Cell Biochemistry and Biophysics

, Volume 71, Issue 2, pp 865–873 | Cite as

Liver Stiffness Measurement, Better than APRI, Fibroindex, Fib-4, and NBI Gastroscopy, Predicts Portal Hypertension in Patients with Cirrhosis

  • Wei Zhang
  • Liqiong Wang
  • Lei Wang
  • Gang Li
  • Aoshuang Huang
  • Ping Yin
  • Zhenhua Yang
  • Changquan Ling
  • Lingtai Wang
Original Paper


Liver stiffness measurement (LSM) is frequently used as non-invasive alternative for liver fibrosis including cirrhosis, which can lead to portal hypertension. This study was conducted to evaluate the predictive value of LSM in cirrhosis-induced portal hypertension patients. Between July 2011 and December 2013, 153 participants were enrolled into a single-center, prospective, cross-sectional study. Each subject received both gastroscopy and LSM. Baseline biochemical, APRI, Fibroindex, and Fib-4 were also performed. LSM of cirrhosis patients with portal hypertension was significantly higher compared to those without portal hypertension (P < 0.05). A LSM ≥ 13.6 kPa had a sensitivity of 83.87 % and a specificity of 72.53 % with an accuracy of 77.1 for the prediction of portal hypertension, which are higher than those of APRI, Fib-4, and Fibroscan separately. A combination of Fibroscan combined with Fib-4 achieved a maximum AUC of 0.833 and accuracy of 77.8. Discriminant and internal validation analysis showed that Fibroscan plus APRI obtained a lower false negative rate compared to Fibroscan plus Fib-4 and Fibroscan plus Fibroindex (9.68, 17.74, and 11.29 %, respectively). A good relationship was found between LSM and NBI mean optical density both by linear and polynomial correlation analysis (r = 0.5533 and r = 0.7349, both P < 0.001). There was a trend toward a better performance of LSM for assessing portal hypertension compared with NBI gastroscopy mean optical density (P = 0.028 and P = 0.05, respectively). Better than APRI, Fibroindex, Fib-4, and NBI gastroscopy, LSM can predict portal hypertension in cirrhosis patients. A LSM of 13.6 kPa can be considered to be the predictive value for portal hypertension.


Liver stiffness measurement Portal vein hypertension APRI Fibroindex Fib-4 NBI gastroscopy 


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Wei Zhang
    • 1
    • 2
  • Liqiong Wang
    • 2
  • Lei Wang
    • 2
  • Gang Li
    • 3
  • Aoshuang Huang
    • 2
  • Ping Yin
    • 2
  • Zhenhua Yang
    • 4
  • Changquan Ling
    • 1
    • 5
  • Lingtai Wang
    • 3
  1. 1.Fujian University of Traditional Chinese MedicineFuzhouChina
  2. 2.Longhua HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
  3. 3.Shuguang HospitalShanghai University of Traditional Chinese MedicineShanghaiChina
  4. 4.Shanghai University of Traditional Chinese MedicineShanghaiChina
  5. 5.Changhai HospitalSecond Military Medical UniversityShanghaiChina

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