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Larger Biopsies Evaluation of Transient Elastography for Detecting Advanced Fibrosis in Patients with Compensated Chronic Hepatitis B.
MedLine Citation:
PMID:  22414330     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective:  Although larger biopsies sample had been recommended for study of non-invasive liver fibrosis assessment, few studies with larger biopsies for transient elastography (TE) detecting liver fibrosis had been reported. Present study tries to re-evaluate performance of TE for detecting advanced fibrosis (≥F3) with larger biopsies in patients with compensated chronic hepatitis B. Methods:  A total of 375 compensated patients were analyzed, which had undergone liver biopsy, reliable TE and routine blood tests. Results:  The area under receiver operating characteristic curve (AUC) was influenced by liver biopsy sample: 0.873 (95% confidence interval 0.838-0.909) in total patients, 0.880 (0.844-0.917) in length ≥15mm, 0.897 (0.863-0.932) in length ≥20mm and 0.911 (0.874-0.949) in length ≥25mm. In patients with sample length ≥20mm, the cutoffs to exclude and confirm advanced fibrosis were 7.1kPa and 12.7kPa, respectively. Stratified by ALT 2×ULN, transient elastography detecting advanced fibrosis with the most efficiency by 72.5% of patients obviated from liver biopsy. In patients with normal bilirubin and ALT <2×ULN, the area was 0.921 (0.860-0.982), and cutoffs for excluding and confirming diagnosis were 7.4kPa and 10.6kPa, respectively; 80% of patients could be classified with or without AF. In patients with normal bilirubin and ALT ≥2×ULN, the corresponding numbers were 0.885 (0.824-0.947), 7.5kPa, 12.7kPa and 79.2%, respectively. Conclusions:  Inadequate sample study would underestimate the efficiency of TE on detecting advanced fibrosis. With ALT 2×ULN stratified cutoffs, TE determined nearly 80% of patients with normal bilirubin as AF or non-AF and obviated them from liver biopsies. © 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Authors:
Yong Peng Chen; Xie Er Liang; Qi Zhang; Jie Peng; You Fu Zhu; Wei Qun Wen; Jin Lin Hou
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-13
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  -     ISSN:  1440-1746     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Affiliation:
Department of Infectious Disease, Nanfang Hospital, Institute for Hepatology Research, Southern Medical University, Guangzhou, 510515, China.
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