Clinical utility of two-dimensional shear-wave elastography in monitoring disease course in autoimmune hepatitis-primary biliary cholangitis overlap syndrome

Table 1 Baseline characteristics of the patients

Characteristic	Value
Gender, female, n (%)	132 (90)
Age, yr	49 (44-55)
BMI (kg/m2)	21.5 (19.6-22.9)
Total bilirubin, μmol/L	36.6 (19.3-72.7)
ALB, g/L	38.7 (34.1-43.7)
PLT, × 109/L	127 (79-185)
ALT, IU/L	100 (63-185)
AST, IU/L	114 (74-177)
ALP, IU/L	342 (194-518)
GGT, IU/L	298 (176-499)
IgG, g/L	20.5 (16.1-24.7)
IgM, g/L	3250 (2023-5095)
LKM, positive, n (%)	0
ANA, positive, n (%)	144/148 (97.3)
AMA, positive, n (%)	89/148 (60.1)
Fibrosis stage, n (%)
S0-S1	25 (15.4)
S2	48 (30.2)
S3	13 (9.9)
S4	62 (44.4)
Activity grade, n (%)
G0-G1	10 (6.8)
G2	53 (35.2)
G3	78 (53.1)
G4	7 (4.9)
LS, kPa	13.6 (9.8-20.6)

Data are presented as median and interquartile range, number (percentage). The reference laboratory parameter value: Total bilirubin: 5-28 μmol/L; alanine aminotransferase < 50 IU/L; aspartate aminotransferase < 40 IU/L; albumin: 40-55 g/L; platelet count: 100-300 × 10⁹/L; alkaline phosphatase: 51-160 IU/L; gamma-glutamyl transpeptidase: < 60 IU/L; immunoglobulin G: 8-15.5 g/L; immunoglobulin M: 700-2200 mg/L. BMI: Body mass index; TB: Total bilirubin; ALB: Albumin; PLT: Platelet count; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transpeptidase; IgG: Immunoglobulin G; IgM: Immunoglobulin M; LKM: Liver-kidney microsomal antibody; AMA: Antimitochondrial antibodies; ANA: Antinuclear antibody; LS: Liver stiffness.

Table 2 Correlation of liver stiffness and serum biomarkers, histological features

	Spearman r	P value
Necro-inflammatory activity grades	0.32	0.0006
Fibrosis stages	0.84	< 0.0001
PLT, × 109/L	-0.43	< 0.0001
TB, μmol/L	0.60	< 0.0001
ALT, IU/L	-0.04	0.63
AST, IU/L	0.33	< 0.0001
ALB, g/L	-0.67	< 0.0001
ALP, IU/L	0.02	0.77
IgG, IU/L	0.38	< 0.0001

PLT: Platelet count; TB: Total bilirubin; ALB: Albumin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transpeptidase; IgG: Immunoglobulin G.

Table 3 Diagnostic accuracy of two-dimensional shear-wave elastography for diagnosing liver fibrosis

	Cutoff	AUC (95%CI)	Sensitivity	Specificity	PPV	NPV	Accuracy
Significant fibrosis (≥ S2)
LS, kPa	12.1	0.91 (0.85-0.96)	67.5%	96.0%	98.8%	37.5%	72.3%
Rule out	7.9		95.1%	60.0%	92.1%	71.3%	89.2%
Rule in	12.1		67.5%	96.0%	98.8%	37.5%	72.3%
Severe fibrosis (≥ S3)
LS, kPa	15.0	0.97 (0.94-0.99)	85.3%	95.9%	95.5%	86.4%	90.5%
Rule out	11.9		94.7%	75.3%	79.8%	93.3%	85.1%
Rule in	15.0		85.3%	95.9%	95.5%	86.4%	90.5%
Cirrhosis (S4)
LS, kPa	15.1	0.96 (0.92-0.99)	90.3%	91.9%	88.9%	92.9%	91.2%
Rule out	13.9		95.2%	84.9%	82.0%	96.1%	89.2%
Rule in	19.4		58.1%	95.3%	89.9%	75.9%	79.7%

AUC: Area under the receiver operating characteristic curve; LS: Liver stiffness; PPV: Positive predictive value; NPV: Negative predictive value.

Table 4 Baseline characteristics of the patients between patients with complete biochemical remission and without biochemical remission

Characteristic	Without biochemical remission (n = 46)	Complete biochemical remission (n = 36)	P value
Sex, female, n (%)	39 (90)	35 (97.2)	0.07
Age, yr	50 (43-54)	49 (44-55)	0.99
BMI (kg/m2)	21.1 (19.4-22.4)	21.9 (20.0-23.0)	0.27
TB, μmol/L	38.7 (27.4-61.2)	19.6 (15.5-43.6)	0.009
ALB, g/L	39.7 (34.8-45.3)	41 (35.5-44.8)	0.56
PLT, × 109/L	126 (90-170)	150 (85-215)	0.18
ALT, IU/L	98 (71-136)	146 (50-215.3)	0.17
AST, IU/L	111 (82-153)	126 (68-247)	0.63
ALP, IU/L	417 (297-533)	217 (143-412)	0.0005
GGT, IU/L	419 (269-558)	289 (111-451)	0.005
IgG, g/L	19.2 (15.3-22.3)	21.9 (16.5-26.2)	0.06
IgM, g/L	3500 (2400-4830)	3290 (2245-5925)	0.86
Fibrosis stage, n			0.19
S0-S1	4	9
S2	19	14
S3	6	2
S4	17	11
Activity grad, n			0.29
G0-G1	1	1
G2	19	8
G3	24	26
G4	2	1
LS, kPa	12.9 (10.0-17.0)	11.3 (7.7-15.4)	0.14

Data are presented as median and interquartile range, number (percentage). The reference laboratory parameter value: Total bilirubin: 5-28 μmol/L; alanine aminotransferase < 50 IU/L; aspartate aminotransferase < 40 IU/L; albumin: 40-55 g/L; platelet count: 100-300 × 10⁹/L; alkaline phosphatase: 51-160 IU/L; gamma-glutamyl transpeptidase: < 60 IU/L; immunoglobulin G: 8-15.5 g/L; immunoglobulin M: 700-2200 mg/L. BMI: Body mass index; TB: Total bilirubin; ALB: Albumin; PLT: Platelet count; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transpeptidase; IgG: Immunoglobulin G; IgM: Immunoglobulin M; LS: Liver stiffness.