Autori: Lupsor Platon M, Stefanescu H, Feier D, Maniu A, Badea R.
Editorial: J Gastrointestin Liver Dis , 22 (2), p.157-166, 2013.
Background & Aims: The current study aimed to establish the liver sti ness (LS) cut-o values and their performance in the prediction of the ¬brosis stage in chronic hepatitis C (CHC) patients, to e¬nd the anthropometric and biochemical factors leading to overestimation of the ¬brosis stage and to analyze the factors leading to the technique failure. Methods: 1,202 consecutive CHC patients were prospectively included in the study. All of them underwent percutaneous liver biopsy for grading and staging the disease (METAVIR) and were referred to LS measurement 1 day prior to biopsy. Results: LS values varied between 2.8-75 kPa. Transient elastography success rate (SR) ranged between 0-100% (84.82±24.46%). In 27 patients (2.2%), no valid measurement was obtained; high BMI in uenced independently the measurement failure. In 11.2% of cases, the SR was <60%, but 10 valid measurements were nevertheless recorded; the female sex and high BMI were the only factors independently leading to a SR<60%. AUROCs for the diagnosis of ¬brosis F≥1, F≥2, F≥3, and F=4 were 0.879, 0.889, 0.941 and 0.970, for the cut-o values of 5.3 kPa, 7.4 kPa, 9.1 kPa and 13.2 kPa respectively, and they did not signi¬cantly di er from the adjusted AUROC values. The patients with false positive results were younger and had signi¬cantly higher serum aminotransferase (ALT, AST) and gamma glutamyl-transpeptidase levels than the patients with concordant results. The multivariate analysis showed that only high ALT levels in uenced independently the occurrence of false positive results. Conclusion: Transient elastography is a useful non-invasive method for the assessment of ¬brosis in CHC patients. However, it must be interpreted in the clinical and biochemical context, in order to insure high-quality results.
Cuvinte cheie: transient elastography – liver stiffness – fibrosis – chronic hepatitis C – non-invasive assessment