{
  "abstract": "Background: Non-invasive assessment of liver fibrosis is essential for managing chronic liver disease (CLD). Serum chitinase-3-like protein 1 (CHI3L1) has been recommended in recent guidelines, while FibroTouch is a domestically produced device for liver stiffness measurement (LSM). However, no study has directly compared their diagnostic performance in CLD patients. Methods: This retrospective study included 235 patients with CLD who underwent liver biopsy, FibroTouch examination, and laboratory testing (including CHI3L1 and routine blood parameters) at Hangzhou Xixi Hospital between October 2019 and December 2024. Liver fibrosis was staged according to the Scheuer scoring system (S0–S4). The diagnostic performance of LSM, CHI3L1, and six serological models (aspartate aminotransferase-to-platelet ratio index [APRI], fibrosis-4 index [FIB-4], S-Index, Forns index, platelet ratio-to-RDW [PRP], and FIB-5) were evaluated using receiver operating characteristic (ROC) curve analysis, with liver biopsy as the reference standard. Results: Among the 235 patients, 125 (53.2%) had significant fibrosis (≥S2). LSM demonstrated excellent diagnostic accuracy, with area under the curve (AUROC) values of 0.86 for detecting significant fibrosis (≥S2), 0.91 for advanced fibrosis (≥S3), and 0.93 for cirrhosis (S4). CHI3L1 showed moderate diagnostic performance, with corresponding AUROC values of 0.72, 0.79, and 0.81. LSM exhibited the strongest correlation with histological staging (r = 0.70, p < 0.0001). Among serological models, APRI and FIB‑4 showed relatively better performance, while FIB‑5 performed poorly. Conclusions: In this biopsy-proven CLD cohort, LSM demonstrated superior diagnostic performance for liver fibrosis assessment compared to CHI3L1 and six serological models, with the strongest correlation with histological staging. Given its better diagnostic efficacy and lower cost, LSM offers a practical advantage as a routine monitoring tool in clinical practice, particularly in resource-constrained settings.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People’s Hospital, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China",
    "Department of Clinical Laboratory, The 903rd Hospital of PLA, Hangzhou, Zhejiang, China",
    "Department of Hepatology, Hangzhou Xixi Hospital, Hangzhou Sixth People’s Hospital, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China",
    "Department of Stomatology, Hangzhou Xixi Hospital, Hangzhou Sixth People’s Hospital, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhongbao Zuo"
    },
    {
      "affs": [
        1
      ],
      "name": "Chunli Yang"
    },
    {
      "affs": [
        2
      ],
      "name": "Lanlan Hu"
    },
    {
      "affs": [
        3
      ],
      "name": "Xiafen Ye"
    },
    {
      "name": "Yazhen Zhang"
    },
    {
      "name": "Lili Huang"
    },
    {
      "name": "Miaochan Wang"
    },
    {
      "name": "Huaizhong Cui"
    },
    {
      "name": "Xiaoqiang Chen"
    },
    {
      "name": "Kenv Pan"
    },
    {
      "name": "Jianfeng Bao"
    },
    {
      "name": "He He"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fpx94681yzp09.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0357883",
  "fulltext_url": null,
  "id": "fpx94681yzp09",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0357883",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Liver Disease Diagnosis and Treatment"
    ],
    [
      "plos",
      "/Biology and life sciences/Developmental biology/Fibrosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Diagnostic medicine"
    ],
    [
      "plos",
      "/Medicine and health sciences/Diagnostic medicine/Serodiagnosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Gastroenterology and hepatology/Liver diseases/Chronic liver disease"
    ],
    [
      "plos",
      "/Medicine and health sciences/Gastroenterology and hepatology/Liver diseases/Cirrhosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Gastroenterology and hepatology/Liver diseases/Liver fibrosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine/Serology"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine/Serology/Serodiagnosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Surgical and invasive medical procedures/Biopsy"
    ]
  ],
  "openalex": "W7220362254",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0357883&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-05",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/fpx94681yzp09.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:37Z",
      "native_id": "10.1371/journal.pone.0357883",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0357883"
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  "subjects": [
    {
      "field": "biology",
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      "subfield": "developmental-biology"
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    {
      "field": "medicine",
      "origin": "plos:surgical and invasive medical procedures",
      "subfield": "surgery"
    }
  ],
  "title": "Superior diagnostic efficacy and cost advantage of FibroTouch over CHI3L1 for liver fibrosis in Chinese patients with chronic liver disease",
  "title_text": "Superior diagnostic efficacy and cost advantage of FibroTouch over CHI3L1 for liver fibrosis in Chinese patients with chronic liver disease",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:37Z",
  "url": "https://research.draconitic.com/paper/fpx94681yzp09",
  "venue": "PLOS One",
  "versions": []
}