title: Prospective evaluation of FibroScan for the diagnosis of hepatic fibrosis compared with liver biopsy/AST platelet ratio index and FIB-4 in patients with chronic HBV infection.
abstract: BACKGROUND
  The FibroScan (FS), the aspartate aminotransferase-to-platelet ratio index (APRI), and the FIB-4 index are simple and inexpensive methods to detect liver fibrosis.
  
  
  OBJECTIVE
  The primary objective was to evaluate the performance of FS for the noninvasive diagnosis of hepatic fibrosis in Western Chinese patients with chronic hepatitis B virus (HBV) infection compared with APRI and FIB-4; the secondary objective was to determine liver stiffness measurement (LSM) cutoff values for the noninvasive diagnosis of significant fibrosis and liver cirrhosis.
  
  
  METHODS
  Overall, 175 consecutive patients with chronic HBV infection, successful liver biopsy, and alanine aminotransferase levels ≤2× ULN were prospectively studied. Liver fibrosis was graded by an independent pathologist using the METAVIR (F0-F4) classification. APRI and FIB-4 were calculated from laboratory data.
  
  
  RESULTS
  The area under receiver operating characteristics curves (AUROC) for LSM for significant fibrosis (METAVIR F2-3) and cirrhosis (F4) was 0.95 (95% confidence interval, 0.91-0.98) and 0.98 (0.96-0.99), respectively. For the detection of significant fibrosis and cirrhosis, the AUROC of APRI were 0.81 (0.74-0.87) and 0.83 (0.77-0.90); the AUROC of FIB-4 were 0.86 (0.80-0.91) and 0.77 (0.68-0.85). FS optimal cutoff values for the identification of significant fibrosis and cirrhosis were 7.9 and 13.8 kPa, respectively.
  
  
  CONCLUSIONS
  FS is a reliable predictor of significant fibrosis and cirrhosis in Western Chinese patients with chronic HBV infection, and is superior to APRI and FIB-4. FS cutoff values could be considered as clinical reference for detecting significant fibrosis and cirrhosis.
authors.affiliation: Center of Infectious Diseases, West China Hospital of Sichuan University, No.37 Guo Xue Xiang, 610041 Wu Hou District, Chengdu, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Zhu
authors.forename: Li-Chun
authors.initials: LC
authors.lastname: Wang
authors.forename: En-Qiang
authors.initials: EQ
authors.lastname: Chen
authors.forename: Xue-Bing
authors.initials: XB
authors.lastname: Chen
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Chen
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.forename: Xue-Zhong
authors.initials: XZ
authors.lastname: Lei
authors.forename: Cong
authors.initials: C
authors.lastname: Liu
authors.forename: Hong
authors.initials: H
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001219:Aspartate Aminotransferases / Q000378:metabolism*; D015415:Biomarkers; D001706:Biopsy; D001792:Blood Platelets / Q000201:enzymology*; D054459:Elasticity Imaging Techniques / Q000295:instrumentation*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases