Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
CHESS, Hepatic Hemodynamic Lab, Institute of Hepatology, Nanfang Hospital, Southern Medical University, Guangdong Provincial Research Center for Liver Fibrosis, Guangzhou, China.
Can J Gastroenterol Hepatol. 2018 May 24;2018:3406789. doi: 10.1155/2018/3406789. eCollection 2018.
The hepatitis B virus infection is a global health issue and the stage of liver fibrosis affects the prognosis in patients with chronic hepatitis B (CHB). We performed the meta-analysis describing diagnostic accuracy of transient elastography (TE) for predicting CHB-related fibrosis.
We performed an adequate literature search to identify studies that assessed the diagnostic accuracy of TE in CHB patients using biopsy as reference standard. Hierarchical summary receiver-operating curves model and the bivariate mixed-effects binary regression model were applied to generate summary receiver-operating characteristic curves and pooled estimates of sensitivity and specificity.
The area under the summary receiver-operating curve for significant fibrosis and cirrhosis was 0.86 (95% confidence interval (CI): 0.83-0.89) and 0.92 (95% CI: 0.90-0.94), respectively. The sensitivity, specificity, and diagnostic odds ratio of TE for significant fibrosis were 0.78 (95% CI: 0.73-0.81, < 0.01; = 85.59%), 0.81 (95% CI: 0.77-0.84, < 0.01; = 88.20%), and 14.44 (95% CI: 10.80-19.31, < 0.01; = 100%) and for cirrhosis were 0.84 (95% CI: 0.80-0.88, < 0.01; = 76.67%), 0.87 (95% CI: 0.84-0.90, < 0.01; = 90.89%), and 36.63 (95% CI: 25.38-52.87, < 0.01; = 100%), respectively. The optimal cut-off values of TE were 7.25 kPa for diagnosing significant fibrosis and 12.4 kPa for diagnosing cirrhosis, respectively.
TE is of great value in the detection of patients with CHB-related cirrhosis but has a suboptimal accuracy in the detection of significant fibrosis.
乙型肝炎病毒感染是一个全球性的健康问题，肝纤维化的阶段影响慢性乙型肝炎（CHB）患者的预后。我们进行了荟萃分析，描述了瞬时弹性成像（TE）预测 CHB 相关纤维化的诊断准确性。
我们进行了充分的文献检索，以确定使用肝活检作为参考标准评估 TE 在 CHB 患者中诊断准确性的研究。应用分层汇总受试者工作特征曲线模型和双变量混合效应二分类回归模型生成汇总受试者工作特征曲线和汇总敏感性和特异性的估计值。
显著纤维化和肝硬化的汇总受试者工作特征曲线下面积分别为 0.86（95%置信区间（CI）：0.83-0.89）和 0.92（95%CI：0.90-0.94）。TE 对显著纤维化的敏感性、特异性和诊断比值比分别为 0.78（95%CI：0.73-0.81， < 0.01； = 85.59%）、0.81（95%CI：0.77-0.84， < 0.01； = 88.20%）和 14.44（95%CI：10.80-19.31， < 0.01； = 100%），对肝硬化的敏感性、特异性和诊断比值比分别为 0.84（95%CI：0.80-0.88， < 0.01； = 76.67%）、0.87（95%CI：0.84-0.90， < 0.01； = 90.89%）和 36.63（95%CI：25.38-52.87， < 0.01； = 100%）。TE 的最佳截断值分别为 7.25 kPa 用于诊断显著纤维化和 12.4 kPa 用于诊断肝硬化。
TE 对检测 CHB 相关肝硬化具有重要价值，但在检测显著纤维化方面准确性欠佳。
