Abstract: Objective To evaluate the diagnostic value of liver and spleen stiffness measured by transient elastography (FibroScan)regarding pathological stages of liver fibrosis in patients with chronic hepatitis B. Methods The clinical data of 317 patients with chronic hepatitis B who received liver biopsy from January 2018 to December 2021 in the No.909 Hospital of the joint logistics support unit were retrospectively analyzed. ROC curve was used to analyze the relationship between liver stiffness measurement (LSM)and spleen stiffness measurement (SSM)measured by FibroScan and fibrosis diagnosed by liver pathology. Logistic regression was used to construct a fibrosis grading stage model based on LSM and SSM. Results There were 79 (24.92%)cases of S0-S1, 102 (32.18%)cases of S2, 87 (27.44%)cases of S3 and 49 (15.46%)cases of S4. There were 31 (9.78%)cases of G1, 109 (34.38%)cases of G2 and 128 (40.34%)cases of G3; G4 was 49 (15.46%). The best LSM values for the diagnosis of significant fibrosis (≥ S2), severe fibrosis (≥ S3)and liver cirrhosis (S4)were 7.4 kPa (AUC = 0.861), 9.8 kPa (AUC = 0.909)and 16.6 kPa (AUC = 0.915), and the SSM values were 36.2 kPa (AUC = 0.817), 42.4 kPa (AUC = 0.913)and 49.1 kPa (AUC = 0.930), respectively. The predictive liver pathological diagnosis model based on LSM and SSM was constructed according to logistic regression, and R = LSM + SSM was obtained after optimization. The diagnostic model was more consistent with the pathological diagnosis than LSM or SSM alone (P<0.001). The AUCs of significant fibrosis, severe fibrosis and liver cirrhosis were 0.913, 0.962 and 0.991, respectively. Conclusion The detection of LSM combined with SSM based on transient elastography can improve the diagnostic efficiency of liver fibrosis in patients with chronic hepatitis B.

Key words: Chronic hepatitis B, Hepatic fibrosis, Transient elastography, Noninvasive diagnosis