Transient elastography for measurement of liver stiffness measurement can detect early significant hepatic fibrosis in Japanese patients with viral and nonviral liver diseases.
BACKGROUND
Many studies have reported the efficiency of transient elastography, a noninvasive, reproducible, and reliable method for predicting liver fibrosis, in patients with chronic hepatitis C (CHC) and B (CHB), but there are few reports about nonviral chronic liver disease (CLD) such as primary biliary cirrhosis (PBC), nonalcoholic steatohepatitis (NAFLD), and autoimmune hepatitis (AIH). We therefore compared the efficiency of transient elastography between CHC and nonviral CLD.


METHODS
We assessed the accuracy of liver stiffness measurement (LSM) using Fibroscan, and compared these values with those of hyaluronic acid, type 4 collagen, platelet count, prothrombin index, and AST/platelet ratio index (APRI) as indices for the diagnosis of liver fibrosis in 114 patients with a variety of chronic liver diseases: CHC (n = 51), CHB (n = 11), NAFLD (n = 17), PBC (n = 20), and AIH (n = 15). The histology was assessed according to the METAVIR score by two pathologists.


RESULTS
The number of fibrosis stage (F0/1/2/3/4) with CHC was 9/15/12/6/10, and that with nonviral CLD was 10/21/11/4/6, respectively. The ability, assessed by area under receiver operating characteristic (AUROC) curve, to predict liver fibrosis F >or= 2 for LSM, HA, type 4 collagen, platelet count, prothrombin index, and APRI, was 0.92, 0.81, 0.87, 0.85, 0.85, and 0.92 in CHC patients, respectively; and 0.88, 0.72, 0.81, 0.67, 0.81, and 0.77 in nonviral CLD patients, respectively.


CONCLUSIONS
In patients with nonviral CLD, LSM was most helpful in predicting significant fibrosis (F >or= 2). Transient elastography is a reliable method for predicting significant liver fibrosis, not only in CHC patients but also in nonviral CLD patients.
Obara
Noriyuki
N
Division of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo, Aoba, Sendai 980-8574, Japan.
Ueno
Yoshiyuki
Y
Fukushima
Koji
K
Nakagome
Yu
Y
Kakazu
Eiji
E
Kimura
Osamu
O
Wakui
Yuta
Y
Kido
Osamu
O
Ninomiya
Masashi
M
Kogure
Takayuki
T
Inoue
Jun
J
Kondo
Yasuteru
Y
Shiina
Masaaki
M
Iwasaki
Takao
T
Yamamoto
Takeshi
T
Shimosegawa
Tooru
T
D001707:Biopsy, Needle; D054459:Elasticity Imaging Techniques; D005234:Fatty Liver / Q000175:diagnosis / Q000473:pathology; D005260:Female; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000473:pathology; D019693:Hepatitis, Autoimmune / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity