Liver stiffness measured by transient elastography correlates with fibrosis area in liver biopsy in patients with chronic hepatitis C.
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.
Nitta
Yoshifumi
Y
Division of Liver, Biliary Tract and Pancreas Diseases, Department of Internal Medicine, Fujita Health University, Fujita Health University Hospital, Aichi, Japan.
Kawabe
Naoto
N
Hashimoto
Senju
S
Harata
Masao
M
Komura
Naruomi
N
Kobayashi
Kyoko
K
Arima
Yuko
Y
Shimazaki
Hiroaki
H
Nakano
Takuji
T
Murao
Michihito
M
Ichino
Naohiro
N
Osakabe
Keisuke
K
Aoki
Hisako
H
Hosoe
Yoko
Y
Sugiyama
Hiroko
H
Nishikawa
Toru
T
Yoshioka
Kentaro
K