Are different cut-off values of liver stiffness assessed by transient elastography according to the etiology of liver cirrhosis for predicting significant esophageal varices?
Are different cut-off values of liver stiffness assessed by transient elastography according to the etiology of liver cirrhosis for predicting significant esophageal varices?
复制标题
瞬时弹性成像是否根据肝硬化的病因评估不同的肝脏硬度临界值来预测显着的食管静脉曲张？
DOI：
10.11152/mu.2013.2066.152.is1ir2
复制
发表时间：
2013
影响因子：
1.7
通讯作者：
A. Jurchiș
中科院分区：
文献类型：
--
作者：
I. Sporea;I. Rațiu;S. Bota;R. Șirli;A. Jurchiș
目的
确定通过瞬态弹性成像（TE）进行的肝硬度（LS）测量是否根据基础肝硬化的病因而变化，并确定是否存在不同的TE截止值，以预测酒精性肝硬化与病毒性肝硬化病因中是否存在显著EV。
方法
这项回顾性研究包括诊断为病毒性或酒精性肝硬化的患者。所有患者均通过TE（FibroScan）和上消化道内镜进行评估。我们对每例患者进行了10次LS测量，并计算了以千帕（kPa）表示的中值。只有SR >/= 60%和IQR<30%的那些被认为是可靠的MS测量。根据EV的存在，将患者分为两类：无显著EV和显著EV（至少2级）的患者。
结果
该研究包括697名具有可靠LS测量值的阿尔茨海默病患者。与病毒性肝病患者相比，酒精性肝病患者TE评估的LS中值显著更高：41 kPa vs. 21.1 kPa，p<0.0001。在整个队列中，通过TE评估LS的截止值>29.5 kPa，预测存在显著EV的灵敏度为77.5%，特异性为86.9%（AUROC=0.871）。酒精性肝硬化患者预测EV的最佳LS临界值高于病毒性肝硬化患者：32.5 kPa（AUROC=0.836）vs. 24.8 kPa（AUROC=0.867）。
结论
与病毒性肝硬化患者相比，酒精性肝硬化患者通过TE评估预测显著EV的LS截止值显著更高。
AIM
To determine if liver stiffness (LS) measurements by means of Transient Elastography (TE) vary according to the etiology of the underlying liver cirrhosis and to find if there are different TE cut-off values able to predict the presence of significant EV in alcoholic vs. viral etiology of cirrhosis.
METHODS
This retrospective study included patients diagnosed with liver cirrhosis of viral or alcoholic etiology. All patients were evaluated by means of TE (FibroScan) and upper gastrointestinal endoscopy. We performed 10 LS measurements in each patient and a median value expressed in kiloPascals (kPa) was calculated. Only those with a SR >/= 60% and an IQR<30% were considered as reliable MS measurements. According to the presence of EV the patients were divided in two categories: without significant EV and patients with significant EV (at least grade 2).
RESULTS
The study included 697 cirrhotic patients with reliable LS measurements. The median LS values assessed by TE were significantly higher in cirrhotic patients with alcoholic etiology as compared with those with viral etiology of liver disease: 41 kPa vs. 21.1 kPa, p<0.0001. In the entire cohort of cirrhotic patients, LS assessed by means of TE for a cut-off value >29.5 kPa, had 77.5% sensitivity and 86.9% specificity for predicting the presence of significant EV (AUROC=0.871). The best LS cut-off value for predicting the presence of significant EV was higher in alcoholic cirrhosis as compared with those with viral etiology of liver cirrhosis: 32.5 kPa (AUROC=0.836) vs. 24.8 kPa (AUROC=0.867).
CONCLUSIONS
LS cut-off values assessed by TE for predicting significant EV are significantly higher in patients with alcoholic cirrhosis as compared with patients with liver cirrhosis of viral etiology.