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©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2018; 24(6): 737-743
Published online Feb 14, 2018. doi: 10.3748/wjg.v24.i6.737
Performance of transient elastography in assessing liver fibrosis in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome
Hui-Min Wu, Li Sheng, Qi Wang, Han Bao, Qi Miao, Xiao Xiao, Can-Jie Guo, Hai Li, Xiong Ma, De-Kai Qiu, Jing Hua
Hui-Min Wu, Li Sheng, Qi Wang, Han Bao, Qi Miao, Xiao Xiao, Can-Jie Guo, Hai Li, Xiong Ma, De-Kai Qiu, Jing Hua, Division of Gastroenterology and Hepatology, Renji Hospital, Shanghai 200127, China
Hui-Min Wu, Li Sheng, Qi Wang, Han Bao, Qi Miao, Xiao Xiao, Can-Jie Guo, Hai Li, Xiong Ma, De-Kai Qiu, Jing Hua, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
Hui-Min Wu, Li Sheng, Qi Wang, Han Bao, Qi Miao, Xiao Xiao, Can-Jie Guo, Hai Li, Xiong Ma, De-Kai Qiu, Jing Hua, Shanghai Institute of Digestive Disease, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai 200127, China
Author contributions: Wu HM and Li S contributed equally to this work and collected and analyzed the data; Wang Q coordinated the research; Bao H and Xiao X performed the transient elastography and coordinated liver biopsy; Miao Q contributed to histological examination; Qiu DK, Ma X, Hua J, Li H, and Guo CJ analyzed the data; Hua J designed the study; Wu HM, Li S and Hua J wrote the paper.
Supported by the National Natural Science Foundation of China, No. 81470842 and No. 81770572 to Hua J.
Institutional review board statement: The study received a waiver of the approval requirement from the ethics committee.
Informed consent statement: All patients signed an informed consent form for liver biopsy.
Conflict-of-interest statement: We declare that there is no conflict of interest to disclose.
Data sharing statement: 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: Jing Hua, MD, PhD, Professor, Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, No. 160, Pujian Road, Shanghai 200127, China.
hua-jing88@hotmail.com
Telephone: +86-21-68383113 Fax: +86-21-63200874
Received: November 7, 2017
Peer-review started: November 8, 2017
First decision: November 21, 2017
Revised: December 5, 2017
Accepted: January 1, 2018
Article in press: January 1, 2018
Published online: February 14, 2018
Processing time: 90 Days and 13.6 Hours
ARTICLE HIGHLIGHTS
Research background
Transient elastography (TE) can reliably stage liver fibrosis via liver stiffness measurement (LSM) in chronic liver disease. However, the accuracy of TE for assessment of liver fibrosis in patients with autoimmune hepatitis-primary biliary cholangitis (AIH-PBC) overlap syndrome is still unclear.
Research motivation
It is important to identify non-invasive markers of liver fibrosis to predict disease progression.
Research objectives
We evaluated the performance and usefulness of TE for detection of fibrosis in these patients and compared TE with other non-invasive diagnostic tools.
Research methods
The diagnostic accuracy of LSM for the prediction of fibrosis stages was calculated using a receiver operator characteristic (ROC) curve. Optimal LSM cut-off values for F2-4 fibrosis were determined based on the highest combined sensitivity and specificity.
Research results
TE can accurately detect hepatic fibrosis as a non-invasive method in patients with AIH-PBC overlap syndrome.
Research conclusions
For the first time, the current study evaluated TE as a non-invasive assessment of liver fibrosis in patients with AIH-PBC overlap syndrome and demonstrated that it was a reliable tool that was superior to serum biomarker scores for predicting severe fibrosis.
Research perspectives
The impact of hepatic inflammation on LSM values was not analyzed due to the relatively small number of patients in each subgroup. Larger studies are needed to confirm these results.
