Duan Xingxing,Yang Liu,Wen Huan,et al.Application value of sound touch elastography combined with gamma-glutamyl transpeptidase in the diagnosis of biliary atresia[J].Journal of Clinical Pediatric Surgery,,21():46-50.[doi:10.3760/cma.j.cn.101785-202105063-009]
Application value of sound touch elastography combined with gamma-glutamyl transpeptidase in the diagnosis of biliary atresia
- Abstract:
- Objective To explore the application value of sound touch elastography (STE) technology plus serum gamma-glutamyl transpeptidase (GGT) in the diagnosis of biliary atresia (BA) in infants. Methods A total of 196 cases of neonates and toddlers with clinical manifestations of hyperbilirubinemia were measured for liver stiffness measurement (LSM) by STE and liver function parameters examined at the same time.They were divided into BA (n=75) and non-BA (n=121) groups.And receiver operating characteristic curve (ROC) was utilized for evaluating the diagnostic efficacy of each index for BA. Results Statistically significant inter-group differences existed in LSM, GGT, direct bilirubin (DBIL) and total bilirubin (TBIL) (all P<0.01).No significant inter-group differences existed in alanine aminotransferase (ALT), aspartate aminotransferase (AST) or indirect bilirubin (IBIL) (all P>0.05).ROC analysis revealed that LSM had the highest diagnostic efficiency.Its optimal cut-off value was 10.95 Kpa and the area under the ROC curve (AUC) 0.926.And the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were 77.3%, 95.9%, 90.6%, 87.1% and 88.3% respectively.The next was GGT with an optimal cutoff value of 187.7 U/L and an AUC of 0.831.And sensitivity, specificity, PPV, NPV and accuracy rate were 80.0%, 75.2%, 66.7%, 85.8% and 77.0% respectively.In parallel test, the sensitivity of LSM plus GGT jumped to 94.7%.In serial test, the specificity rose to 100%. Conclusion Both STE and GGT can help to differentiate BA from children with hyperbilirubinemia.The combination of two parameters can improve the diagnostic sensitivity or specificity to a certain extent, thereby reducing missed diagnosis or misdiagnosis as much as possible.
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Memo
收稿日期:2021-05-31。
基金项目:湖南省自然科学基金面上项目（2017JJ2141）；湖南省卫生健康委科研计划课题（20200149）
通讯作者:陈文娟,Email:chenwjok@126.com