Diagnosis of hepatic steatosis and fibrosis by transient elastography in asymptomatic healthy individuals: a prospective study of living related potential liver donors
Diagnosis of hepatic steatosis and fibrosis by transient elastography in asymptomatic healthy individuals: a prospective study of living related potential liver donors
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DOI：
10.1007/s00535-007-2016-1
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发表时间：
2007-05-01
影响因子：
6.3
通讯作者：
Suh, Dong-Jin
中科院分区：
文献类型：
--
作者：
Kim, Kang Mo;Choi, Won-Beom;Suh, Dong-Jin
背景这项前瞻性研究旨在评估瞬时弹性成像在无症状健康个体（如潜在肝脏供体）中识别组织学参数（包括脂肪变性）的能力，并将这些结果与肝病患者的结果进行比较。方法.连续入选47例肝功能异常和/或肝炎症状患者和80例活体亲属潜在肝供体，对每例受试者进行肝活检和Fibroscan检测。由一名病理学家根据METAVIR量表评价组织学参数。结果在肝病患者中，硬度与纤维化分期显著相关（斯皮尔曼相关系数，0.700; P < 0.001），F >= 2、F >= 3和F = 4的最佳硬度临界值分别为7.35、8.85和15.1 kPa。然而，在潜在的肝脏供体中，硬度与纤维化无关（0.023; P = 0.851）。在后一组中，受试者工作特征曲线下面积为0.70（95%置信区间，0.58-0.81），最佳刚度截止值为4.00（F >= 2），低于肝病患者。在潜在的肝脏供体中，脂肪变性与僵硬度无关（0.088; P = 0.463）。结论.瞬时弹性成像对无症状健康个体检测脂肪变性的价值有限，应重新评估这些受试者的纤维化临界值。
Background. This prospective study aimed to assess the ability of transient elastography to identify histologic parameters, including steatosis, in asymptomatic healthy individuals such as potential liver donors, and to compare these findings with results in liver disease patients. Methods. Forty-seven patients with abnormal liver function and/or hepatitis symptoms and 80 living related potential liver donors were consecutively enrolled, and liver biopsy and a Fibroscan test were performed in each subject. Histologic parameters were evaluated according to METAVIR scale by a single pathologist. Results. In liver disease patients, stiffness was significantly correlated with fibrosis stage (Spearman correlation coefficient, 0.700; P < 0.001), and the optimal stiffness cutoff values for F >= 2, F >= 3, and F = 4 were 7.35, 8.85, and 15.1 kPa respectively. In potential liver donors, however, stiffness was not correlated with fibrosis (0.023; P = 0.851). In the latter group, the area under the receiver-operating characteristics curve was 0.70 (95% confidence interval, 0.58-0.81), and the optimal stiffness cutoff value was 4.00 for F >= 2, which was lower than that in liver disease patients. Steatosis was not correlated with stiffness (0.088; P = 0.463) in potential liver donors. Conclusions. Transient elastography has limited value for detecting steatosis in asymptomatic healthy individuals, and the cutoff value for fibrosis should be reevaluated in these subjects.