[Role of FibroScan in liver fibrosis evaluation in patients with chronic hepatitis B virus infection and related influencing factors]

Zhonghua Gan Zang Bing Za Zhi. 2016 Sep 20;24(9):659-664. doi: 10.3760/cma.j.issn.1007-3418.2016.09.005.
[Article in Chinese]

Abstract

Objective: To investigate the role of FibroScan(FS)in liver fibrosis evaluation in patients with chronic hepatitis B virus(HBV)infection and related influencing factors. Methods: A total of 313 patients with chronic HBV infection were enrolled, and liver tissue was obtained through ultrasound-guided"1-second fast tissue cutting". The liver stiffness measurement(LSM)was determined by FS, serum HBeAg and liver function were measured, and the patients' demographic data were recorded. The t-test was used for comparison of normally distributed data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed data between groups; the Spearman or Pearson correlation coefficient was used for correlation analysis; the ROC curve and AUC were used to evaluate the efficiency of FS in the diagnosis of liver fibrosis ≥S2. Results: LSM was positively correlated with liver inflammation grade and fibrosis stage(r = 0.428 and 0.402 in HBeAg-positive group and r = 0.296 and 0.283 in HBeAg-negative group, all P < 0.001). The correlation of LSM with sex, age, alanine aminotransferase(ALT)level, and total bilirubin(TBil)was affected by HBeAg status and ALT level, and LSM was only positively correlated with TBil in HBeAg-negative group(r = 0.298, P < 0.001). In patients with ALT ≥2×upper limit of normal(ULN), FS had a low efficiency in the diagnosis of liver fibrosis ≥S2(AUC < 0.75, P > 0.05), regardless of their HBeAg status. The cut-off values of FS in the diagnosis of liver fibrosis ≥S2 varied with ALT level and HBeAg status, and in the ALT <1×ULN and 1-2×ULN groups, the cut-off values of FS in the diagnosis of liver fibrosis ≥S2 in patients with positive and negative HBeAg were 5.85 kPa/7.3 kPa and 6.35 kPa/8.5 kPa, respectively. In the patients with positive HBeAg in ALT < 2×ULN group, LSM was positively correlated with age(r = 0.278, P = 0.014). FS had relatively high diagnostic efficiency in patients aged > 30 years(AUC = 0.867, P < 0.001)and low diagnostic efficiency in patients aged≤30 years(AUC = 0.632, P > 0.05). Conclusion: LSM is positively correlated with liver inflammation grade and fibrosis stage. The cut-off value of FS in the diagnosis of marked liver fibrosis is affected by age, ALT level, and HBeAg status. FS has low diagnostic efficiency in patients aged ≤30 years.

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Biomarkers / blood
  • Chronic Disease
  • Elasticity
  • Elasticity Imaging Techniques*
  • Female
  • Hepatitis B e Antigens
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / diagnostic imaging
  • Hepatitis B, Chronic / physiopathology*
  • Humans
  • Liver / diagnostic imaging*
  • Liver / pathology
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / diagnostic imaging
  • Liver Cirrhosis / physiopathology*
  • Male
  • Middle Aged
  • ROC Curve
  • Serologic Tests

Substances

  • Biomarkers
  • Hepatitis B e Antigens
  • Alanine Transaminase