Liver, Pancreas, and Biliary Tract

Journal of Gastroenterology

, 43:720

First online:

Transient elastography for measurement of liver stiffness measurement can detect early significant hepatic fibrosis in Japanese patients with viral and nonviral liver diseases

  • Noriyuki ObaraAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
  • , Yoshiyuki UenoAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
  • , Koji FukushimaAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
  • , Yu NakagomeAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
  • , Eiji KakazuAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
  • , Osamu KimuraAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
  • , Yuta WakuiAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
  • , Osamu KidoAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
  • , Masashi NinomiyaAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
    • , Takayuki KogureAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
    • , Jun InoueAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
    • , Yasuteru KondoAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
    • , Masaaki ShiinaAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
    • , Takao IwasakiAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine
    • , Takeshi YamamotoAffiliated withDepartment of Gastroenterology, Tohoku Koseinenkin Hospital
    • , Tooru ShimosegawaAffiliated withDivision of Gastroenterology, Tohoku University Graduate School of Medicine

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Abstract

Background

Many studies have reported the efficiency of transient elastography, a noninvasive, reproducible, and reliable method for predicting liver fibrosis, in patients with chronic hepatitis C (CHC) and B (CHB), but there are few reports about nonviral chronic liver disease (CLD) such as primary biliary cirrhosis (PBC), nonalcoholic steatohepatitis (NAFLD), and autoimmune hepatitis (AIH). We therefore compared the efficiency of transient elastography between CHC and nonviral CLD.

Methods

We assessed the accuracy of liver stiffness measurement (LSM) using Fibroscan, and compared these values with those of hyaluronic acid, type 4 collagen, platelet count, prothrombin index, and AST/platelet ratio index (APRI) as indices for the diagnosis of liver fibrosis in 114 patients with a variety of chronic liver diseases: CHC (n = 51), CHB (n = 11), NAFLD (n = 17), PBC (n = 20), and AIH (n = 15). The histology was assessed according to the METAVIR score by two pathologists.

Results

The number of fibrosis stage (F0/1/2/3/4) with CHC was 9/15/12/6/10, and that with nonviral CLD was 10/21/11/4/6, respectively. The ability, assessed by area under receiver operating characteristic (AUROC) curve, to predict liver fibrosis F ≥ 2 for LSM, HA, type 4 collagen, platelet count, prothrombin index, and APRI, was 0.92, 0.81, 0.87, 0.85, 0.85, and 0.92 in CHC patients, respectively; and 0.88, 0.72, 0.81, 0.67, 0.81, and 0.77 in nonviral CLD patients, respectively.

Conclusions

In patients with nonviral CLD, LSM was most helpful in predicting significant fibrosis (F ≥ 2). Transient elastography is a reliable method for predicting significant liver fibrosis, not only in CHC patients but also in nonviral CLD patients.

Key words

transient elastography fibrosis chronic liver disease NAFLD