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Background@#Obstructive sleep apnea hypopnea syndrome (OSAHS) is a contributing factor for non-alcoholic fatty liver disease (NAFLD). Non-invasive algorithms including fatty liver index (FLI) and hepatic steatosis index (HSI) have been used as a screening test for NAFLD in epidemiologic studies. The aim of this study is to compare the diagnostic accuracy of FLI and HSI for NAFLD detection in adults with OSAHS.@*Methods@#We enrolled consecutive adult subjects who were newly diagnosed with OSAHS from March 2016 to January 2018. NAFLD was diagnosed by ultrasonography. The accuracy and cut-off point of the FLI and HSI to detect NAFLD were assessed by analyzing the area under the receiver operating characteristic (AUROC) curve and the maximum Youden index analysis, respectively.@*Results@#The 326 subjects were diagnosed as NAFLD according to ultrasound findings, while 105 subjects who had normal abdominal ultrasonography were grouped as controls. Both FLI and HSI values were significantly higher in patients with NAFLD compared with controls. The AUROC of FLI and HSI for predicting NAFLD was 0.802 (95% confidence interval [CI] 0.762-0.839) and 0.753 (95% CI 0.710-0.793), respectively. The AUROC of FLI was significantly higher than that of HSI (P = 0.0383). The optimal cut-off value of FLI and HSI was 60 (sensitivity 66% and specificity 80%) and 35 (sensitivity 81% and specificity 60%), respectively.@*Conclusions@#Both FLI and HSI can serve as screening tools for NAFLD in OSAHS adults. The FLI shows better performance in diagnosing NAFLD than HSI.@*Trial registration@#Chinese Clinical Trial Registry (No. ChiCTR-OOB-15007253), http://www.chictr.org.cn/showproj.aspx?proj=11606.
Résumé
BACKGROUND@#Obstructive sleep apnea hypopnea syndrome (OSAHS) is a contributing factor for non-alcoholic fatty liver disease (NAFLD). Non-invasive algorithms including fatty liver index (FLI) and hepatic steatosis index (HSI) have been used as a screening test for NAFLD in epidemiologic studies. The aim of this study is to compare the diagnostic accuracy of FLI and HSI for NAFLD detection in adults with OSAHS.@*METHODS@#We enrolled consecutive adult subjects who were newly diagnosed with OSAHS from March 2016 to January 2018. NAFLD was diagnosed by ultrasonography. The accuracy and cut-off point of the FLI and HSI to detect NAFLD were assessed by analyzing the area under the receiver operating characteristic (AUROC) curve and the maximum Youden index analysis, respectively.@*RESULTS@#The 326 subjects were diagnosed as NAFLD according to ultrasound findings, while 105 subjects who had normal abdominal ultrasonography were grouped as controls. Both FLI and HSI values were significantly higher in patients with NAFLD compared with controls. The AUROC of FLI and HSI for predicting NAFLD was 0.802 (95% confidence interval [CI] 0.762-0.839) and 0.753 (95% CI 0.710-0.793), respectively. The AUROC of FLI was significantly higher than that of HSI (P = 0.0383). The optimal cut-off value of FLI and HSI was 60 (sensitivity 66% and specificity 80%) and 35 (sensitivity 81% and specificity 60%), respectively.@*CONCLUSIONS@#Both FLI and HSI can serve as screening tools for NAFLD in OSAHS adults. The FLI shows better performance in diagnosing NAFLD than HSI.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry (No. ChiCTR-OOB-15007253), http://www.chictr.org.cn/showproj.aspx?proj=11606.
Résumé
<p><b>OBJECTIVE</b>To analyze the clinical pathologic characteristics, diagnosis, treatment and outcome of patients with primary gastrointestinal non-Hodgkin's lymphoma(PGI-NHL).</p><p><b>METHODS</b>The clinical and pathological features of 50 cases of PGI-NHL were analyzed retrospectively, the Kaplan-Meier was applied to estimate the survival time of all the patients.</p><p><b>RESULTS</b>The median age of patients was 58 years old, the cases of male patient were more than that of femal. The main clinical symptoms included pain and discomfort. The patients of Ⅰ-Ⅱstage accounted for 66%, DLBCL was most common. The clinical and pathological features were not significantly different between gastric and intestinal lymphoma. In 58% of the patients, surgery was the first choice for treatment. The median survival time was 74 months. The OS rates at 1-, 3- and 5-year were 78%, 65.9% and 61.8% respectively. Log-rank univariate analysis showed that age, sex, ECOG score, B symptoms, disease location and treatment methods all did not relate with OS, however, IPI, stage, LDH, cell phenotype and pathological type closely related with the OS.</p><p><b>CONCLUSION</b>As lacking characteristic clinical manifestations of PGI-NHL, the DLBCL is the most common type. The prognosis of B cell lymphoma is significantly better than that of T cell lymphoma. The prognosis of PTCL is the worst.</p>