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...

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Publicado en:Gastroenterology & Hepatology Vol. 4; no. 12; pp. 862 - 871
Autores principales: Nudo CG, Jeffers LJ, Bejarano PA, Servin-Abad LA, Leibovici Z, De Medina M, Schiff ER
Formato: research tables/charts Journal Article
Publicado: Gastro-Hep Communications, Inc 2008 Dec
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2008 Dec
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      pub: Gastro-Hep Communications, Inc
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        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
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