Yan YL, Xing X, Wang Y, Wang XZ, Wang Z, Yang L. Clinical utility of two-dimensional shear-wave elastography in monitoring disease course in autoimmune hepatitis-primary biliary cholangitis overlap syndrome. World J Gastroenterol 2022; 28(18): 2021-2033 [PMID: 35664960 DOI: 10.3748/wjg.v28.i18.2021]
Corresponding Author of This Article
Li Yang, MD, Director, Doctor, Full Professor, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, Sichuan Province, China. yangli_hx@scu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
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/
World J Gastroenterol. May 14, 2022; 28(18): 2021-2033 Published online May 14, 2022. doi: 10.3748/wjg.v28.i18.2021
Clinical utility of two-dimensional shear-wave elastography in monitoring disease course in autoimmune hepatitis-primary biliary cholangitis overlap syndrome
Yu-Ling Yan, Xian Xing, Yi Wang, Xiao-Ze Wang, Zhi Wang, Li Yang
Yu-Ling Yan, Xian Xing, Yi Wang, Xiao-Ze Wang, Zhi Wang, Li Yang, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Yu-Ling Yan, Xian Xing, Yi Wang, Xiao-Ze Wang, Zhi Wang, Li Yang, Sichuan University, University of Oxford Huaxi Joint for Gastrointestinal Cancer Centre, Chengdu 610207, Sichuan Province, China
Author contributions: Yan YL and Yang L designed the research study; Wang Z, Wang Y, Xing X and Yan YL performed the research; Wang XZ and Wang Y contributed new reagents and analytic tools; Yan YL and Xing X analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: The study was reviewed and approved by the West China Hopsital Institutional Review Board (Approval No. 459).
Informed consent statement: The Informed consent was waived by the West China Hopsital Institutional Review Board.
Conflict-of-interest statement: There are no conflicts of interest to be declared.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li Yang, MD, Director, Doctor, Full Professor, Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, Sichuan Province, China. yangli_hx@scu.edu.cn
Received: October 13, 2021 Peer-review started: October 13, 2021 First decision: December 3, 2021 Revised: December 16, 2021 Accepted: April 2, 2022 Article in press: April 2, 2022 Published online: May 14, 2022 Processing time: 211 Days and 1 Hours
Abstract
BACKGROUND
Autoimmune hepatitis-primary biliary cholangitis (AIH-PBC) overlap syndrome has a worse prognosis than AIH or PBC alone. Therefore, accurately staging liver fibrosis and dynamically monitoring disease progression are essential.
AIM
To investigate the performance of two-dimensional shear-wave elastography (2D-SWE) for noninvasively staging liver fibrosis and assessing the clinical utility of repeated 2D-SWE for monitoring treatment response in AIH-PBC overlap syndrome.
METHODS
A total of 148 patients diagnosed with AIH-PBC overlap syndrome were retrospectively enrolled. Among them, 82 patients had a 2D-SWE follow-up time of more than 1 year. The Scheuer scoring system was used to evaluate stages of hepatic inflammation and liver fibrosis. The performance of 2D-SWE for staging liver fibrosis was evaluated with the liver biopsy. Changes in liver stiffness (LS) measured by 2D-SWE in patients with or without complete biochemical remission were evaluated.
RESULTS
LS value was strongly correlated with liver fibrosis stage (Spearman r = 0.84, P < 0.0001). The areas under the receiver operating characteristic curves of LS for diagnosing significant fibrosis (≥ S2), severe fibrosis (≥ S3), and cirrhosis (S4) were 0.91, 0.97, and 0.96, respectively. Patients with complete biochemical remission had a considerable decrease in LS values (P < 0.0001). More importantly, the declined LS in patients with S0-S2 was significantly lower than that in patients with S3-S4 (P = 0.0002). In contrast, patients who failed to achieve biochemical remission had a slight but not significant decrease in LS (P = 0.37).
CONCLUSION
LS measured by 2D-SWE is an accurate and reliable method in assessing liver fibrosis, especially for diagnosing severe fibrosis (≥ 3) and monitoring treatment response in patients with AIH-PBC overlap syndrome.
Core Tip: Two-dimensional shear-wave elastography is an accurate and reliable method in monitoring treatment response in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome.
