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©The Author(s) 2015.
World J Gastroenterol. Jan 21, 2015; 21(3): 953-960
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.953
Published online Jan 21, 2015. doi: 10.3748/wjg.v21.i3.953
Table 1 Baseline clinical and biochemical characteristics of all patients
All | HCV | ASH/NASH | HBV | Cryptogenic | HDV | Other causes | |
(n = 291) | (n = 92) | (n = 109) | (n = 35) | (n = 13) | (n = 10) | (n = 32) | |
Age, yr | 54 ± 15 | 59 ± 13b | 53 ± 15 | 51 ± 13b | 59 ± 15 | 43 ± 9a | 50 ± 17a |
Gender,% | |||||||
Female | 39.9 | 41.3 | 36.7 | 28.6 | 38.5 | 30 | 59.4a |
Male | 60.1 | 58.7 | 63.3 | 71.4 | 61.5 | 70 | 40.6 |
Cirrhosis, % | 62.5 | 76.1 | 56 | 68.6 | 100b | 70 | 25.0d |
BMI, kg/m² | 25.5 ± 4.2 | 24.6 ± 3.9a | 25.8 ± 4.8 | 27.2 ± 3.3 | 25.3 ± 3.0 | 23.2 ± 4.9 | 25.2 ± 3.6 |
Bilirubin, mg/dL | 2.7± 4.8 | 1.5 ± 2.5b | 4.3 ± 7.0 | 1.5 ± 1.5b | 1.8 ± 1.3 | 2.0 ± 1.6 | 4.1 ± 5.8 |
Albumin, g/dL | 3.6 ± 0.7 | 3.8 ± 0.6b | 3.4 ± 0.7a | 3.8 ± 0.7 | 3.4 ± 0.7 | 3.4 ± 0.6 | 3.7 ± 0.4 |
Immunoglobulins, g/dL | 1.7 ± 0.7 | 1.8 ± 0.7 | 1.5 ± 0.7 | 1.7 ± 0.8 | 1.5 ± 0.4 | 2.6 ± 0.7b | 1.7 ± 0.5 |
AST, U/L | 116 ± 175 | 100 ± 54 | 113 ± 187 | 76 ± 51 | 70 ± 55 | 155 ± 94 | 243 ± 400 |
ALT, U/L | 106 ± 176 | 102 ± 71 | 73 ± 100b | 72 ± 52 | 43 ± 20 | 131 ± 62 | 300 ± 462a |
AFP, μg/L¹ | 6.2 | 9.7 | 5.8 | 3.4 | 5.9 | 7.2 | 2.9 |
Platelets, a1000/μL | 170 ± 83 | 152 ± 82 | 181 ± 79 | 165 ± 78 | 168 ± 77 | 127 ± 74 | 208 ± 96 |
Prothrombin time, % | 83 ± 18 | 88 ± 16b | 78 ± 21b | 85 ± 13 | 81 ± 23 | 73 ± 14 | 86 ± 15 |
Table 2 Sensitivity, specificity, positive and negative predictive value of the different non-invasive examinations for detection of liver cirrhosis
All | Viral hepatitis1 | |||||||||
Sensitivity | Specificity | PPV | NPV | P value3 | Sensitivity | Specificity | PPV | NPV | P value3 | |
Liver stiffness ≥ 13 kPa | 90.4 | 51.4 | 75.2 | 76.7 | 91.3 | 44.4 | 82.5 | 64.0 | ||
Ultrasound2 | 80.1 | 82.4 | 88.7 | 70.6 | 0.02 | 96.6 | 61.2 | 81.4 | 90.9 | 0.04 |
Platelets < 150.000/μL | 58.0 | 80.2 | 83.3 | 52.8 | 0.03 | 63.1 | 72.2 | 86.7 | 40.6 | 0.05 |
Cutaneous liver signs2 | 45.1 | 72.1 | 70.4 | 47.2 | 0.0001 | 42.7 | 64.7 | 77.4 | 28.6 | 0.01 |
APRI-Score ≥ 2 | NA | NA | NA | NA | NA | 56.1 | 63.3 | 87.7 | 24.1 |
Table 3 Sensitivities for detection of liver cirrhosis by different combinations of non-invasive examinations
All patients (n = 182) | |||||
Sensitivity | Specificity | PPV | NPV | P value1 | |
Liver stiffness ≥ 13 kPa and/or ultrasound cirrhosis | 96.1% | 50.5% | 76.5% | 88.5% | |
Liver stiffness ≥ 13 kPa and/or platelets < 150.000/μL | 93.9% | 49.1% | 75.4% | 82.8% | < 0.0001 |
Ultrasound and/or platelets < 150.000/μL | 88.2% | 68.0% | 82.6% | 76.9% | < 0.0001 |
Ultrasound and/or cutaneous liver signs | 87.6% | 62.0% | 79.7% | 74.7% | < 0.0001 |
Platelets < 150000/μL and/or cutaneous liver signs | 79.4% | 63.7% | 78.5% | 65% | < 0.004 |
Table 4 Comparison of transient elastography with clinical and biochemical parameters
≥ 13 kPa(n = 161) | ≥ 27.5 kPa1(n = 94) | ≥ 54 kPa1(n = 48) | ≥ 27.5kPa vs< 27.5 kPaP value | ≥ 54 kPa vs< 54 kPaP value | ≥ 54 kPa vs27.5-54 kPaP value | |
Age, yr | 60 ± 14 | 56 ± 13 | 55 ± 13 | NS | NS | NS |
BMI, kg/m² | 26.2 ± 3.7 | 25.5 ± 4.0 | 24.8 ± 3.7 | NS | 0.05 | NS |
Bilirubin, mg/dL | 1.1 ± 1.0 | 3.2 ± 5.6 | 4.4 ± 6.9 | 0.0001 | 0.007 | 0.04 |
Albumin, g/dL | 3.9 ± 0.4 | 3.4 ± 0.7 | 3.2 ± 0.7 | 0.0001 | 0.0001 | 0.02 |
Immunoglobulins, g/dL | 1.6 ± 0.7 | 2.0 ± 0.7 | 2.1 ± 0.8 | 0.02 | 0.007 | 0.03 |
AST, U/L | 79 ± 49 | 102 ± 71 | 115 ± 83 | 0.02 | 0.015 | 0.07 |
ALT, U/L | 79 ± 56 | 71 ± 51 | 69 ± 54 | NS | NS | NS |
AFP, μg/L2 | 7.6 | 7.7 | 7.8 | NS | NS | NS |
Platelets, 1000/μL | 145 ± 68 | 144 ± 82 | 151 ± 77 | NS | NS | NS |
Prothrombin time, % | 88 ± 13 | 76 ± 19 | 70 ± 18 | 0.0001 | 0.0001 | 0.02 |
APRI-Score3 | 2.4 ± 1.8 | 3.6 ± 3.1 | 4.3 ± 3.6 | 0.03 | NS | NS |
Platelets < 150.000/μL, % | 59.7 | 60.6 | 56.3 | NS | NS | NS |
Ultrasound cirrhosis, % | 73.1 | 88.9 | 93.6 | 0.02 | 0.01 | NS |
Splenomegaly, % | 57.8 | 71.4 | 72.3 | 0.09 | NS | NS |
Ascites, % | 16.4 | 35.5 | 52.1 | 0.01 | 0.0001 | 0.01 |
Cutaneous liver signs, % | 43.3 | 55.3 | 63.2 | NS | 0.09 | NS |
Table 5 Usefulness of transient elastography in cirrhotic patients with Child-Pugh A or normal platelet count
Child-Pugh A1 | Normal platelet count2 | |||||||||
Sensitivity | Specificity | PPV | NPV | P value3 | Sensitivity | Specificity | PPV | NPV | P value3 | |
Liver stiffness ≥ 13 kPa | 91.5% | 48.8% | 59.5 | 87.5 | 85.3% | 62.4% | 66.7 | 82.8 | ||
Ultrasound | 75.2% | 75.2% | 72.5 | 77.8 | 0.02 | 71.2% | 86.4% | 82.5 | 76.9 | 0.04 |
Platelets < 150.000/μL | 55.1% | 78.6% | 68.6 | 67.3 | NS | NA | NA | NA | NA | |
Cutaneous liver signs | 42.0% | 74.8% | 59.2 | 59.7 | 0.01 | 46.2% | 81.3% | 66.7 | 65.0 | 0.001 |
- Citation: Göbel T, Schadewaldt-Tümmers J, Greiner L, Poremba C, Häussinger D, Erhardt A. Transient elastography improves detection of liver cirrhosis compared to routine screening tests. World J Gastroenterol 2015; 21(3): 953-960
- URL: https://www.wjgnet.com/1007-9327/full/v21/i3/953.htm
- DOI: https://dx.doi.org/10.3748/wjg.v21.i3.953