Marcin Krawczyk1,2, Joanna Ligocka3, Mariusz Ligocki4, Joanna Raszeja-Wyszomirska4, Małgorzata Milkiewicz5, Grzegorz Szparecki6, Tomasz Ilczuk6, Barbara Górnicka6, Krzysztof Zieniewicz3, Marek Krawczyk3, Frank Lammert1, Piotr Milkiewicz4,7. 1. a Department of Medicine II , Saarland University Medical Center , Homburg , Germany. 2. b Laboratory of Metabolic Liver Diseases, Centre for Preclinical Research, Department of General, Transplant and Liver Surgery , Medical University of Warsaw , Warsaw , Poland. 3. c Department of General, Transplant and Liver Surgery , Medical University of Warsaw , Warsaw , Poland. 4. d Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery , Medical University of Warsaw , Warsaw , Poland. 5. e Department of Medical Biology , Pomeranian Medical University , Szczecin , Poland. 6. f Department of Pathology , Medical University of Warsaw , Warsaw , Poland. 7. g Translational Medicine Group , Pomeranian Medical University , Szczecin , Poland.
Abstract
BACKGROUND AND AIMS: Previous studies demonstrated a close correlation between transient elastography (TE) and liver histology in chronic liver diseases. Data on the accuracy of TE in primary sclerosing cholangitis (PSC) remains scarce. Here, we investigated the association between TE, serum marker of liver injury and histology of explanted livers in PSC patients. METHODS: Thirty patients were prospectively recruited. TE (Fibroscan®) and blood sampling were performed during evaluation for liver transplantation (LT); the second blood sampling was performed on the day of LT. Fibrosis of explanted livers according to the seven-point Laennec staging system and liver collagen contents were measured. RESULTS: TE correlated with Laennec stages of fibrosis (p = .001), collagen contents (p < .001) and with diameter of thickest septa (p = .034) in explanted livers. It also correlated with serum indices of liver injury, namely AST, bilirubin as well as FIB-4 and APRI scores (all p < .05). In a multivariate model, only liver fibrosis, according to either Laennec score (p = .035) or collagen contents (p = .005), was significantly associated with TE. Finally, patients with cirrhosis had increased liver stiffness (p = .002) and the TE cut-off of 13.7 kPa showed the best predictive value (AUC = .90, 95% CI: 0.80-1.00, p < .001) for detecting cirrhosis. CONCLUSIONS: TE correlates with liver fibrosis and markers of liver injury in patients with PSC. However, liver fibrosis seems to be the strongest predictor of liver stiffness assessed with TE. Hence, we postulate that TE is a reliable tool for non-invasive monitoring of PSC.
BACKGROUND AND AIMS: Previous studies demonstrated a close correlation between transient elastography (TE) and liver histology in chronic liver diseases. Data on the accuracy of TE in primary sclerosing cholangitis (PSC) remains scarce. Here, we investigated the association between TE, serum marker of liver injury and histology of explanted livers in PSC patients. METHODS: Thirty patients were prospectively recruited. TE (Fibroscan®) and blood sampling were performed during evaluation for liver transplantation (LT); the second blood sampling was performed on the day of LT. Fibrosis of explanted livers according to the seven-point Laennec staging system and liver collagen contents were measured. RESULTS:TE correlated with Laennec stages of fibrosis (p = .001), collagen contents (p < .001) and with diameter of thickest septa (p = .034) in explanted livers. It also correlated with serum indices of liver injury, namely AST, bilirubin as well as FIB-4 and APRI scores (all p < .05). In a multivariate model, only liver fibrosis, according to either Laennec score (p = .035) or collagen contents (p = .005), was significantly associated with TE. Finally, patients with cirrhosis had increased liver stiffness (p = .002) and the TE cut-off of 13.7 kPa showed the best predictive value (AUC = .90, 95% CI: 0.80-1.00, p < .001) for detecting cirrhosis. CONCLUSIONS:TE correlates with liver fibrosis and markers of liver injury in patients with PSC. However, liver fibrosis seems to be the strongest predictor of liver stiffness assessed with TE. Hence, we postulate that TE is a reliable tool for non-invasive monitoring of PSC.
Authors: Neeraja Mahalingam; Andrew T Trout; Deep B Gandhi; Rashmi D Sahay; Ruchi Singh; Alexander G Miethke; Jonathan R Dillman Journal: Abdom Radiol (NY) Date: 2021-12-21
Authors: Beata Kruk; Roman Liebe; Małgorzata Milkiewicz; Ewa Wunsch; Joanna Raszeja-Wyszomirska; Frank Lammert; Piotr Milkiewicz; Marcin Krawczyk Journal: PLoS One Date: 2018-08-30 Impact factor: 3.240
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