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Baseline and serial liver stiffness measurement in prediction of portal hypertension progression for patients with compensated cirrhosis
Author(s) -
Wang JingHoung,
Chuah SengKee,
Lu ShengNan,
Hung ChaoHung,
Kuo ChungMou,
Tai WeiChen,
Chiou ShueShian
Publication year - 2014
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12525
Subject(s) - medicine , transient elastography , cirrhosis , hepatocellular carcinoma , gastroenterology , portal hypertension , decompensation , tumor progression , esophageal varices , cancer , liver fibrosis
Background & Aims Liver stiffness measurement ( LSM ) using transient elastography is useful in prediction of significant portal hypertension ( PHT ). To evaluate the usefulness of baseline and serial LSM in predicting clinical disease progression ( CDP ) for patients with compensated hepatic cirrhosis. Methods Consecutive patients with compensated cirrhosis and without hepatocellular carcinoma ( HCC ) were prospectively enrolled. Baseline LSM was assessed at enrolment, then at a 6‐ to 12‐month interval. Esophagogastroduodenoscopy and ultrasonography were performed regularly for surveillance of varices and HCC , while CDP including HCC development and PHT progression was recorded. Results Two hundred and twenty patients were enrolled. In a median follow‐up of 36.9 months, CDP were detected in 49 patients including 30 PHT progression and 19 HCC developments. The cumulative incidence of CDP , PHT progression and HCC development at 3 years was 20.7%, 12.8% and 9.1% respectively. Multivariate analyses showed that baseline LSM was an independent predictor of PHT progression and CDP , however, not of HCC occurrence. The performance of baseline LSM in predicting PHT progression, varices growth/development and hepatic decompensation was 0.744, 0.638 and 0.929. With 17, 12 and 21.1 kPa as the cut‐off, the negative predictive value was 92, 94 and 99% respectively. Patients with baseline LSM ≧17 kPa without serial changes had higher risk of PHT progression. Conclusion For patients with compensated cirrhosis, LSM was an independent predictor of PHT progression and CDP , but not of HCC occurrence. Baseline LSM was useful to exclude PHT progression. Patients with baseline and serial LSM ≧17 kPa had higher risk of PHT progression.