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Transient elastography compared to serum markers to predict liver fibrosis in a cohort of C hinese patients with chronic hepatitis B
Author(s) -
Jia Jidong,
Hou Jinlin,
Ding Huiguo,
Chen Guofeng,
Xie Qing,
Wang Yuming,
Zeng Minde,
Zhao Jingmin,
Wang Tailing,
Hu Xiqi,
Schuppan D.
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12840
Subject(s) - transient elastography , medicine , fibrosis , receiver operating characteristic , gastroenterology , chronic hepatitis , liver fibrosis , stage (stratigraphy) , cohort , hepatic fibrosis , elastography , alanine aminotransferase , pathology , ultrasound , radiology , immunology , virus , paleontology , biology
Background and Aim Liver stiffness measurement ( LSM ) using transient elastography ( F ibro S can) is a useful tool to assess fibrosis in various chronic liver diseases. However, studies were mainly performed in W estern countries and largely focused on chronic hepatitis C ( CHC ). We therefore carried out a multicenter study to validate the accuracy of LSM in the assessment of liver fibrosis in a large cohort of C hinese patients with chronic hepatitis B ( CHB ). Methods We compared LSM results to histological staging and serum fibrosis markers (five direct markers, APRI and FIB ‐4) using S pearman correlation analysis and area under receiver operating characteristic ( ROC ) curves ( AUROC s). Results Four hundred sixty‐nine patients were enrolled and eligible for statistical analysis. LSM in F 0 to F 4 was 5.5 ± 1.7, 5.8 ± 2.2, 7.6 ± 3.4, 14.5 ± 10.8, and 22.3 ± 13.6 kPa, respectively (correlation with fibrosis stage r = 0.522, P < 0.001). AUROC for LSM to correctly allocate patients to histological fibrosis stage ≥ F 2, ≥ F 3, and F 4 was 0.82, 0.88, and 0.90, respectively. LSM outperformed serum fibrosis markers for detection of fibrosis F ≥ 2 and F 4. Patients with ALT levels 1–5x and > 5x the upper limit of normal values had significantly higher stiffness values than stage‐matched patients with normal alanine aminotransferase. Conclusion Transient elastography is a reliable noninvasive technique to predict significant liver fibrosis in C hinese patients with CHB , being superior to current biomarker panels. However, enhanced inflammatory activity can lead to elevated stiffness values unrelated to histological fibrosis stage.