Prospective Evaluation of FibroScan for the Diagnosis of Hepatic Fibrosis Compared with Liver Biopsy/AST Platelet Ratio Index and FIB-4 in Patients with Chronic HBV Infection

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http://www.springerlink.com/content/7g5h38r70up71105/

Digestive Diseases and Sciences

DOI: 10.1007/s10620-011-1659-1Online Firstâ„¢

Original Article

Prospective Evaluation of FibroScan for the Diagnosis of Hepatic Fibrosis

Compared with Liver Biopsy/AST Platelet Ratio Index and FIB-4 in Patients with

Chronic HBV Infection

Xia Zhu, Li-Chun Wang, En-Qiang Chen, Xue-Bing Chen, Li-Yu Chen, Li Liu,

Xue-Zhong Lei, Cong Liu and Hong Tang

Abstract

Background

The FibroScan (FS), the aspartate aminotransferase-to-platelet ratio index

(APRI), and the FIB-4 index are simple and inexpensive methods to detect liver

fibrosis.

Aims

The primary objective was to evaluate the performance of FS for the noninvasive

diagnosis of hepatic fibrosis in Western Chinese patients with chronic hepatitis

B virus (HBV) infection compared with APRI and FIB-4; the secondary objective

was to determine liver stiffness measurement (LSM) cutoff values for the

noninvasive diagnosis of significant fibrosis and liver cirrhosis.

Methods

Overall, 175 consecutive patients with chronic HBV infection, successful liver

biopsy, and alanine aminotransferase levels ≤2× ULN were prospectively

studied. Liver fibrosis was graded by an independent pathologist using the

METAVIR (F0–F4) classification. APRI and FIB-4 were calculated from laboratory

data.

Results

The area under receiver operating characteristics curves (AUROC) for LSM for

significant fibrosis (METAVIR F2–3) and cirrhosis (F4) was 0.95 (95%

confidence interval, 0.91–0.98) and 0.98 (0.96–0.99), respectively. For the

detection of significant fibrosis and cirrhosis, the AUROC of APRI were 0.81

(0.74–0.87) and 0.83 (0.77–0.90); the AUROC of FIB-4 were 0.86 (0.80–0.91)

and 0.77 (0.68–0.85). FS optimal cutoff values for the identification of

significant fibrosis and cirrhosis were 7.9 and 13.8 kPa, respectively.

Conclusions

FS is a reliable predictor of significant fibrosis and cirrhosis in Western

Chinese patients with chronic HBV infection, and is superior to APRI and FIB-4.

FS cutoff values could be considered as clinical reference for detecting

significant fibrosis and cirrhosis.

[Guest guest]

http://www.springerlink.com/content/7g5h38r70up71105/

Digestive Diseases and Sciences

DOI: 10.1007/s10620-011-1659-1Online Firstâ„¢

Original Article

Prospective Evaluation of FibroScan for the Diagnosis of Hepatic Fibrosis

Compared with Liver Biopsy/AST Platelet Ratio Index and FIB-4 in Patients with

Chronic HBV Infection

Xia Zhu, Li-Chun Wang, En-Qiang Chen, Xue-Bing Chen, Li-Yu Chen, Li Liu,

Xue-Zhong Lei, Cong Liu and Hong Tang

Abstract

Background

The FibroScan (FS), the aspartate aminotransferase-to-platelet ratio index

(APRI), and the FIB-4 index are simple and inexpensive methods to detect liver

fibrosis.

Aims

The primary objective was to evaluate the performance of FS for the noninvasive

diagnosis of hepatic fibrosis in Western Chinese patients with chronic hepatitis

B virus (HBV) infection compared with APRI and FIB-4; the secondary objective

was to determine liver stiffness measurement (LSM) cutoff values for the

noninvasive diagnosis of significant fibrosis and liver cirrhosis.

Methods

Overall, 175 consecutive patients with chronic HBV infection, successful liver

biopsy, and alanine aminotransferase levels ≤2× ULN were prospectively

studied. Liver fibrosis was graded by an independent pathologist using the

METAVIR (F0–F4) classification. APRI and FIB-4 were calculated from laboratory

data.

Results

The area under receiver operating characteristics curves (AUROC) for LSM for

significant fibrosis (METAVIR F2–3) and cirrhosis (F4) was 0.95 (95%

confidence interval, 0.91–0.98) and 0.98 (0.96–0.99), respectively. For the

detection of significant fibrosis and cirrhosis, the AUROC of APRI were 0.81

(0.74–0.87) and 0.83 (0.77–0.90); the AUROC of FIB-4 were 0.86 (0.80–0.91)

and 0.77 (0.68–0.85). FS optimal cutoff values for the identification of

significant fibrosis and cirrhosis were 7.9 and 13.8 kPa, respectively.

Conclusions

FS is a reliable predictor of significant fibrosis and cirrhosis in Western

Chinese patients with chronic HBV infection, and is superior to APRI and FIB-4.

FS cutoff values could be considered as clinical reference for detecting

significant fibrosis and cirrhosis.