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KMID : 0882420080740030264
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Korean Journal of Medicine
2008 Volume.74 No. 3 p.264 ~ p.270
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The efficacy of measuring liver stiffness for the assessment of liver fibrosis in patients with chronic liver diseases
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Kim Eun-Sun
Seo Yeon Seok
Lee Kwang-Gyun
Park Sang-Hoon
Kwon Yong-Dae
Keum Bo-Ra
Kim Yong-Sik
Jean Yoon-Tae
Chun Hoon-Jai
Kim Chang-Duck
Ryu Ho-Sang
Um Soon-Ho
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Abstract
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Background : Accurate assessment of liver fibrosis is very important for predicting the prognosis of patients with chronic liver diseases. Liver biopsy is still considered the gold-standard for assessing liver fibrosis. However, it is an invasive procedure with several limitations such as its questionable outcomes. Recent studies have suggested that liver stiffness measurement (LSM) using Fibroscan is noninvasive and useful for assessing liver fibrosis. This study was performed to evaluate the efficacy of LSM for evaluating liver fibrosis in patients with chronic liver diseases.
Methods : We prospectively enrolled 93 patients with chronic liver diseases, as confirmed by liver biopsy. The patients underwent liver biopsy and LSM. The METAVIR liver fibrosis stages of the biopsy specimens were assessed by an experienced pathologist. LSM was performed by Fibroscan. The efficacy of LSM and the optimal cutoff values for assessment of the fibrosis stage were determined by a receiver-operating characteristics (ROC) curve analysis.
Results : LSM was well correlated with the fibrosis stage (Kendall correlation coefficient: 0.58; p<0.001). The areas under the ROC curves were 0.871 (95% CI, 0.715-0.924) for the patients with significant fibrosis (F≥2), 0.874 (0.761-0.929) for the patients with severe fibrosis (F≥3) and 0.894 (0.792-0.956) for the patients with cirrhosis (F=4). The optimal LSM cutoff values for F ≥2, F ≥3 and F=4 were 6.9, 11.75 and 14.5 kPa, respectively.
Conclusion : LSM was a simple, effective method for assessing liver fibrosis in patients with chronic liver diseases. Its use for the follow up and management of these patients could be of great interest and so further investigation is required. (Korean J Med 74:264-270, 2008)
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KEYWORD
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Liver, Fibrosis, Fibroscan, Stiffness
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