Diagnostic accuracy of liver stiffness measurement in chronic hepatitis B patients with normal or mildly elevated alanine transaminase levels.

Abstract

We aimed to evaluate the diagnostic accuracy of liver stiffness measurement (LSM) in 188 chronic hepatitis B (CHB) patients with alanine transaminase (ALT) ≤ twice the upper limit of normal (ULN). Liver fibrosis was staged using METAVIR scoring system. Define significant fibrosis as F2-F4, severe fibrosis as F3-F4, and cirrhosis as F4. To predict F2-F4, the AUROC of LSM was higher than that of APRI (0.86 vs 0.73, p = 0.001) and FIB-4 (0.86 vs 0.61, p < 0.001). To predict F4, the AUROC of LSM was also higher than that of APRI (0.93 vs 0.77, p = 0.012) and FIB-4 (0.93 vs 0.64, p < 0.001). Patients with ALT levels 1-2 ULN had higher cut-off values than patients with normal ALT levels for the diagnosis of F2-F4 (6.5 vs 6 kPa) and F4 (10.2 vs 7.8 kPa). Using cut-off values regardless of ALT levels, the diagnostic accuracy of LSM was 81% for F2-F4, and 89% for F4. Applying ALT-stratified cut-off values, the diagnostic accuracy of LSM was 82% for F2-F4, and 86% for F4. In conclusion, LSM is a reliable noninvasive test for the diagnosis of liver fibrosis. Applying ALT-stratified cut-off values did not enhance diagnostic accuracy of LSM in CHB patients with ALT ≤ 2 ULN.

• Authors: Qiang Li, Liang Chen, Yu Zhou
• Journal: Scientific reports (Sci Rep) Vol. 8 Issue 1 Pg. 5224 (03 27 2018) ISSN: 2045-2322 [Electronic] England
• PMID: 29588489 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Alanine Transaminase

Topics

• Adult
• Alanine Transaminase (blood)
• Elasticity Imaging Techniques
• Female
• Hepatitis B, Chronic (blood, complications, pathology)
• Humans
• Liver (pathology)
• Liver Cirrhosis (blood, complications, pathology)
• Male
• Middle Aged
• Platelet Count