Comparison of the efficacy between shear wave elastrography and serum fibrosis indexes in non-invasive evaluation of hepatic fibrosis in chronic hepatitis B patients

Abstract

Abstract: Objective To compare the efficacy between shear wave elastrography (SWE) and serological fibrosis markers in non-invasive evaluation of hepatic fibrosis in patients with chronic hepatitis B (CHB). Methods 74 patients (44 males and 30 females) with CHB were admitted to our hospital from January 2018 to March 2020, with an average age of (40.2±7.8) years. The measurement data were analyzed by t-test and the counting data were analyzed by chi-square test. Univariate and multivariate Logistic regression analysis were performed to determine the independent predictors of significant liver fibrosis in patients with CHB. To construct the Receiver operating characteristic (ROC) curve of shear wave velocity (SWV) and serological fibrosis indexes for diagnosing significant hepatic fibrosis in patients with CHB. The area under the curve (AUC), sensitivity and specificity were calculated. The maximum Jordan index was taken as the cutoff point for each diagnostic index. Results Hepatic fibrosis was graded by Scheuer score system. S0 and S1 stages were defined as non-significant hepatic fibrosis (non-significant fibrotic group), and S2, S3 and S4 stages were defined as significant hepatic fibrosis (significant fibrotic group). Among 74 CHB patients, 7 cases were in S0 stage of liver fibrosis, 18 cases were in S1 stage, 27 cases were in S2 stage, 11 cases in S3 stage and 11 cases in S4 stage. The average age of the non-significant fibrotic group was (37.2±6.0) years, which was younger than that of the significant fibrotic group [(42.9±9.6) years, P<0.05]. The levels of ALT, ALP, GGT, total cholesterol, PLT, RDW and INR in the non-significant fibrotic group were (42.4±7.9)U/L, (102.4±22.2)U/L, (42.3±11.4)U/L, (3.8±1.0)mg/dL, (182.6±40.8)×10⁹/L, (13.8±0.9)% and (1.0±0.2), respectively, which were significantly different with those of the control group [58.3±18.2)U/L, (131.5±28.5)U/L, (80.2±16.3)U/L, (5.5±1.4)mg/dL, (92.4±32.4)×10⁹/L, (11.6±1.8)% and (1.2±0.3)], (P<0.05). The SWV in non-significant fibrotic group was (1.44±0.22)m/s, which was significantly lower than that in the significant fibrotic group [(1.92±0.38) m/s, P<0.05]. The serological fibrosis indexes HA, C-IV, APRI, FIB-4, Forns score and RPR in the non-significant group were (70.2±12.6)ng/mL, (63.4±21.5)ng/mL, (0.3±0.2), (0.8±0.3), (-0.6±0.5) and (0.08±0.02), respectively, which were significantly different with the control group [(55.9±30.8)ng/ml, (42.8±18.9)ng/mL, (0.7±0.5), (1.3±0.4), (0.4±0.8) and (0.11±0.02)] (P<0.05). Multivariate Logistic regression analysis was carried out with the existence of significant liver fibrosis in patients with CHB as dependent variables and the above significant differences as independent variables. GGT, HA, C-IV, PLT, SWV, FIB-4, APRI, FIB-4, Forns score and RPR were independent predictors of significant liver fibrosis. When evaluating significant hepatic fibrosis, the AUC values of SWE were significantly higher than those of APRI, FIB-4, Forns, FibroIndex, RPR, HA and C-IV, respectively. Conclusion SWE is a reliable and non-invasive method for evaluating hepatic fibrosis in patients with CHB. The diagnostic performance of SWE is superior to serological fibrosis indexes such as HA, C-IV, APRI, FIB-4, Forns score and RPR.

Key words: Chronic hepatitis B, Shear wave elastography, APRI, FIB-4

ZHANG Rong-rong, ZHOU Jing, ZHAO Peng, ZHU Li-yao, ZHANG Xin, YE Xiao-hang. Comparison of the efficacy between shear wave elastrography and serum fibrosis indexes in non-invasive evaluation of hepatic fibrosis in chronic hepatitis B patients[J]. Chinese Hepatolgy, 2021, 26(3): 255-258.

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