Published online May 14, 2022. doi: 10.3748/wjg.v28.i18.2021
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
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.
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.
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.
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.
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).
2D-SWE is an accurate and reliable method in assessing liver fibrosis and monitoring treatment response in patients with AIH-PBC overlap syndrome.
2D-SWE can monitor the treatment effect in patients with AIH-PBC overlap syndrome.