Liver international : official journal of the International Association for the Study of the Liver · 2013
The role of transient elastography in the detection of liver disease in patients with chronic pancreatitis.
Сравнительное исследованиеСтатьяВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Frossard Jean Louis, Giostra Emiliano, Rubbia-Brandt Laura, Hadengue Antoine, Spahr Laurent
Аннотация
BACKGROUND & AIMS: Quantification of liver stiffness with transient elastography (TE) is validated for staging hepatic fibrosis in chronic hepatitis C infection. The current study was aimed to assess the diagnostic performance of liver stiffness measurement for the determination of fibrosis stage in patients with chronic pancreatitis.
METHODS: Thirty consecutive patients with chronic pancreatitis and increased liver enzyme were enrolled over a 2.5-year period. Eight liver living donor candidates were recruited to serve as internal controls. The TE values were compared with non-invasive fibrosis scoring systems including aspartate transaminase (AST)/alanine aminotransferase (ALT) ratio, APRI, non-alcoholic fatty liver disease NAFLD score, FIB-4 index and to liver histology.
RESULTS: TE was successful in all patients. Stiffness values ranged from 3.1 to 69 kPa (mean 16.9). Liver stiffness was correlated with fibrosis stage (Spearman's correlation 0.73, P < 0.0001). Areas under receiver operator characteristics curves for fibrosis F = 4 were 0.92 for TE, 0.87 for FIB-4 index, 0.81 for APRI, 0.73 for NAFLD score and 0.71 for AST/ALT ratio. Optimal stiffness cut-off values for diagnosis fibrosis F = 4 was 10.9 kPa, with 90% sensitivity, 85% specificity and 86% accuracy.
CONCLUSION: Our study provides for the first time evidence that liver stiffness in patients with chronic pancreatitis and concomitant cholestasis can be measured by TE.
METHODS: Thirty consecutive patients with chronic pancreatitis and increased liver enzyme were enrolled over a 2.5-year period. Eight liver living donor candidates were recruited to serve as internal controls. The TE values were compared with non-invasive fibrosis scoring systems including aspartate transaminase (AST)/alanine aminotransferase (ALT) ratio, APRI, non-alcoholic fatty liver disease NAFLD score, FIB-4 index and to liver histology.
RESULTS: TE was successful in all patients. Stiffness values ranged from 3.1 to 69 kPa (mean 16.9). Liver stiffness was correlated with fibrosis stage (Spearman's correlation 0.73, P < 0.0001). Areas under receiver operator characteristics curves for fibrosis F = 4 were 0.92 for TE, 0.87 for FIB-4 index, 0.81 for APRI, 0.73 for NAFLD score and 0.71 for AST/ALT ratio. Optimal stiffness cut-off values for diagnosis fibrosis F = 4 was 10.9 kPa, with 90% sensitivity, 85% specificity and 86% accuracy.
CONCLUSION: Our study provides for the first time evidence that liver stiffness in patients with chronic pancreatitis and concomitant cholestasis can be measured by TE.