836. Liver Stiffness Measurement and Serum Markers for Predicting Significant Fibrosis in Chronic Hepatitis B

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836. Liver Stiffness Measurement and Serum Markers for Predicting Significant

Fibrosis in Chronic Hepatitis B

Y. Seo; E. Jung; H. An; B. Keum; Y. Kim; H. Yim; Y. Jeen; H. Chun; C. Kim; H.

Ryu; S. Um

Background and Aims:

Various non-invasive methods were reported to be very useful for predicting

fibrosis stage in patients with chronic hepatitis. However, most published

studies focused on the patients with chronic hepatitis C. Therefore, it is still

uncertain which non-invasive method is most accurate for fibrosis assessment in

patients with chronic hepatitis B (CHB). This study was performed to evaluate

the non-invasive indicators for predicting significant fibrosis in patients with

CHB.

Methods:

We enrolled patients with CHB who performed liver biopsy. Fibrosis stage on

liver biopsy was determined according to METAVIR scoring system. Liver stiffness

measurement (LSM) and laboratory tests (AST, ALT, prothrombin time [PT],

gamma-GT, cholesterol, triglyceride, platelet, haptoglobin, collagen-IV,

hyaluronic acid, apolipoprotein-A1, á2-macroglobulin, and procollagen III

N-terminal peptide [PIIINP]) were performed on biopsy-performed day. Fibrosis

models including AST/ALT ratio (AAR), AST-to-platelet ratio index (APRI),

age-platelet index (API), Forns index, and PGA index were determined using the

results of laboratory tests. Patients were divided into two groups according to

the fibrosis stage: mild fibrosis group.

Results:

Eighty-five patients with CHB were enrolled (66 males and 19 females; age, 35±10

years). Significant fibrosis was noted in 58 patients (68.2%): F0-1, 27 patients

(31.8%); F2, 25 (29.4%); F3, 23 (27.1%); F4, 10 (11.8%). Liver stiffness was

6.1±2.0 kPa, 11.5±6.6 kPa, 15.2±6.7 kPa, and 18.3±7.6 kPa in patients with F0-1,

F2, F3, and F4, respectively. Liver stiffness, platelet, PT, AST, ALT,

bilirubin, gamma-GT, triglyceride, haptoglobin, collagen-IV, hyaluronic acid,

á2-macroglobulin, and PIIINP were significantly different between two groups.

When binary logistic analysis was performed with the results of laboratory

tests, bilirubin, PIIINP, and PT were the significant independent indicators for

significant fibrosis. However, when liver stiffness was added into the

variables, only liver stiffness (P=0.009) and PT (P=0.014) were independent

predictive factors. In area under ROC curve analysis for significant fibrosis,

LSM was superior to APRI, AAR, API, Forn's index, and PGA index.

Conclusions:

LSM was useful method for predicting significant fibrosis in patients with CHB.

PT might improve the diagnostic accuracy of LSM for predicting significant

fibrosis.