Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Aliment Pharmacol Ther. 2010 Aug;32(3):498-505. doi: 10.1111/j.1365-2036.2010.04353.x. Epub 2010 May 11.
Interquartile range/median value (IQR/M) of liver stiffness measurement (LSM) is a factor in chronic hepatitis C (CHC) leading to over estimation of fibrosis by Fibroscan.
To investigate factors that affect the accuracy of LSM in chronic hepatitis B (CHB).
One hundred and ninety-nine patients were enrolled. Only procedures yielding > or =10 valid measurements were considered reliable. Liver fibrosis was evaluated using the Batts and Ludwig system. Liver biopsy (LB) specimens <15 mm were considered ineligible.
The mean age (142 men and 57 women) was 40.1 years. A significant discordance (discordance of at least two stages between LB and LSM) was identified in 38 (19.1%) and 47 (23.6%) patients respectively, according to Marcellin et al. and Chan et al.'s cutoff values. In multivariate analyses, BMI and fibrosis stage (F0-2 vs. F3-4) were identified as independent predictors for significant discordance (P = 0.040; hazard ratio [HR], 1.126; 95% confidence interval [CI], 1.005-1.261 and P = 0.036; HR, 0.450; 95% CI, 0.213-0.949 respectively) with Marcellin et al.'s cutoffs, whereas fibrosis stage was the only independent predictor (P = 0.004; HR, 0.300; 95% CI, 0.131-0.685) with Chan's cutoffs.
Success rate and IQR/M were not predictive factors of the accuracy for diagnosing liver fibrosis by Fibroscan in CHB. Fibrosis stage (F0-2) was the only factor to predict significant discordance between LB and LSM.
肝硬度测量（LSM）的四分位间距/中位数（IQR/M）是慢性丙型肝炎（CHC）导致 Fibroscan 过度估计纤维化的一个因素。
研究影响慢性乙型肝炎（CHB）中 LSM 准确性的因素。
共纳入 199 例患者。仅对产生> =10 个有效测量值的程序进行可靠性评估。采用 Batts 和 Ludwig 系统评估肝纤维化。肝活检（LB）标本<15mm 视为不合格。
平均年龄（142 名男性和 57 名女性）为 40.1 岁。根据 Marcellin 等和 Chan 等的截断值，分别有 38 例（19.1%）和 47 例（23.6%）患者的 LB 和 LSM 之间存在显著不一致（至少两个阶段不一致）。多变量分析中，BMI 和纤维化分期（F0-2 与 F3-4）是与 Marcellin 等截断值的显著不一致的独立预测因素（P=0.040；危险比[HR]，1.126；95%置信区间[CI]，1.005-1.261 和 P=0.036；HR，0.450；95%CI，0.213-0.949），而纤维化分期是唯一的独立预测因素（P=0.004；HR，0.300；95%CI，0.131-0.685）与 Chan 的截断值。
成功率和 IQR/M 不是 Fibroscan 诊断 CHB 肝纤维化准确性的预测因素。纤维化分期（F0-2）是预测 LB 和 LSM 之间显著不一致的唯一因素。
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