title: Liver stiffness measured by transient elastography correlates with fibrosis area in liver biopsy in patients with chronic hepatitis C.
abstract: OBJECTIVE
  Liver stiffness (LS) measured by transient elastography (TE) has been reported to correlate with liver fibrosis, which is usually semiquantitatively assessed. In the present study, the fibrosis area was measured by image analysis software in liver biopsy specimens and its correlation with LS was assessed.
  
  
  METHODS
  LS was measured by TE in all 165 patients with chronic hepatitis C virus (HCV) infection who underwent liver biopsy consecutively in Fujita Health University Hospital from July 2004 to September 2007.
  
  
  RESULTS
  Fibrosis area was significantly correlated with fibrosis stage as assessed by the Metavir score (rho = 0.733, P < 0.0001). The optimal cut-off value of fibrosis area was 1.6% for F > or = 2, 3.1% for F > or = 3, and 3.8-6.4% for F4. LS was significantly correlated with fibrosis stage (rho = 0.734, P < 0.0001). The optimal cut-off value of LS was 7.1 kPa for F > or = 2, 9.6 kPa for F > or = 3 and 11.6-16.9 kPa for F4. Multiple linear regression analysis selected fibrosis area (P = 0.0002), alanine aminotransferase (ALT) (P = 0.0237), gamma-glutamyltransferase (gamma-GTP) (P = 0.0114), prothrombin time (P = 0.0114) and hyaluronic acid (P < 0.0001) as factors correlating with LS.
  
  
  CONCLUSIONS
  The correlation between LS and liver fibrosis was confirmed by the objective measurement of fibrosis area. ALT was significantly correlated with LS, suggesting that inflammatory activity also affects LS values. Despite some limitation, LS measurement is a useful method for the diagnosis of liver fibrosis.
authors.affiliation: Division of Liver, Biliary Tract and Pancreas Diseases, Department of Internal Medicine, Fujita Health University, Fujita Health University Hospital, Aichi, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Nitta
authors.forename: Naoto
authors.initials: N
authors.lastname: Kawabe
authors.forename: Senju
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Masao
authors.initials: M
authors.lastname: Harata
authors.forename: Naruomi
authors.initials: N
authors.lastname: Komura
authors.forename: Kyoko
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Arima
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimazaki
authors.forename: Takuji
authors.initials: T
authors.lastname: Nakano
authors.forename: Michihito
authors.initials: M
authors.lastname: Murao
authors.forename: Naohiro
authors.initials: N
authors.lastname: Ichino
authors.forename: Keisuke
authors.initials: K
authors.lastname: Osakabe
authors.forename: Hisako
authors.initials: H
authors.lastname: Aoki
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hosoe
authors.forename: Hiroko
authors.initials: H
authors.lastname: Sugiyama
authors.forename: Toru
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yoshioka