Published online Oct 21, 2023. doi: 10.3748/wjg.v29.i39.5503
Peer-review started: July 2, 2023
First decision: August 30, 2023
Revised: September 9, 2023
Accepted: October 11, 2023
Article in press: October 11, 2023
Published online: October 21, 2023
Processing time: 109 Days and 3.6 Hours
Noninvasive criteria are needed for autoimmune liver diseases (AILDs) to assess liver fibrosis stage for prognosis and treatment decisions.
Results of individual diagnostic test accuracy studies assessing the diagnostic accuracy of transient elastography (TE) for the diagnosis of AILD appear promising. However, previous systematic review and meta-analyses have focused primarily on other liver diseases, which is still lacking in AILD.
To compare the diagnostic accuracy of imaging techniques with serum biomarkers of fibrosis in AILD.
The PubMed, Cochrane and EMBASE databases were searched for literature. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to evaluate the quality. Meta-Disc 1.4 and STATA 12.0 software were used to analyze the combined statistics: sensitivity; specificity; positive likelihood ratio; negative likelihood ratio; diagnostic odds ratio; and area under the curve fitted to the total receiver operating characteristic curve (AUROC).
A total of 60 studies were included in the meta-analysis. The AUROC curve values were 0.93, 0.93 and 0.91 for significant fibrosis, advanced fibrosis and cirrhosis, respectively, in primary biliary cholangitis patients, while the AUROC curve values were 0.84, 0.88 and 0.90, respectively, in autoimmune hepatitis patients.
TE is a reliable method for diagnosis in AILD patients, especially in primary biliary cholangitis patients. The appropriate cutoff value for staging advanced fibrosis and cirrhosis ranged from 9.6 to 10.7 KPa and 14.4 to 16.9 KPa, respectively.
We propose a suitable diagnostic threshold for TE in PBC patients. However, future prospective multicenter studies with TE and histopathology protocol are required to validate our results.