited more variation in HCC-associated liver stiffness than the HBV and HCV patients. Conclusions: Using appropriate markers and tools, we can establish a stepwise, practical, noninvasive, and etiology-based screening and follow-up system in primary and specialty care.
JGH Open. 2020, 4(5), 827-837.
新大院博(医)第978号
eng
doctoral thesis
http://hdl.handle.net/10191/0002000283
https://niigata-u.repo.nii.ac.jp/records/2000283
https://doi.org/10.1002/jgh3.12406
甲第4824号
博士(医学)
2021-03-23
13101
新潟大学
Niigata University
https://niigata-u.repo.nii.ac.jp/record/2000283/files/r2nmk978.pdf
application/pdf
2.32MB
2022-04-04
https://niigata-u.repo.nii.ac.jp/record/2000283/files/r2nmk978_a.pdf
application/pdf
547KB
2022-04-04