Abstract
BackgroundNoninvasive diagnostic technologies that can dynamically monitor changes in liver inflammation are highly important for the management of chronic hepatitis B (CHB) patients and thus warrant further exploration. This study assessed the diagnostic efficacy of FibroScan for liver inflammation in CHB patients.MethodsA total of 1185 patients were selected, and ultrasound-guided liver biopsy was performed within 1 month after the FibroScan test. The liver stiffness measurement (LSM), the reliability criteria (IQR/M) of LSM, the quality of liver biopsy (complete portal area, PA), and the liver inflammation grades were the main observation items of this study. With liver biopsy as the control, the diagnostic efficacy of FibroScan for liver inflammation in CHB patients was evaluated by receiver operating characteristic (ROC) curve analysis.ResultsThe grade of liver inflammation was positively correlated with the stage of fibrosis (rho = 0.829, P < 0.001). Different grades of inflammation will have significant rise in LSM values within the same fibrosis stage, and LSM values were positively correlated with liver inflammation grade and fibrosis stage, and the rho is 0.579 and 0.593 respectively (P < 0.001). Significant differences in the LSM of FibroScan were observed among different grades of liver inflammation (P < 0.0001). Liver biopsy (PA > 10) served as the control, and the cutoff point and the area under ROC curves (AUCs) of the LSMs for different inflammation grades were as follows: G2, 8.6 kPa, 0.775; G3 9.8 kPa, 0.818; and G4, 11.0 kPa; 0.832. With LSM cutoff values of 8.6 kPa, 9.8 kPa and 11.0 kPa, FibroScan showed certain diagnostic value for CHB patients with G2, G3 and G4 liver inflammation, especially those with G4 inflammation.ConclusionsThe grade of liver inflammation was positively correlated with the stage of fibrosis, different grades of inflammation will have significant rise in LSM values within the same fibrosis stage. In addition to liver fibrosis, FibroScan could evaluate liver inflammation in CHB patients in a noninvasive manner.
Highlights
Noninvasive diagnostic technologies that can dynamically monitor changes in liver inflammation are highly important for the management of chronic hepatitis B (CHB) patients and warrant further exploration
Further analysis of the correlation between liver fibrosis stage, liver inflammation grade and liver stiffness measurement (LSM) values in patients with chronic hepatitis B showed that LSM values were positively correlated with liver inflammation grade and fibrosis stage, the Spearman’s Rho was 0.579 and 0.593, respectively (P < 0.001)
It seemed to indicate that different grades of inflammation will have significant rise in LSM values within the same fibrosis stage.In order to further confirm this, we carried out Spearman rank correlation coefficient analysis. It showed that LSM values were positively correlated with liver inflammation grade and fibrosis stage, and the Spearman’s rho is 0.579 and 0.593 respectively (P < 0.001)
Summary
Noninvasive diagnostic technologies that can dynamically monitor changes in liver inflammation are highly important for the management of chronic hepatitis B (CHB) patients and warrant further exploration. This study assessed the diagnostic efficacy of FibroScan for liver inflammation in CHB patients. Among untreated patients with CHB virus infection, 15–40% progress to cirrhosis, which may lead to liver failure and liver cancer [3]. The prevention and treatment of CHB is so urgent that, in addition to drug research, researchers must explore rapid, dynamic and noninvasive diagnostic methods that could be used to monitor the occurrence and development of CHB. FibroScan, which is based on TE techniques, is widely used across the globe and has become an important method for the assessment of liver fibrosis in patients with CHB [6,7,8]. The LSM value obtained with FibroScan was found to correlate significantly with both liver fibrosis and necroinflammatory activity on biopsy, which was considered to explain the TE measurement of TE [12]
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