Accuracy of transient elastography in assessing liver fibrosis in chronic viral hepatitis: A multicentre, retrospective study

作者：Seo Yeon Seok; Kim Moon Young; Kim Seung Up; Hyun Bae Si; Jang Jae Young; Lee Jin Woo; Lee Jung Il; Suh Sang Jun; Park Soo Young; Park Hana; Jung Eun Uk; Kim Byung Seok; Kim In Hee; Lee Tae Hee; Um Soon Ho; Han Kwang Hyub; Kim Sang Gyune; Paik Soon Koo; Choi Jong Young; Jeong Soung Won; Jin Young Joo; Lee Kwan Sik; Yim Hyung Joon; Tak Won Young; Hwang Seong Gyu; Lee Youn Jae; Lee Chang Hyeong; Kim Dae Ghon; Kang Young Woo; Kim Young Seok^*

来源：Liver International, 2015, 35(10): 2246-2255.

DOI：10.1111/liv.12808

• chronic liver disease
• cirrhosis
• Fibroscan
• liver fibrosis
• liver stiffness
• performance
• Transient elastography

Background/AimsTransient elastography (TE) has become an alternative to liver biopsy (LB). This study investigated the diagnostic performance of liver stiffness (LS) measurement using TE in Korean patients with chronic hepatitis B and C (CHB and CHC).
MethodsFrom April 2006 to June 2014, 916 patients (567 CHB and 349 CHC) who underwent LB and TE at 15 centres were analyzed. The Batts and Ludwig scoring system was used for histologic assessment. Aspartate aminotransferase (AST)-to-platelet ratio indexes (APRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used.
ResultsThe median age, LS value, and APRI score were 45years, 8.8kPa, and 0.61, respectively, in CHB patients vs. 51years, 6.8kPa and 0.55, respectively, in CHC patients. TE was significantly superior to APRI in CHB patients (AUROC 0.774 vs. 0.72 for F2, 0.849 vs. 0.812 for F3, and 0.902 vs. 0.707 for F4, respectively; all P<0.05). Furthermore, TE was significantly superior for predicting F3 stage (AUROC 0.865 vs. 0.840, P=0.009) whereas it was similar for predicting F2 and F4 stage (AUROC 0.822 vs. 0.796; 0.910 vs. 0.884; all P>0.05) in CHC patients. In CHB patients, optimal cut-off LS values were 7.8kPa for F2, 8.2kPa for F3, and 11.6kPa for F4, vs. 6.8kPa, 8.6kPa, and 14.5kPa, respectively, in CHC patients.
ConclusionsTE can accurately assess the degree of liver fibrosis in Korean patients with CVH. TE was superior to APRI for predicting each fibrosis stage.

• 出版日期2015-10