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Prognostic value of the combined use of transient elastography and fibrotest in patients with chronic hepatitis B

 Mi Sung Park  ;  Seung Up Kim  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Seung Hwan Shin  ;  Wonseok Kang  ;  Chansoo Moon  ;  Kwang-Hyub Han 
 LIVER INTERNATIONAL, Vol.35(2) : 455-462, 2015 
Journal Title
Issue Date
Area Under Curve ; Biopsy ; Carcinoma, Hepatocellular/diagnosis* ; Carcinoma, Hepatocellular/etiology ; Disease Progression ; Elasticity Imaging Techniques ; Female ; Follow-Up Studies ; Hepatitis B, Chronic/complications* ; Humans ; Liver/pathology* ; Liver Failure/diagnosis* ; Liver Failure/etiology ; Liver Neoplasms/diagnosis* ; Liver Neoplasms/etiology ; Male ; Prognosis ; Proportional Hazards Models ; ROC Curve
chronic hepatitis B ; fibrotest ; liver-related event ; prognostic value ; transient elastography
BACKGROUND & AIMS: Liver stiffness (LS) measurement using transient elastography and the FibroTest (FT) are alternatives to liver biopsy (LB) in assessing liver fibrosis. We investigated the prognostic role of the combined use of LS and FT in predicting liver-related events (LREs) in patients with chronic hepatitis B (CHB).

METHODS: Consecutive patients with CHB who underwent LB, along with LS and FT on the same day were recruited. LRE was defined as hepatic decompensation, hepatocellular carcinoma (HCC) or liver-related death.

RESULTS: A total of 151 patients (86 male) were analyzed. During follow-up (median 59.9 months), overall 18 (11.9%) patients experienced LREs. The areas under receiver-operating characteristic curves of LS, FT, LS + FT and LS × FT in predicting LRE were 0.701, 0.668, 0.702 and 0.741 respectively. After adjusting for age and histological fibrosis staging, significant variables in univariate analysis (both P < 0.05), LS + FT and LS × FT were independent predictors of LREs with hazard ratios (HRs) of 1.080 and 1.126 (all P < 0.05) respectively. When subjects were divided into three groups according to quartile stratification (low quartile, interquartile and high quartile) using LS + FT and LS × FT, cumulative LRE development rate significantly increased with a corresponding increase in value among three groups respectively (log-rank test, all P < 0.05).

CONCLUSION: The combined use of LS and FT significantly predicted forthcoming LRE development, but with only a slight additional benefit compared to LS or FT alone.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Won Suk(강원석)
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Moon, Chan Soo(문찬수)
Park, Mi Sung(박미성)
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Shin, Seung Hwan(신승환)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
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