Abstract
BackgroundEvaluation of fibrosis stage is important to monitor progression of liver disease and risk of hepatocellular carcinoma (HCC). While liver biopsy is the gold standard, the method is invasive and faces several limitations. The aim of this study was to determine correlations among METAVIR scores and FibroScan, Virtual-Touch tissue quantification (VTQ), fibrosis index based on four factors (FIB-4 index), and Mac-2 binding protein glycosylation isomer (M2BPGi) level, and for examine differences in the reliability of non-invasive methods to evaluate fibrosis.MethodsWe used liver resection specimens from patients with hepatitis C virus (HCV), correlations were assessed between METAVIR scores and non-invasive method. Receiver operating characteristic (ROC) curves were generated to determine the sensitivity, specificity, and cut off values of the methods.ResultsAll Patients group: In F0–2 vs F3–4, the areas under the ROC curve (AUC) (0.85) of FibroScan was significantly higher than that (0.67) of FIB-4 index (p = 0.002) and that (0.67) of M2BPGi (p = 0.001). The AUC (0.83) of VTQ was significantly higher than that (0.67) of FIB-4 index (p = 0.01) and that (0.67) of M2BPGi (p = 0.002). In F0–3 vs F4, the AUC (0.86) of VTQ was significantly higher than that (0.65) of FIB-4 index (p = 0.04). The AUC (0.89) of FibroScan was significantly higher than that (0.65) of FIB-4 index (p = 0.002) and that (0.76) of M2BPGi (p = 0.02).Non-SVR group: In F0–2 vs F3–4, the AUC (0.85) of FibroScan was significantly higher than that (0.84) of FIB-4 index (p = 0.02) and that (0.73) of M2BPGi (p = 0.003). The AUC (0.84) of VTQ was significantly higher than that (0.74) of FIB-4 index (p = 0.04). In F0–3 vs F4, the AUC (0.91) of FibroScan was significantly higher than that (0.67) of FIB-4 index (p = 0.003) and that (0.78) of M2BPGi (p = 0.02). The AUC (0.88) of VTQ was significantly higher than that of FIB-4 index (0.67) and that of M2BPGi (0.78) (p = 0.04).ConclusionsFibroScan and VTQ best reflected the results of hepatic fibrosis diagnosis using liver resection specimens among the four examination methods evaluated.
Highlights
Evaluation of fibrosis stage is important to monitor progression of liver disease and risk of hepatocellular carcinoma (HCC)
FibroScan and VirtualTouch tissue quantification (VTQ) best reflected the results of hepatic fibrosis diagnosis using liver resection specimens among the four examination methods evaluated
Noninvasive methods of assessing liver fibrosis stage include measuring platelet counts, levels of liver fibrosis markers such as hyaluronic acid and type 4 collagen 7S, the aspartate aminotransferase to platelet ratio index, the fibrosis index based on four factors (FIB4 index), FibroTest, and the serum level of Mac-2 binding protein glycosylation isomer (M2BPGi) [10,11,12,13,14]
Summary
Evaluation of fibrosis stage is important to monitor progression of liver disease and risk of hepatocellular carcinoma (HCC). Further progression results in liver cirrhosis and an increased risk of developing hepatocellular carcinoma (HCC). Various problems are associated with biopsy that prevent accurate evaluation, such as sampling difficulty, the small amount of specimen obtained, and the subjectivity of the pathologist’s evaluation [8, 9]. For this reason, visual evaluation by ultrasonography and measurements of various blood-based parameters have been conducted as noninvasive alternative methods of hepatic fibrosis diagnosis
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