The cut off value of liver stiffness measurement needs to be lowered to predict liver fibrosis after sustained virologic response in chronic hepatitis C patients
10.3969/j.issn.1001-5256.2021.12.016
- VernacularTitle:降低肝脏弹性临界值对慢性丙型肝炎患者获得持续病毒学应答后肝纤维化的评估价值
- Author:
Lixia QIU
1
;
Jingjing SONG
1
;
Shan LIANG
1
;
Yali LIU
1
;
Jing ZHANG
1
Author Information
1. Third Department of Liver Diseases, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
- Publication Type:Original articles_Liver fibrosis and liver cirrhosis
- Keywords:
Hepatitis C, Chronic;
Liver Cirrhosis;
Elasticity Imaging Techniques;
Sustained Virologic Response
- From:
Journal of Clinical Hepatology
2021;37(12):2808-2812
- CountryChina
- Language:Chinese
-
Abstract:
Objective To further verify the ability of noninvasive diagnostic method for liver fibrosis in predicting liver fibrosis in chronic hepatitis C patients followed up after sustained virologic response (SVR) based on liver biopsy. Methods A prospective cohort study was performed for the chronic hepatitis C patients who attended Beijing YouAn Hospital, Capital Medical University, from October 2015 to December 2017, and all patients were followed up regularly after SVR and underwent liver biopsy. The diagnostic efficiency of the noninvasive diagnostic method for liver fibrosis was verified based on pathological results. The receiver operating characteristic (ROC) curve was used to evaluate the ability of LSM, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) in the diagnosis of liver fibrosis, and STATA and R language were used to compare the area under the ROC curve (AUC). Results A total of 96 patients were successfully enrolled. The LSM after SVR was significantly lower than that at baseline, and LSM had a significantly larger AUC than APRI (0.89 vs 0.67, P < 0.05) and FIB (0.89 vs 0.69, P < 0.05) in the diagnosis of liver cirrhosis after SVR. LSM at a cut-off value of 7.95 kPa, and based on the best specificity, the diagnosis of liver cirrhosis could be considered when LSM was greater than 9.15 kPa, with a positive likelihood ratio of 5.91%; progressive liver fibrosis could be excluded based on LSM < 6.85 kPa, with a negative predictive value of 0.98. Follow-up time and antiviral regimen had no influence on the diagnostic ability of LSM. Conclusion The cut off value of LSM needs to be lowered to predict liver fibrosis after SVR in chronic hepatitis C patients.
