Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2024; 16(7): 1018-1028
Published online Jul 27, 2024. doi: 10.4254/wjh.v16.i7.1018
Liver stiffness in hepatocellular carcinoma and chronic hepatitis patients: Hepatitis B virus infection and transaminases should be considered
Jia-Yao Huang, Jian-Yun Peng, Hai-Yi Long, Xian Zhong, Yu-Hua Xie, Lu Yao, Xiao-Yan Xie, Man-Xia Lin
Jia-Yao Huang, Jian-Yun Peng, Hai-Yi Long, Xian Zhong, Yu-Hua Xie, Lu Yao, Xiao-Yan Xie, Man-Xia Lin, Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
Author contributions: Huang JY and Lin MX designed the research study; Huang JY, Peng JY, Long HY, Zhong X, Xie YH, Yao L, Xie XY and Lin MX collected the cases in the study; Huang JY, Peng JY, Long HY, Zhong X, Xie YH, Yao L, Xie XY and Lin MX performed the research; Huang JY and Lin MX analyzed the data; Huang JY and Lin MX wrote the manuscript; All authors have read and approved the final manuscript.
Supported by Natural Science Foundation of Guangdong Province, No. 2023A1515012464 and No. 2022A1515011716; and Basic and Applied Basic Research Foundation of Guangdong Province, No. 2022A1515110666.
Institutional review board statement: The protocol of this single-center retrospective study was in accordance with the Declaration of Helsinki (as revised in 2013) and was approved by the Institutional Review Board of the First Affiliated Hospital of Sun Yat-sen University (Approval No. [2019]046).
Informed consent statement: The need for written informed consent was waived for the retrospective analysis.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: The data that support the findings of this study are available from the corresponding author (linmxia@mail.sysu.edu.cn) upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Man-Xia Lin, PhD, Doctor, Professor, Department of Medical Ultrasonics, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan Road II, Yuexiu District, Guangzhou 510080, Guangdong Province, China. linmxia@mail.sysu.edu.cn
Received: March 23, 2024
Revised: May 27, 2024
Accepted: June 27, 2024
Published online: July 27, 2024
Processing time: 124 Days and 23 Hours
Abstract
BACKGROUND

Liver condition is a crucial prognostic factor for patients with hepatocellular carcinoma (HCC), but a convenient and comprehensive method to assess liver condition is lacking. Liver stiffness (LS) measured by two-dimensional shear wave elastography may help in assessing liver fibrosis and liver condition. Chronic hepatitis B (CHB) is an important risk factor for HCC progression, but LS was found to be less reliable in assessing liver fibrosis following hepatitis viral eradication. We hypothesize that the status of hepatitis virus infection would affect the accuracy of LS in assessing the liver condition.

AIM

To test the feasibility and impact factors of using LS to assess liver condition in patients with HCC and CHB.

METHODS

A total of 284 patients were retrospectively recruited and classified into two groups on the basis of serum CHB virus hepatitis B virus (HBV)-DNA levels [HBV-DNA ≥ 100.00 IU/mL as Pos group (n = 200) and < 100.00 IU/mL as Neg group (n = 84)]. Correlation analyses and receiver operating characteristic analyses were conducted to evaluate the relationship between LS and liver condition.

RESULTS

A significant correlation was found between LS and most of the parameters considered to have the ability to evaluate liver condition (P < 0.05). When alanine aminotransferase (ALT) concentrations were normal (≤ 40 U/L), LS was correlated with liver condition indices (P < 0.05), but the optimal cutoff of LS to identify a Child-Pugh score of 5 was higher in the Neg group (9.30 kPa) than the Pos group (7.40 kPa). When ALT levels were elevated (> 40 U/L), the correlations between LS and liver condition indices were not significant (P > 0.05).

CONCLUSION

LS was significantly correlated with most liver condition indices in patients with CHB and HCC. However, these correlations varied according to differences in HBV-DNA and transaminase concentrations.

Keywords: Liver function; Liver stiffness; Elastography; Chronic hepatitis B; Hepatocellular carcinoma

Core Tip: Liver stiffness measurement by two-dimensional shear wave elastography was significantly correlated with most liver condition indices in patients with chronic hepatitis B and hepatocellular carcinoma, but these correlations varied according to differences in hepatitis virus DNA and transaminase concentrations.