Correlation of laparoscopic liver biopsy to elasticity measurements (FibroScan) in patients with chronic liver disease.
Background: Elastography is a noninvasive method to assess liver fibrosis by measuring liver stiffness. Studies have compared elastography to percutaneous biopsy. Laparoscopic biopsy is associated with decreased sampling error compared to percutaneous biopsy, as laparoscopic biopsies are obtained fr...
| Publicado en: | Gastroenterology & Hepatology Vol. 4; no. 12; pp. 862 - 871 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Gastro-Hep Communications, Inc
2008 Dec
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105252827&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105252827 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15547914 6N5B jtl: Gastroenterology & Hepatology issn: 15547914 maglogo: N pubinfo: dt: 2008 Dec vid: 4 iid: 12 pid: 72163 pub: Gastro-Hep Communications, Inc place: New York, New York artinfo: ui: 105252827 105252827 2010490140 105252827 ppf: 862 ppct: 9 formats: tig: atl: Correlation of laparoscopic liver biopsy to elasticity measurements (FibroScan) in patients with chronic liver disease. aug: au: Nudo CG Jeffers LJ Bejarano PA Servin-Abad LA Leibovici Z De Medina M Schiff ER affil: Center for Liver Diseases and Dividion of Hepatology, University of Miami Leonard M. Miller School of Medicine, Miami, FL sug: subj: Biopsy Fibrosis Pathology Laparoscopy Liver Diseases Pathology Adult Chronic Disease Elasticity Female Human Male Middle Age Multiple Regression ROC Curve Spearman's Rank Correlation Coefficient T-Tests Adult: 19-44 years Middle Aged: 45-64 years Female Male ab: Background: Elastography is a noninvasive method to assess liver fibrosis by measuring liver stiffness. Studies have compared elastography to percutaneous biopsy. Laparoscopic biopsy is associated with decreased sampling error compared to percutaneous biopsy, as laparoscopic biopsies are obtained from both liver lobes and gross nodularity can be visualized. Methods: Patients undergoing laparoscopic liver biopsy were enrolled. Gross liver appearance was assessed, and biopsy specimens were blindly evaluated by a pathologist. Elastography (FibroScan) was used to measure liver stiffness. Results: 101 patients were examined. Fibrosis was related to elasticity (Spearman correlation r=0.63; P<.0001). Elasticity was strongly associated with advanced stages of fibrosis (stages 3 and 4; Spearman correlation r2=0.44; P<.001). Significant fibrosis was associated with an irregular liver surface, nodularity, and thickened edge (multiple regression r2=0.41; P<.001). Increased elasticity was associated with a fatty-appearing liver, irregular surface, firmness, and nodularity (multiple regression r2=0.46; P<.001). Receiver operating characteristic curve for elasticity for identifying patients with a liver fibrosis stage of at least 3 or of 4 had an area under the curve (AUC) of 0.85 or 0.86, respectively. AUC was 0.857 when gross nodularity was used as the gold standard for cirrhosis and 0.875 when nodularity/histology were used. Elasticity of at least 7 kPa, at least 9.5 kPa, and at least 11.8 kPa had the highest accuracy for identifying patients with a fibrosis stage of at least 2, at least 3, and 4, respectively. In hepatitis C patients, AUC was 0.921, 0.882, and 0.925 when histology, gross nodularity, and nodularity/histology, respectively, were used as the gold standard for cirrhosis. Conclusion: FibroScan could be useful for detecting advanced stages of fibrosis when validated against laparoscopic liver biopsy. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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