Performance of liver stiffness measurements by transient elastography in chronic hepatitis

Table 1 Patients demographics, and their biochemical and histological data at liver biopsy examination (%)

Characteristics	All patients (n = 246)	HCV patients (n = 195)	HBV patients (n = 41)
Sex (men)	171 (69.5)	139 (71.3)	30 (73.2)
Age (yr)	44.7 (11.8)1	45.3 (11.5)1	41.2 (13.7)1
BMI (kg/m2)	25.2 (3.9)1	25.3 (3.6)1	25.2 (5.3)1
AST (IU/L)	39 (24-78)2	40 (26-80)2	28 (21-48)2
ALT (IU/L)	65 (32-116)2	70 (35-120)2	50 (23-109)2
Platelets count (103/mm3)	209 (171-262)2	212 (176-270)2	203 (172-253)2
Fibrosis score (Metavir)
F0-F1	129 (52.3)	98 (50.3)	30 (73.2)
F2	54 (22.0)	46 (23.6)	6 (14.6)
F3	24 (9.8)	19 (9.7)	3 (7.3)
F4	39 (15.9)	32 (16.4)	2 (4.9)
Steatosis
S0 (0%)	157 (63.8)	126 (64.6)	26 (63.4)
S1 (< 33%)	56 (22.8)	44 (22.6)	10 (24.4)
S2 (33%-66%)	19 (7.7)	15 (7.7)	4 (9.8)
S3 (> 66%)	14 (5.7)	10 (5.1)	1 (2.4)
HAI
Mild	109 (44.3)	80 (41.0)	28 (68.3)
Moderate	102 (41.5)	89 (45.7)	7 (17.1)
Severe	35 (14.2)	26 (13.3)	6 (14.6)

¹mean ± SD

²Median value and interquartile range (IQR). BMI: Body mass index; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; HAI: Histological activity index; HCV: Hepatitis C virus; HBV: Hepatitis B virus.

Table 2 Cut-off values of transient elastography obtained by receiver operating characteristic curve analysis for each Metavir fibrosis stage

	Sensitivity%	Specificity%	PPV%	NPV%	LR+	LR-	AUC
F≥ 21
7.0 kPa	70 (66-75)	81 (77-85)
F≥ 22
6.9 kPa	70.9 (61.8-79.0)	86.1 (78.8-91.5)	82.2 (73.3-89.1)	76.6 (68.8-83.2)	5.1 (4.4-5.8)	0.34 (0.2-0.6)	0.86 (0.81-0.90)
F≥ 23
6.9 kPa	69.1 (58.9-78.1)	89.8 (82.0-95.0)	87.0 (77.4-93.6)	74.6 (65.7-82.1)	6.8 (5.8-7.9)	0.34 (0.2-0.7)	0.86 (0.80-0.90)
F≥ 31
9.5 kPa	80 (72-85)	85 (79-90)
F≥ 32
7.9 kPa	88.9 (78.4-95.4)	85.8 (79.9-90.5)	68.3 (57.1-78.1)	95.7 (91.4-98.3)	6.3 (5.6-7.0)	0.13 (0.06-0.3)	0.94 (0.91-0.97)
9.6 kPa4	76.3 (73.8-86.9)	94.5 (90.2-97.3)	82.8 (70.6-91.4)	92.0 (87.2-95.5)	13.9 (12.1-16.1)	0.25 (0.1-0.5)
F≥ 33
7.3 kPa	94.1 (83.8-98.8)	85.4 (70.6-90.7)	69.6 (57.3-80.1)	97.6 (93.2-99.4)	6.5 (5.9-7.1)	0.07 (0.02-0.2)	0.95 (0.91-0.98)
9.3 kPa4	74.5 (60.4-85.7)	96.5 (92.1-98.9)	88.4 (74.9-96.1)	91.4 (85.8-95.4)	21.5 (18.2-25.3)	0.3 (0.1-0.7)
F = 41
12 kPa	86 (80-91)	88 (82-91)
F = 42
9.6 kPa	95 (83-99)	90 (85-94)	64 (50-76)	99 (96-100)	9.4 (8.6-10.2)	0.06 (0.01-0.2)	0.96 (0.93-0.98)
12.2 kPa4	84.6 (69.5-94.1)	94.7 (90.7-97.3)	75.0 (59.7-86.8)	97.0 (93.6-98.9)	15.9 (13.9-18.3)	0.16 (0.06-0.4)
F = 43
9.3 kPa	93.8 (79.2-99.2)	92.0 (86.7-95.7)	69.0 (53.9-82.8)	98.7 (93.3-99.8)	11.8 (10.6-13.0)	0.07 (0.02-0.3)	0.97 (0.93-0.99)
12.3 kPa4	81.3 (63.6-92.8)	95.7 (91.4-98.3)	78.8 (61.1-91.0)	96.3 (92.1-98.6)	18.9 (16.0-22.4)	0.2 (0.07-0.5)

¹Cut-off values of transient elastography from the paper of Tsochatzis et al[8];

²Cut-off values of transient elastography in all patients (n = 246);

³Cut-off values of transient elastography in patients with chronic hepatitis C (n = 195);

⁴Cut-off values obtained by maximizing specificity. PPV: Positive predictive value; NPV: Negative predictive value; LR+: Positive likelihood ratio; LR-: Negative likelihood ratio; AUC: The area under the receiver operating characteristic.