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

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Abstract

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.

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Acknowledgments

The authors thank Lüjin Li of Shanghai University of Traditional Chinese Medicine for his invaluable help with the statistical analysis.

Conflict of Interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China

    Wei Zhang & Changquan Ling

  2. Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China

    Wei Zhang, Liqiong Wang, Lei Wang, Aoshuang Huang & Ping Yin

  3. Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200021, China

    Gang Li & Lingtai Wang

  4. Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China

    Zhenhua Yang

  5. Changhai Hospital, Second Military Medical University, Shanghai, 200433, China

    Changquan Ling

Authors
  1. Wei Zhang
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  2. Liqiong Wang
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  3. Lei Wang
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  4. Gang Li
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  5. Aoshuang Huang
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  7. Zhenhua Yang
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  8. Changquan Ling
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Corresponding authors

Correspondence to Changquan Ling or Lingtai Wang.

Additional information

Wei Zhang and Liqiong Wang contributed equally to this work.

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Zhang, W., Wang, L., Wang, L. et al. Liver Stiffness Measurement, Better than APRI, Fibroindex, Fib-4, and NBI Gastroscopy, Predicts Portal Hypertension in Patients with Cirrhosis. Cell Biochem Biophys 71, 865–873 (2015). https://doi.org/10.1007/s12013-014-0275-z

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