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Liver Stiffness Measurement in Combination With Noninvasive Markers for the Improved Diagnosis of B-viral Liver Cirrhosis

2009; Lippincott Williams & Wilkins; Volume: 43; Issue: 3 Linguagem: Inglês

10.1097/mcg.0b013e31816f212e

1539-2031

Seung Up Kim, Sang Hoon Ahn, Jun Yong Park, Wonseok Kang, Do Young Kim, Young Nyun Park, Chae Yoon Chon, Kwang–Hyub Han,

Liver Disease and Transplantation

Goal To investigate the performance of liver stiffness measurement (LSM) in combination with available noninvasive markers in hepatitis B virus-related chronic liver disease. Background Few noninvasive methods are available for predicting liver cirrhosis in chronic hepatitis B (CHB). Study Between January 2006 and June 2007, we studied 130 consecutive treatment-naive CHB patients who underwent liver biopsy (LB) and LSM. The aspartate to alanine aminotransferase ratio, age-platelet index (API), aspartate aminotransferase to platelet ratio index (APRI), LSM, and their combinations were compared with liver histology. Results The API, APRI, and LSM, but not the aspartate to alanine aminotransferase ratio, correlated significantly with liver cirrhosis (all P<0.001). The diagnostic accuracy of LSM and API exceed that of the other diagnostic methods for predicting liver cirrhosis (area under the receiver operating characteristic curve=0.840 and 0.818). When LSM was combined with API and APRI, the diagnostic accuracy was improved markedly (area under the receiver operating characteristic curve =0.871, and 0.846). When both LSM and API results were in agreement, LB confirmed them in 89.1% (41/46) of cases for liver cirrhosis. LB could have been avoided in 41 (31.5%) of the 130 patients who were examined for the potential diagnosis of liver cirrhosis. Conclusions The combination of LSM and API can avoid unnecessary invasive LB procedures in CHB patients.