Journal of Clinical and Translational Hepatology

Journal of Clinical and Translational Hepatology

Wednesday, 01 / 29 / 2020

Articles

Liver Stiffness Measurement Can Reflect the Active Liver Necroinflammation in Population with Chronic Liver Disease: A Real-world Evidence Study

ORIGINAL ARTICLE

Liver Stiffness Measurement Can Reflect the Active Liver Necroinflammation in Population with Chronic Liver Disease: A Real-world Evidence Study

Leijie Wang#,1, Mingyu Zhu#,2, Lihua Cao#,3, Mingjie Yao#,4, Yiwei Lu5, Xiajie Wen1, Ying Zhang6, Jing Ning1, Huiling Long7, Yueyong Zhu8, Guoxin Hu9, Shuangsuo Dang10, Qingchun Fu11, Liang Chen12, Xinxin Zhang2, Jingmin Zhao13, Zhiliang Gao7, Yuemin Nan*,6 and Fengmin Lu*,1,14

1Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
2Department of Infectious Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
3Liver Disease Center, Qinhuangdao Third Hospital, Qinhuangdao, Hebei, China
4Department of Anatomy and Embryology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
5Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
6Department of Traditional and Western Medical Hepatology, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
7Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
8Liver Research Center, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
9Department of Infectious Diseases, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
10Department of Infectious Diseases, Second Affiliated Hospital of Medical College of Xi’an Jiaotong University, Xi’an, Shaanxi, China
11Shanghai Liver Diseases Research Center, 85th Hospital, Nanjing Military Command, Shanghai, China
12Department of Liver Disease, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
13Department of Pathology and Hepatology, The Fifth Medical Center of PLA General Hospital, Beijing, China
14Intervention and Cell Therapy Center, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China

#These authors contributed equally to this study.
*Correspondence to: Yuemin Nan,. Department of Traditional and Western Medical Hepatology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, Hebei 050017, China. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. ; Fengmin Lu, Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China. Tel: +86-10-82805136, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

Journal of Clinical and Translational Hepatology 2019;7(4):313-321 DOI: 10.14218/JCTH.2019.00040
Received: August 28, 2019 Accepted: November 5, 2019 Published online: December 11, 2019

Abstract

Background and Aims: Non-invasive evaluation of liver necroinflammation in patients with chronic liver disease is an unmet need in clinical practice. The diagnostic accuracy of transient elastography-based liver stiffness measurement (LSM) for liver fibrosis could be affected by liver necroinflammation, the latter of which could intensify stiffness of the liver. Such results have prompted us to explore the diagnosis potential of LSM for liver inflammation.

Methods: Three cross-sectional cohorts of liver biopsy-proven chronic liver disease patients were enrolled, including 1417 chronic hepatitis B (CHB) patients from 10 different medical centers, 106 non-alcoholic steatohepatitis patients, and 143 patients with autoimmune-related liver diseases. Another longitudinal cohort of 14 entecavir treatment patients was also included. The receiver operating characteristic (ROC) curve was employed to explore the diagnostic value of LSM.

Results: In CHB patients, LSM value ascended with the increased severity of liver necroinflammation in patients with the same fibrosis stage. Such positive correlation between LSM and liver necroinflammation was also found in non-alcoholic steatohepatitis and autoimmune-related liver diseases populations. Furthermore, the ROC curve exhibited that LSM could identify moderate and severe inflammation in CHB patients (area under the ROC curve as 0.779 and 0.838) and in non-alcoholic steatohepatitis patients (area under the ROC curve as 0.826 and 0.871), respectively. Such moderate diagnostic value was also found in autoimmune-related liver diseases patients. In addition, in the longitudinal entecavir treated CHB cohort, a decline of LSM values was observed in parallel with the control of inflammatory activity in liver.

Conclusions: Our study implicates a diagnostic potential of LSM to evaluate the severity of liver necroinflammation in chronic liver disease patients.

Keywords
Liver stiffness measurement, Liver necroinflammatory grade, Alanine aminotransferase, Chronic liver disease

 

 

 

Journal of Clinical and Translational Hepatology 2019 vol. 7, 313-321  [ Html ] [ PDF Full-text ]

© The Authors 2019. This article is published under the terms of the Creative Commons Attribution-Noncommercial License (CC BY-NC 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non-commercial and is otherwise in compliance with the license.

 

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