Yeon Seok Seo1, Moon Young Kim2, Seung Up Kim3, Bae Si Hyun4, Jae Young Jang5, Jin Woo Lee6, Jung Il Lee3, Sang Jun Suh7, Soo Young Park8, Hana Park9, Eun Uk Jung10, Byung Seok Kim11, In Hee Kim12, Tae Hee Lee13, Soon Ho Um1, Kwang-Hyub Han3, Sang Gyune Kim14, Soon Koo Paik3, Jong Young Choi4, Soung Won Jeong5, Young Joo Jin6, Kwan Sik Lee3, Hyung Joon Yim7, Won Young Tak8, Seong Gyu Hwang9, Youn Jae Lee10, Chang Hyeong Lee11, Dae-Ghon Kim12, Young Woo Kang13, Young Seok Kim14. 1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, South Korea. 2. Yonsei University, Wonju College of Medicine, Department of Internal Medicine, Wonju, South Korea. 3. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, South Korea. 4. Division of Hepatology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea. 5. Institute for Digestive Research, Digestive Disease Center, Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, South Korea. 6. Department of Internal Medicine, Division of Hepatology, Inha University School of Medicine, Incheon, South Korea. 7. Department of Internal Medicine, Korea University Ansan Hospital, Ansan, South Korea. 8. Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu, South Korea. 9. Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Bundang, South Korea. 10. Departments of Internal Medicine and Preventive Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea. 11. Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, South Korea. 12. Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Seoul, South Korea. 13. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University School of Medicine, Daejeon, South Korea. 14. Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.
Abstract
BACKGROUND/AIMS: Transient elastography (TE) has become an alternative to liver biopsy (LB). This study investigated the diagnostic performance of liver stiffness (LS) measurement using TE in Korean patients with chronic hepatitis B and C (CHB and CHC). METHODS: From April 2006 to June 2014, 916 patients (567 CHB and 349 CHC) who underwent LB and TE at 15 centres were analyzed. The Batts and Ludwig scoring system was used for histologic assessment. Aspartate aminotransferase (AST)-to-platelet ratio indexes (APRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used. RESULTS: The median age, LS value, and APRI score were 45 years, 8.8 kPa, and 0.61, respectively, in CHB patients vs. 51 years, 6.8 kPa and 0.55, respectively, in CHC patients. TE was significantly superior to APRI in CHB patients (AUROC 0.774 vs. 0.72 for ≥F2, 0.849 vs. 0.812 for ≥F3, and 0.902 vs. 0.707 for F4, respectively; all P < 0.05). Furthermore, TE was significantly superior for predicting ≥ F3 stage (AUROC 0.865 vs. 0.840, P = 0.009) whereas it was similar for predicting ≥ F2 and F4 stage (AUROC 0.822 vs. 0.796; 0.910 vs. 0.884; all P > 0.05) in CHC patients. In CHB patients, optimal cut-off LS values were 7.8 kPa for ≥F2, 8.2 kPa for ≥ F3, and 11.6 kPa for F4, vs. 6.8 kPa, 8.6 kPa, and 14.5 kPa, respectively, in CHC patients. CONCLUSIONS: TE can accurately assess the degree of liver fibrosis in Korean patients with CVH. TE was superior to APRI for predicting each fibrosis stage.
BACKGROUND/AIMS: Transient elastography (TE) has become an alternative to liver biopsy (LB). This study investigated the diagnostic performance of liver stiffness (LS) measurement using TE in Korean patients with chronic hepatitis B and C (CHB and CHC). METHODS: From April 2006 to June 2014, 916 patients (567 CHB and 349 CHC) who underwent LB and TE at 15 centres were analyzed. The Batts and Ludwig scoring system was used for histologic assessment. Aspartate aminotransferase (AST)-to-platelet ratio indexes (APRI) were calculated. Area under the receiver operating characteristic curve (AUROC) was used. RESULTS: The median age, LS value, and APRI score were 45 years, 8.8 kPa, and 0.61, respectively, in CHB patients vs. 51 years, 6.8 kPa and 0.55, respectively, in CHCpatients. TE was significantly superior to APRI in CHB patients (AUROC 0.774 vs. 0.72 for ≥F2, 0.849 vs. 0.812 for ≥F3, and 0.902 vs. 0.707 for F4, respectively; all P < 0.05). Furthermore, TE was significantly superior for predicting ≥ F3 stage (AUROC 0.865 vs. 0.840, P = 0.009) whereas it was similar for predicting ≥ F2 and F4 stage (AUROC 0.822 vs. 0.796; 0.910 vs. 0.884; all P > 0.05) in CHCpatients. In CHB patients, optimal cut-off LS values were 7.8 kPa for ≥F2, 8.2 kPa for ≥ F3, and 11.6 kPa for F4, vs. 6.8 kPa, 8.6 kPa, and 14.5 kPa, respectively, in CHCpatients. CONCLUSIONS: TE can accurately assess the degree of liver fibrosis in Korean patients with CVH. TE was superior to APRI for predicting each fibrosis stage.
Authors: Yeon Seok Seo; Mi Na Kim; Seung Up Kim; Sang Gyune Kim; Soon Ho Um; Kwang-Hyub Han; Young Seok Kim Journal: Medicine (Baltimore) Date: 2016-03 Impact factor: 1.889
Authors: Ja Yoon Heo; Seung Up Kim; Beom Kyung Kim; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Young Nyun Park; Sung Soo Ahn; Kwang-Hyub Han; Hyon-Suk Kim Journal: Medicine (Baltimore) Date: 2016-04 Impact factor: 1.889
Authors: Hye Won Lee; Soo Young Park; Seung Up Kim; Jae Young Jang; Hana Park; Ja Kyung Kim; Chun Kyon Lee; Young Eun Chon; Kwang-Hyub Han Journal: PLoS One Date: 2016-06-10 Impact factor: 3.240
Authors: Yeon Seok Seo; Byoung Kuk Jang; Soon Ho Um; Jae Seok Hwang; Kwang-Hyub Han; Sang Gyune Kim; Kwan Sik Lee; Seung Up Kim; Young Seok Kim; Jung Il Lee Journal: Oncotarget Date: 2017-11-03