The usefulness of liver stiffness measurement using FibroScan® in chronic hepatitis C in South Korea: A multicenter, prospective study

[Guest guest]

http://www3.interscience.wiley.com/journal/123468367/abstract

Journal of Gastroenterology and Hepatology

Published Online: 24 May 2010

Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd and Journal of

Gastroenterology and Hepatology Foundation

The usefulness of liver stiffness measurement using FibroScan® in chronic

hepatitis C in South Korea: A multicenter, prospective study

1 Seung Up Kim, † 1 Hui Won Jang, † Jae Youn Cheong, §,‡‡ Ja Kyung Kim,

†,*,‡‡ Myung Hee Lee, §,‡‡ Dong Joon Kim, ¶ Jin Mo Yang,** Sung Won

Cho, §,‡‡ Kwan Sik Lee, †,*,‡‡ Eun Hee Choi, ‡ Young Nyun Park,

†† and Kwang-Hyub Han †,*,‡‡

*Institute of Gastroenterology, †Department of Internal Medicine,

‡Biostatistics, Yonsei University College of Medicine, Seoul, South Korea,

§Department of Internal Medicine, Ajou University School of Medicine, Suwon,

South Korea, ¶Department of Internal Medicine, Hallym University College of

Medicine, Chuncheon, South Korea, **Department of Internal Medicine, Catholic

University School of Medicine, Suwon, South Korea, ††Department of

Pathology, Yonsei University College of Medicine, Seoul, South Korea, and

‡‡Liver Cirrhosis Clinical Research Center, Seoul, South Korea

Correspondence to Kwang-Hyub Han, MD

Department of Internal Medicine, Yonsei University College of Medicine

250 Seongsanno, Seodaemun–gu, Seoul, 120–752, South Korea

Tel: +82-2-2228-1949

Fax: +82-2-393-6884

E-mail: gihankhys@...

1 The first two authors have contributed equally to this work.

This is an Accepted Article that has been peer-reviewed and approved for

publication in the Journal of Gastroenterology and Hepatology, but has yet to

undergo copy-editing and proof correction. Please cite this article as an

" Accepted Article " ; doi: 10.1111/j.1440-1746.2010.06385.x

Copyright Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd and

Journal of Gastroenterology and Hepatology Foundation

ABSTRACT

Aim: We investigated the accuracy of liver stiffness measurement (LSM) in

chronic hepatitis C (CHC) in multicenter and prospective study in South Korea.

Methods: Between June 2005 and July 2009, 91 CHC patients without a previous

history of antiviral treatment, clinical evidences of cirrhosis, coinfection

with other viruses, and heavy alcohol consumption and with ALT ≤5x upper limit

of normal, total bilirubin ≤1.5 mg/dL, sufficient liver biopsy quality (≥15

mm and more than 6 portal tracts), interquartile range to median liver stiffness

(LS) value ratio ≤0.21, and more than 10 valid measurement, were recruited.

Batts and Ludwig scoring system was used for histologic assessment.

Age–platelet index (API), AST–to–platelet ratio index (APRI), and

age–spleen–platelet ratio index (ASPRI) were calculated. Area under the

receiver operating characteristic curve (AUROC) was used to evaluate the

performance of LSM and other noninvasive models.

Results: The mean age was 47.9 years, and the mean LS value was 7.7 kPa (44 men

and 47 women). LS value was highly correlated to the fibrosis stages (r = 0.835,

P < 0.001). The AUROCs of LSM were 0.909 for ≥F2, 0.993 for ≥F3, and 0.970

for F = 4 and were superior to those of API (0.72, 0.858, and 0.948,

respectively), APRI (0.780, 0.887, and 0.904, respectively), and ASPRI (0.713,

0.862, and 0.957, respectively). The optimal cutoff LS values were 6.2 kPa for

≥F2, 7.7 kPa for ≥F3, and 11.0 kPa for F = 4.

Conclusions: Our data suggest that LSM can accurately assess liver fibrosis in

patients with CHC and be applied in South Korea.

--------------------------------------------------------------------------------

Received date: 28-Jan-2010

Accepted date: 03-May-2010

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1440-1746.2010.06385

[Guest guest]

http://www3.interscience.wiley.com/journal/123468367/abstract

Journal of Gastroenterology and Hepatology

Published Online: 24 May 2010

Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd and Journal of

Gastroenterology and Hepatology Foundation

The usefulness of liver stiffness measurement using FibroScan® in chronic

hepatitis C in South Korea: A multicenter, prospective study

1 Seung Up Kim, † 1 Hui Won Jang, † Jae Youn Cheong, §,‡‡ Ja Kyung Kim,

†,*,‡‡ Myung Hee Lee, §,‡‡ Dong Joon Kim, ¶ Jin Mo Yang,** Sung Won

Cho, §,‡‡ Kwan Sik Lee, †,*,‡‡ Eun Hee Choi, ‡ Young Nyun Park,

†† and Kwang-Hyub Han †,*,‡‡

*Institute of Gastroenterology, †Department of Internal Medicine,

‡Biostatistics, Yonsei University College of Medicine, Seoul, South Korea,

§Department of Internal Medicine, Ajou University School of Medicine, Suwon,

South Korea, ¶Department of Internal Medicine, Hallym University College of

Medicine, Chuncheon, South Korea, **Department of Internal Medicine, Catholic

University School of Medicine, Suwon, South Korea, ††Department of

Pathology, Yonsei University College of Medicine, Seoul, South Korea, and

‡‡Liver Cirrhosis Clinical Research Center, Seoul, South Korea

Correspondence to Kwang-Hyub Han, MD

Department of Internal Medicine, Yonsei University College of Medicine

250 Seongsanno, Seodaemun–gu, Seoul, 120–752, South Korea

Tel: +82-2-2228-1949

Fax: +82-2-393-6884

E-mail: gihankhys@...

1 The first two authors have contributed equally to this work.

This is an Accepted Article that has been peer-reviewed and approved for

publication in the Journal of Gastroenterology and Hepatology, but has yet to

undergo copy-editing and proof correction. Please cite this article as an

" Accepted Article " ; doi: 10.1111/j.1440-1746.2010.06385.x

Copyright Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd and

Journal of Gastroenterology and Hepatology Foundation

ABSTRACT

Aim: We investigated the accuracy of liver stiffness measurement (LSM) in

chronic hepatitis C (CHC) in multicenter and prospective study in South Korea.

Methods: Between June 2005 and July 2009, 91 CHC patients without a previous

history of antiviral treatment, clinical evidences of cirrhosis, coinfection

with other viruses, and heavy alcohol consumption and with ALT ≤5x upper limit

of normal, total bilirubin ≤1.5 mg/dL, sufficient liver biopsy quality (≥15

mm and more than 6 portal tracts), interquartile range to median liver stiffness

(LS) value ratio ≤0.21, and more than 10 valid measurement, were recruited.

Batts and Ludwig scoring system was used for histologic assessment.

Age–platelet index (API), AST–to–platelet ratio index (APRI), and

age–spleen–platelet ratio index (ASPRI) were calculated. Area under the

receiver operating characteristic curve (AUROC) was used to evaluate the

performance of LSM and other noninvasive models.

Results: The mean age was 47.9 years, and the mean LS value was 7.7 kPa (44 men

and 47 women). LS value was highly correlated to the fibrosis stages (r = 0.835,

P < 0.001). The AUROCs of LSM were 0.909 for ≥F2, 0.993 for ≥F3, and 0.970

for F = 4 and were superior to those of API (0.72, 0.858, and 0.948,

respectively), APRI (0.780, 0.887, and 0.904, respectively), and ASPRI (0.713,

0.862, and 0.957, respectively). The optimal cutoff LS values were 6.2 kPa for

≥F2, 7.7 kPa for ≥F3, and 11.0 kPa for F = 4.

Conclusions: Our data suggest that LSM can accurately assess liver fibrosis in

patients with CHC and be applied in South Korea.

--------------------------------------------------------------------------------

Received date: 28-Jan-2010

Accepted date: 03-May-2010

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1440-1746.2010.06385