Diagnostic value of transient elastography for the staging of liver fibrosis and cirrhosis in patients with chronic hepatitis C: a meta analysis / 中华传染病杂志

ABSTRACT

Objective To assess the diagnostic value of transient elastography (TE) for the staging of liver fibrosis and cirrhosis in patients with chronic hepatitis C.Methods Systematic and comprehensive literatures related to diagnosis value of TE for chronic hepatitis C were searched in FMJS biomedical database (from Jan.1st,2003 to Aug.31st,2013).Full texts were obtained from PubMed,EBSCO,Elsevier Science,Ovid,Wiley database.The quality of the studies was rated with quality assessment of diagnostic accuracy studies (QUADAS).The accuracy of TE in diagnosing liver fibrosis and cirrhosis were assessed by Stata software bivariate mixed effects model.Results Twenty seven eligible studies which included 5 937 subjects were enrolled.The meta-analysis of fitting the bivariate mixed effects model showed that the pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio,and the area under curve (AUC) of summary receiver operating characteristic (SROC) for liver fibrosis were 0.75(95％CI0.70-0.80),0.84(95％CI0.78-0.88),4.70(95％CI3.60-6.20),0.29(95％CI0.24-0.36),16.00(95％CI12.00-22.00) and 0.86(95％CI0.83-0.89),respectively.And those for cirrhosis were 0.86(95％CI0.82-0.89),0.89(95％CI0.86-0.92),8.10(95％CI6.30-10.40),0.16(95％CI0.12-0.20),51.00(95％CI35.00-76.00) and 0.94(95％CI0.91-0.96),respectively.Conclusions TE shows better diagnostic accuracy for cirrhosis than for significant fibrosis in patients with chronic hepatitis C.More high quality trials are required to further confirm this finding.