{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:56:24Z","timestamp":1791222984759,"version":"4.1.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hangzhou Biomedical and Health Industry Development Support Technology Special Project","award":["2023WJC191"],"award-info":[{"award-number":["2023WJC191"]}]},{"name":"Hangzhou Biomedical and Health Industry Development Support Technology Special Project","award":["2024WJC154"],"award-info":[{"award-number":["2024WJC154"]}]},{"name":"Medical and Health Science Program of Zhejiang Province","award":["2025HY0712"],"award-info":[{"award-number":["2025HY0712"]}]},{"name":"Hangzhou Key Projects for Agricultural and Social Development","award":["20231203A10"],"award-info":[{"award-number":["20231203A10"]}]},{"name":"The Construction Fund of Key Medical Disciplines of Hangzhou","award":["2025HZGF09"],"award-info":[{"award-number":["2025HZGF09"]}]},{"name":"The Construction Fund of Key Medical Disciplines of Hangzhou","award":["2025HZZD13"],"award-info":[{"award-number":["2025HZZD13"]}]},{"name":"National Administration of Traditional Chinese Medicine Inspection and Statistics Center Project","award":["2025JCTJC64"],"award-info":[{"award-number":["2025JCTJC64"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2013S4). 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 235 patients, 125 (53.2%) had significant fibrosis (\u2265S2). LSM demonstrated excellent diagnostic accuracy, with area under the curve (AUROC) values of 0.86 for detecting significant fibrosis (\u2265S2), 0.91 for advanced fibrosis (\u2265S3), 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\u2009=\u20090.70, p\u2009&lt;\u20090.0001). Among serological models, APRI and FIB\u20114 showed relatively better performance, while FIB\u20115 performed poorly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0357883","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:31:06Z","timestamp":1791221466000},"page":"e0357883","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Superior diagnostic efficacy and cost advantage of FibroTouch over CHI3L1 for liver fibrosis in Chinese patients with chronic liver disease"],"prefix":"10.1371","volume":"21","author":[{"given":"Zhongbao","family":"Zuo","sequence":"first","affiliation":[{"name":"Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University","place":["Hangzhou, Zhejiang, China"],"department":["Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou 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