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Dig Dis Sci. 2011 Sep;56(9):2742-9. doi: 10.1007/s10620-011-1659-1. Epub 2011 Mar 12.

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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1
Center of Infectious Diseases, West China Hospital of Sichuan University, No.37 Guo Xue Xiang, 610041 Wu Hou District, Chengdu, China.

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.

PMID:
21399926
DOI:
10.1007/s10620-011-1659-1
[Indexed for MEDLINE]

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