Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
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.
Supported by China Postdoctoral Science Foundation, No. 2020M673263.
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
ARTICLE HIGHLIGHTS
Research background

Autoimmune hepatitis-primary biliary cholangitis (AIH-PBC) overlap syndrome has a worse prognosis than AIH or PBC alone. Therefore, accurately diagnosing liver fibrosis and dynamically monitoring disease progression are essential.

Research motivation

The evaluation of two-dimensional shear-wave elastography (2D-SWE) in detecting liver fibrosis and monitoring treatment response in patients with AIH-PBC overlap syndrome remains blank.

Research objectives

To evaluate the diagnostic utility of 2D-SWE in staging liver fibrosis and assess the usefulness of repeated 2D-SWE for monitoring treatment response in AIH-PBC overlap syndrome.

Research methods

Patients with biopsy-proven AIH-PBC overlap syndrome were retrospectively enrolled. The performances of 2D-SWE and serum indexes for staging liver fibrosis were evaluated. The Scheuer scoring system was used to evaluate hepatic inflammation and liver fibrosis. Changes in liver stiffness (LS) measured by 2D-SWE in patients with or without complete biochemical remission were measured.

Research results

LS 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 significant fibrosis, severe fibrosis, and cirrhosis were 0.91, 0.97, and 0.96, respectively. Patients with complete biochemical remission showed a considerable decrease in LS values (P < 0.0001). More importantly, the decline in 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 showed a slight but not significant decrease in LS (P = 0.37).

Research conclusions

2D-SWE is an accurate and reliable method in assessing liver fibrosis and monitoring treatment response in patients with AIH-PBC overlap syndrome.

Research perspectives

2D-SWE can monitor the treatment effect in patients with AIH-PBC overlap syndrome.