Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2015; 21(22): 6931-6936
Published online Jun 14, 2015. doi: 10.3748/wjg.v21.i22.6931
Assessment of liver fibrosis by Fibroscan as compared to liver biopsy in biliary atresia
Qiu-Long Shen, Ya-Jun Chen, Zeng-Meng Wang, Ting-Chong Zhang, Wen-Bo Pang, Jun Shu, Chun-Hui Peng
Qiu-Long Shen, Ya-Jun Chen, Zeng-Meng Wang, Ting-Chong Zhang, Wen-Bo Pang, Jun Shu, Chun-Hui Peng, Department of Pediatric General Surgery, Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China
Author contributions: Chen YJ and Shen QL designed the study and wrote the manuscript; Wang ZM and Pang WB analyzed the data; Zhang TC, Shu J and Peng CH were involved in editing the manuscript.
Ethics approval: The study was reviewed and approved by the Beijing Children Hospital’s Institutional Review Board.
Informed consent: All study participants’ legal guardian provided informed written consent prior to study enrollment.
Conflict-of-interest: There are not any conflict-of-interest problems in this study.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ya-Jun Chen, MD, PHD, Department of Pediatric General Surgery, Beijing Children’s Hospital, Capital Medical University, 56 South Lishi Road, Beijing 100045, China. shenqlyishi@163.com
Telephone: +86-10-59616161
Received: November 28, 2014
Peer-review started: December 3, 2014
First decision: December 26, 2014
Revised: January 19, 2015
Accepted: February 12, 2015
Article in press: February 13, 2015
Published online: June 14, 2015
Abstract

AIM: To evaluate liver stiffness measurement (LSM) using non-invasive transient elastography (Fibroscan) in comparison with liver biopsy for assessment of liver fibrosis in children with biliary atresia (BA).

METHODS: Thirty-one children with BA admitted to the Department of Pediatric Surgery of Beijing Children’s Hospital from March 2012 to February 2013 were included in this study. Their preoperative LSM, liver biopsy findings, and laboratory results were studied retrospectively.

RESULTS: The grade of liver fibrosis in all 31 patients was evaluated according to the METAVIR scoring system, which showed that 4 cases were in group F2, 20 in group F3 and 7 in group F4. There were 24 non-cirrhosis cases (F2-F3) and 7 cirrhosis cases (F4). In groups F2, F3 and F4, the mean LSM was 9.10 ± 3.30 kPa, 11.02 ± 3.31 kPa and 22.86 ± 12.43 kPa, respectively. LSM was statistically different between groups F2 and F4 (P = 0.002), and between groups F3 and F4 (P = 0.000), however, there was no statistical difference between groups F2 and F3 (P = 0.593). The area under the receiver operating characteristic curve of LSM for ≥ F4 was 0.866. The cut-off value of LSM was 15.15 kPa for ≥ F4, with a sensitivity, specificity, positive predictive value and negative predictive value of 0.857, 0.917, 0.750 and 0.957, respectively.

CONCLUSION: Fibroscan can be used as a non-invasive technique to assess liver fibrosis in children with BA. The cut-off value of LSM (15.15 kPa) can distinguish cirrhotic patients from non-cirrhotic patients.

Keywords: Biliary atresia, Transient elastography, Fibroscan, Liver fibrosis, Liver biopsy

Core tip: This study was designed to evaluate liver fibrosis using non-invasive transient elastography (Fibroscan) in comparison with liver biopsy in children with biliary atresia (BA). According to the METAVIR scoring system, in groups F2, F3 and F4, the mean liver stiffness measurement (LSM) was 9.10 ± 3.30 kPa, 11.02 ± 3.31 kPa and 22.86 ± 12.43 kPa, respectively. The AUC of LSM for ≥ F4 was 0.886. The cut-off value of LSM was 15.15 kPa for ≥ F4, with high sensitivity, specificity, positive predictive value and negative predictive value. In conclusion, Fibroscan can be effectively used as a non-invasive technique to assess liver fibrosis in children with BA.