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. 2016 May;11(5):1673-1677.
doi: 10.3892/etm.2016.3135. Epub 2016 Mar 9.

Fibroscan improves the diagnosis sensitivity of liver fibrosis in patients with chronic hepatitis B

Rengang Huang  1 , Nan Jiang  1 , Renguo Yang  1 , Xiaoxia Geng  1 , Jianmei Lin  1 , Gang Xu  2 , Dandan Liu  2 , Jidog Chen  3 , Guo Zhou  3 , Shuqiang Wang  1 , Tingting Luo  1 , Jiazhen Wu  1 , Xiaoshu Liu  1 , Kaiju Xu  1 , Xingxiang Yang  1
Affiliations

Fibroscan improves the diagnosis sensitivity of liver fibrosis in patients with chronic hepatitis B

Rengang Huang et al. Exp Ther Med. 2016 May.

Abstract

The aim of the present study was to investigate the diagnostic accuracy of Fibroscan for liver fibrosis in patients with chronic hepatitis B (CHB) with alanine aminotransferase (ALT) levels <2 times the upper normal limit. A total of 263 consecutive patients with CHB and ALT levels <2 times the upper normal limit were enrolled in the present study. Liver biopsies and liver stiffness measurements (LSM) were conducted. Receiver operating characteristic (ROC) analysis was used to determine the predictive ability of LSM for the development of liver fibrosis in patients with stage S1, S2 and S3 liver fibrosis. Bivariate Spearman rank correlation analysis was performed in order to determine the association between liver stiffness value, which was measured by Fibroscan, and liver fibrosis stage, which was measured by liver biopsy. The liver stiffness value was found to be positively correlated with the liver fibrosis stage (r=0.522, P<0.001) and necroinflammatory activity (r=0.461, P<0.001), which was measured by liver biopsy. The optimal cut-off value in the patients with stage S1, S2 and S3 liver fibrosis was 5.5, 8.0 and 10.95 kPa, respectively. The area under the ROC curve for the prediction of the development of liver fibrosis in these patients was 0.696, 0.911 and 0.923, respectively. The threshold of the optimal cut-off value exhibited a high sensitivity and specificity. The results of the present study suggested that Fibroscan may improve the sensitivity of the diagnosis of liver fibrosis in patients with CHB and ALT levels <2 times the upper normal limit, and that this sensitivity may increase with the progression of liver fibrosis.

Keywords: chronic hepatitis B; fibroscan; liver fibrosis; liver stiffness measurement.

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Figures

Figure 1.
Figure 1.
ROC curve for the analysis of liver stiffness measurement values, which were measured by Fibroscan, in the patients with stage S1 liver fibrosis. The area under the ROC curve for the prediction of the development of liver fibrosis was 0.696, and the optimal cut-off value was 5.55 kPa in the patients with stage S1 liver fibrosis. The threshold of the optimal cut-off value had a sensitivity of 61.8% and a specificity of 70.6%. ROC, receiver operating characteristic.
Figure 2.
Figure 2.
ROC curve for the analysis of liver stiffness measurement values, which were measured by Fibroscan, in the patients with stage S2 liver fibrosis. The area under the ROC curve for the prediction of the development of liver fibrosis was 0.911, and the optimal cut-off value was 8.0 kPa in the patients with stage S2 liver fibrosis. The threshold of the optimal cut-off value had a sensitivity of 86.4% and a specificity of 85.3%. ROC, receiver operating characteristic.
Figure 3.
Figure 3.
ROC curve for the analysis of liver stiffness measurement values, which were measured by Fibroscan, in the patients with stage S3 liver fibrosis. The area under ROC curve for the prediction of the development of liver fibrosis was 0.923, and the optimal cut-off value was 10.95 kPa in the patients with stage S3 liver fibrosis. The threshold of the optimal cut-off value had a sensitivity of 78.6% and a specificity of 90.4%. ROC, receiver operating characteristic.
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