Diagnostic value of endoscopic ultrasonography, fibroscan, acoustic radiation pulse imaging, serological index, and their combination for early stage liver cirrhosis
10.3760/cma.j.issn.1007-3418.2019.08.006
- VernacularTitle: 超声内镜、Fibroscan、声辐射力脉冲成像、血清学指数及其联合对早期肝硬化的诊断价值
- Author:
Chunhua TU
1
;
Jia LI
2
;
Chunyan WANG
2
;
Li ZHOU
2
;
Ying MA
2
;
Min GAO
2
;
Jing WANG
2
;
Qingmin ZENG
1
;
Wei LU
3
Author Information
1. Graduate School of Tianjin Medical University, Tianjin 300070, China
2. Tianjin Second People’s Hospital, Tianjin Hepatopathy Research Institute, Tianjin 300192, China
3. Tianjin First Central Hospital, Tianjin Hepatopathy Research Institute, Tianjin 300192, China
- Publication Type:Journal Article
- Keywords:
Liver cirrhosis;
Diagnosis;
Ultrasonography;
Serology
- From:
Chinese Journal of Hepatology
2019;27(8):615-620
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the diagnostic value of endoscopic ultrasonography (EUS), Fibroscan, acoustic radiation force impulse (ARFI), and aspartate aminotransferase-to-platelet ratio (APRI) and their combination for early stage liver cirrhosis.
Methods:Three hundred and twenty-two hospitalized patients who had been diagnosed with chronic viral liver disease from March 2016 to April 2018 were included. According to the clinical diagnosis, patients were divided into chronic hepatitis and the early stage liver cirrhosis group (Child-Pugh A grade). All patients were examined by Fibroscan to detect liver stiffness measurement (LSM), ARFI to detect liver virtual touch tissue quantification (VTQ) value, esophagogastroduodenoscopy and EUS to detect esophagogastric varices, laboratory and imaging examination. The index of EUS, Fibroscan, ARFI, and APRI was analyzed and the regression model was established by binary logistic regression, and the diagnostic efficacy of the above index and regression model for early stage of cirrhosis was evaluated by the area under a receiver operating characteristic curve (AUROCs).
Results:An early stage cirrhosis group had significantly higher detection rate with EUS (esophagogastric varices), Fibroscan (LSM), ARFI (VTQ) and APRI than chronic hepatitis group [76.7% vs. 10.7%, 10.4 (7.8, 17.3) vs. 6.1 (5.2, 8.4) kPa, 1.71(1.48, 2.07) m/s vs. 1.25(1.14, 1.43) m/s and 0.65 (0.38, 1.15) vs. 0.38(0.26, 0.62), respectively]. The corresponding chi-square test were 140.86, Z = -9.069, Z = -9.948 and Z = -5.764, respectively and the differences were statistically significant (P < 0.01). The areas under the receiver operating characteristic curve and regression model were 0.830 (0.783 ~ 0.877), 0.793 (0.744 ~ 0.841), 0.821 (0.775 ~ 0.868), 0.686 (0.628 ~ 0.744) and 0.947 (0.925 ~ 0.969) for the diagnosis of early stage cirrhosis, respectively. Among them, the regression model of three indices (EUS, LSM and VTQ) had the largest AUROCs (0.947) and the corresponding sensitivity and specificity were 0.878 and 0.867, respectively.
Conclusion:The combination of EUS, LSM and ARFI had a superior diagnostic value for early stage liver cirrhosis, and may improve the diagnosis rate and reduce the misdiagnosis rate.
