Superior diagnostic efficacy and cost advantage of FibroTouch over CHI3L1 for liver fibrosis in Chinese patients with chronic liver disease
4 affiliations
- 1Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People’s Hospital, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- 2Department of Clinical Laboratory, The 903rd Hospital of PLA, Hangzhou, Zhejiang, China
- 3Department of Hepatology, Hangzhou Xixi Hospital, Hangzhou Sixth People’s Hospital, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
- 4Department of Stomatology, Hangzhou Xixi Hospital, Hangzhou Sixth People’s Hospital, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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.
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BibTeX
@article{zuo2026superior,
title = {{Superior diagnostic efficacy and cost advantage of FibroTouch over CHI3L1 for liver fibrosis in Chinese patients with chronic liver disease}},
author = {Zhongbao Zuo and Chunli Yang and Lanlan Hu and Xiafen Ye and Yazhen Zhang and Lili Huang and Miaochan Wang and Huaizhong Cui and Xiaoqiang Chen and Kenv Pan and Jianfeng Bao and He He},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0357883},
url = {https://doi.org/10.1371/journal.pone.0357883},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Superior diagnostic efficacy and cost advantage of FibroTouch over CHI3L1 for liver fibrosis in Chinese patients with chronic liver disease
AU - Zhongbao Zuo
AU - Chunli Yang
AU - Lanlan Hu
AU - Xiafen Ye
AU - Yazhen Zhang
AU - Lili Huang
AU - Miaochan Wang
AU - Huaizhong Cui
AU - Xiaoqiang Chen
AU - Kenv Pan
AU - Jianfeng Bao
AU - He He
PY - 2026
DA - 2026/10/05
JO - PLOS One
DO - 10.1371/journal.pone.0357883
UR - https://doi.org/10.1371/journal.pone.0357883
AB - 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.
SN - 1932-6203
ER -