title: Liver stiffness measurement-based scoring system for significant inflammation related to chronic hepatitis B.
abstract: OBJECTIVE
  Liver biopsy is indispensable because liver stiffness measurement alone cannot provide information on intrahepatic inflammation. However, the presence of fibrosis highly correlates with inflammation. We constructed a noninvasive model to determine significant inflammation in chronic hepatitis B patients by using liver stiffness measurement and serum markers.
  
  
  METHODS
  The training set included chronic hepatitis B patients (n = 327), and the validation set included 106 patients; liver biopsies were performed, liver histology was scored, and serum markers were investigated. All patients underwent liver stiffness measurement.
  
  
  RESULTS
  An inflammation activity scoring system for significant inflammation was constructed. In the training set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.964, 91.9%, and 90.8% in the HBeAg(+) patients and 0.978, 85.0%, and 94.0% in the HBeAg(-) patients, respectively. In the validation set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.971, 90.5%, and 92.5% in the HBeAg(+) patients and 0.977, 95.2%, and 95.8% in the HBeAg(-) patients. The liver stiffness measurement-based activity score was comparable to that of the fibrosis-based activity score in both HBeAg(+) and HBeAg(-) patients for recognizing significant inflammation (G ≥3).
  
  
  CONCLUSIONS
  Significant inflammation can be accurately predicted by this novel method. The liver stiffness measurement-based scoring system can be used without the aid of computers and provides a noninvasive alternative for the prediction of chronic hepatitis B-related significant inflammation.
authors.affiliation: Department of Infectious Diseases, Chenggong Hospital affiliated to Xiamen University (the 174th Hospital of PLA), Xiamen, Fujian, China.
authors.forename: Mei-Zhu
authors.initials: MZ
authors.lastname: Hong
authors.affiliation: Hepatology Unit and Department of Infectious Diseases, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, Fujian, China.
authors.forename: Ru-Mian
authors.initials: RM
authors.lastname: Zhang
authors.affiliation: Hepatology Unit and Department of Infectious Diseases, Xiamen Hospital of Traditional Chinese Medicine, Xiamen, Fujian, China.
authors.forename: Guo-Liang
authors.initials: GL
authors.lastname: Chen
authors.affiliation: Department of Infectious Diseases, Chenggong Hospital affiliated to Xiamen University (the 174th Hospital of PLA), Xiamen, Fujian, China.
authors.forename: Wen-Qi
authors.initials: WQ
authors.lastname: Huang
authors.affiliation: Department of Infectious Diseases, Chenggong Hospital affiliated to Xiamen University (the 174th Hospital of PLA), Xiamen, Fujian, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Min
authors.affiliation: Department of Infectious Diseases, Chenggong Hospital affiliated to Xiamen University (the 174th Hospital of PLA), Xiamen, Fujian, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Infectious Diseases, Chenggong Hospital affiliated to Xiamen University (the 174th Hospital of PLA), Xiamen, Fujian, China.
authors.forename: Jin-Chao
authors.initials: JC
authors.lastname: Xu
authors.affiliation: Department of Gastroenterology, Zhongshan Hospital affiliated to Xiamen University, Xiamen, Fujian, China.
authors.forename: Jin-Shui
authors.initials: JS
authors.lastname: Pan
mesh_terms: D000328:Adult; D019540:Area Under Curve; D001696:Biomechanical Phenomena; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000473:pathology*; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000473:pathology*; D008099:Liver / Q000473:pathology* / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D008954:Models, Biological; D015203:Reproducibility of Results; D012307:Risk Factors