ABSTRACT
BACKGROUND: Transient elastography (FibroScan(R)) is a rapid and non-invasive method to measure liver stiffness and this allow the assessment of liver fibrosis. The aim of this study was to assess the diagnostic accuracy of measuring the liver stiffness in addition to measuring the other biochemical markers such as the aspartate transaminase to platelet ratio index [APRI] and the AST/ALT ratio. METHODS: We enrolled 228 HBsAg positive patients whose liver stiffness was measured by FibroScan(R) between March 2005 and September 2005. Liver biopsy examinations were performed in 34 patients. The fibrosis (F) was staged on a 0-4 scale according to the Ludwig classification. RESULTS: According to the clinical diagnosis, the median values of liver stiffness were 7.0+/-2.7 kPa for inactive carriers (n=29), 8.3+/-5.3 kPa for chronic hepatitis patients (n=106), 15.9+/-8.3 kPa for compensated cirrhosis patients (n=63), 31.8+/-20.3 kPa for decompensated cirrhosis patients (n=26), and 45.1+/-34.5 kPa for HCC patients (n=4). The degree of liver stiffness was significantly different between the different disease groups (p or =2; 0.92, 0.73, and 0.56, respectively, for F> or =3; and 0.97, 0.79, and 0.55, respectively, for F=4. FibroScan(R) offered the best diagnostic performance both for significant fibrosis (F> or =2) and severe fibrosis-cirrhosis (F3-F4). CONCLUSIONS: FibroScan(R) is a reliable, rapid non-invasive method to diagnose the severity of chronic liver disease and to predict fibrosis in patients with chronic hepatitis B, in addition to using the APRI and AST/ALT ratio.
Subject(s)
Humans , Aspartate Aminotransferases , Biomarkers , Biopsy , Blood Platelets , Classification , Diagnosis , Elasticity Imaging Techniques , Fibrosis , Hepatitis B , Hepatitis B Surface Antigens , Hepatitis B, Chronic , Hepatitis, Chronic , Liver Cirrhosis , Liver Diseases , LiverABSTRACT
BACKGROUND: Screening tests for hepatocellular carcinoma (HCC) in the high risk population can detect tumors at an earlier stage and thus confer a higher chance of receiving treatment. However, the usefulness, frequency and cost-effectiveness of screening for HCC may differ in different areas, possibly reflecting differences in risk factors. Last decade, we have identified risk factors for HCC in 4339 Korean patients. The aim of this study was to investigate the efficacy and usefulness of individual prediction model for the early diagnosis of HCC. METHODS: We studied a total of 833 patients who visited Yonsei University Medical Center for regular check-up including ultrasonography and alpha-fetoprotein from January 1999 to December 2000. The patients were classified into a low risk group ( 15%) by the probability of HCC development according to individual prediction model (IPM). The patients who developed HCC during the follow-up periods were analyzed using IPM. All the detailed data of clinical parameters were obtained by our self-exploited data base system prospectively and analyzed by SAS program. RESULTS: 44 (5.3%) out of 833 patients developed HCC during mean follow-up periods of 36 months. According to IPM, 2 (0.62%) of 324 patients in the low risk group, 20 (4.84%) of 413 patients in the intermediate risk group, and 22 (22.9%) of 96 patients in the high risk group were diagnosed as HCC. In 29 of 44 HCC patients (65.9%), initial presentation of tumor size was less than 3 cm in diameter. CONCLUSION: We confirmed the reliability of established IPM for screening of HCC and this model may help screening program to be done effectively by focusing high risk groups for HCC.