Diagnostic performance of liver stiffness measurement for staging of liver fibrosis of patients with nonalcoholic steatohepatitis / 解放军医学杂志

ABSTRACT

Objective: To assess the diagnostic performance of liver stiffness measurement (LSM) for liver fibrosis of patients with nonalcoholic steatohepatitis (NASH). Methods: Four hundred and seventy patients with NASH selected from January 2006 to April 2018 were enrolled in the study, and LSM was performed within 3 days before liver biopsy. Clinical parameters and the pathological features were analyzed retrospectively. Non-invasive models (APRI and FIB-4) were calculated based on their own formula. The correlations between these 3 non-invasive approaches and liver fibrosis stages were analyzed with Spearman method, the diagnostic performances were analyzed with receiver operating characteristic (ROC). Results: Of the 470 NASH patients, 346 were male (73.6%). The degree of hepatic fibrosis was detected by liver puncture. The number of patients with S0, S1, S2, S3, S4 were 73, 253, 96, 40, 8 cases respectively. The median value of LSM in each group was 5.4, 6.5, 8.6, 10.7, 22.9 kPa, respectively. Spearman analysis showed that LSM and APRI were positively correlated with the stages of liver fibrosis, and the correlation coefficients were 0.626 and 0.342(P<0.001). ROC analysis showed that the value of LSM for different fibrosis stages was significantly higher than APRI. The AUROC of hepatic fibrosis S1, S2, S3 and S4 in LSM was 0.784, 0.857, 0.953 and 0.986 respectively. The corresponding optimal diagnostic cut-off values were 5.6, 7.7, 8.8 and 12.3 kPa, respectively. Conclusion: The value of LSM is positively correlated with hepatic fibrosis stage of NASH and LSM is a useful reference index for diagnosing the stage of hepatic fibrosis in NASH.