Usefulness of noninvasive transient elastography for assessment of liver fibrosis stage in chronic hepatitis C.
OBJECTIVE
To evaluate the method of noninvasive transient elastography for assessment of histological stage of liver fibrosis in patients with chronic hepatitis C (CHC).


METHODS
Two hundred and thirty-seven patients with CHC were included in this study. Liver biopsy was performed under ultrasonography on 217 of the patients, excluding twenty with clear clinical evidence of liver cirrhosis. Fifty subjects without liver disease were enrolled as a control group (stage 0). Twenty-five patients with sustained virological response (SVR) to interferon (IFN) therapy were also enrolled. These patients underwent liver biopsy before IFN therapy. Examination of liver stiffness (LS) was performed by elastography.


RESULTS
Medians (50% levels) of LS were 4.1 (3.5-4.9), 6.3 (4.8-8.5), 8.8 (6.8-12.0), 14.6 (10.5-18.6), and 22.2 (15.4-28.0), respectively, in the fibrosis stages 0-4 (P < 0.001). LS was significantly correlated with four serum fibrosis markers. LS values in patients with SVR were 3.8 (3.5-5.6), 5.2 (4.4-6.8), 6.8 (6.1-7.6), and 6.1 (3.6-7.9), respectively, in the fibrosis stages 1-4. In all stages, LS for patients with SVR was significantly lower than that for patients who did not undergo IFN therapy. LS was significantly correlated with serum concentrations of hyaluronic acid, type IV collagen, type IV collagen 7S, and type III procollagen N peptide.


CONCLUSIONS
LS correlated well with the histological stage of fibrosis. Changes in liver fibrosis stage may thus be estimated noninvasively using transient elastography.
Takeda
Tadashi
T
Department of Hepatology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahimachi Abeno-ku, Osaka 545-8585, Japan. takeda@med.osaka-cu.ac.jp
Yasuda
Takahiro
T
Nakayama
Yuji
Y
Nakaya
Mika
M
Kimura
Megumi
M
Yamashita
Mariko
M
Sawada
Ayumi
A
Abo
Koji
K
Takeda
Setsuko
S
Sakaguchi
Hiroki
H
Shiomi
Susumu
S
Asai
Hitoshi
H
Seki
Shuichi
S
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D016022:Case-Control Studies; D024141:Collagen Type IV / Q000097:blood; D018450:Disease Progression; D004548:Elasticity; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D007372:Interferons / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000097:blood / Q000145:classification* / Q000209:etiology / Q000473:pathology*; D008297:Male; D008433:Mathematics; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D011379:Prognosis; D018617:Ultrasonography, Doppler, Pulsed / Q000379:methods*
D000998:Antiviral Agents; D024141:Collagen Type IV; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide; D006820:Hyaluronic Acid; D007372:Interferons