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Discordance between liver biopsy and Fibroscan® in assessing liver fibrosis in chronic hepatitis b: risk factors and influence of necroinflammation

Authors
 Seung Up Kim  ;  Ja Kyung Kim  ;  Young Nyun Park  ;  Kwang-Hyub Han 
Citation
 PLOS ONE, Vol.7(2) : e32233, 2012 
Journal Title
 PLOS ONE 
Issue Date
2012
MeSH
Adult ; Biopsy/methods* ; Cohort Studies ; Elasticity Imaging Techniques ; Female ; Hepatitis B, Chronic/diagnosis* ; Hepatitis B, Chronic/pathology ; Humans ; Inflammation ; Liver/pathology* ; Liver/physiopathology ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/pathology* ; Male ; Middle Aged ; Proportional Hazards Models ; Prospective Studies ; Reproducibility of Results ; Risk Factors
Keywords
Adult ; Biopsy/methods* ; Cohort Studies ; Elasticity Imaging Techniques ; Female ; Hepatitis B, Chronic/diagnosis* ; Hepatitis B, Chronic/pathology ; Humans ; Inflammation ; Liver/pathology* ; Liver/physiopathology ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/pathology* ; Male ; Middle Aged ; Proportional Hazards Models ; Prospective Studies ; Reproducibility of Results ; Risk Factors
Abstract
BACKGROUND: Few studies have investigated predictors of discordance between liver biopsy (LB) and liver stiffness measurement (LSM) using FibroScan®. We assessed predictors of discordance between LB and LSM in chronic hepatitis B (CHB) and investigated the effects of necroinflammatory activity. METHODS: In total, 150 patients (107 men, 43 women) were prospectively enrolled. Only LSM with ≥ 10 valid measurements was considered reliable. Liver fibrosis was evaluated using the Laennec system. LB specimens <15 mm in length were considered ineligible. Reference cutoff LSM values to determine discordance were calculated from our cohort (6.0 kPa for ≥ F2, 7.5 kPa for ≥ F3, and 9.4 kPa for F4). RESULTS: A discordance, defined as a discordance of at least two stages between LB and LSM, was identified in 21 (14.0%) patients. In multivariate analyses, fibrosis stages F3-4 and F4 showed independent negative associations with discordance (P = 0.002; hazard ratio [HR], 0.073; 95% confidence interval [CI], 0.014-0.390 for F3-4 and P = 0.014; HR, 0.067; 95% CI, 0.008-0.574 for F4). LSM values were not significantly different between maximal activity grades 1-2 and 3-4 in F1 and F2 fibrosis stages, whereas LSM values were significantly higher in maximal activity grade 3-4 than 1-2 in F3 and F4 fibrosis stage (median 8.6 vs. 11.3 kPa in F3, P = 0.049; median 11.9 vs. 19.2 kPa in F4, P = 0.009). CONCLUSION: Advanced fibrosis stage (F3-4) or cirrhosis (F4) showed a negative correlation with discordance between LB and LSM in patients with CHB, and maximal activity grade 3-4 significantly influenced LSM values in F3 and F4.
Files in This Item:
T201202433.pdf Download
DOI
22384189
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Kim, Ja Kyung(김자경) ORCID logo https://orcid.org/0000-0001-5025-6846
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91690
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