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Original Article
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Korean J Med. 2008;74(3):264-270.
- 원저 : 만성 간질환 환자에서 간 섬유화 평가에 대한 간 탄력도 측정의 유용성
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김은선 . 서연석 . 이광균 . 박상훈 . 권용대 . 금보라 . 김용식 . 진윤태 . 전훈, , , , , , , , , , ,
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- The efficacy of measuring liver stiffness for the assessment of liver fibrosis in patients with chronic liver diseases
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Eun Sun Kim, Yeon Seok Seo, Kwang Gyun Lee, Sanghoon Park, Yong Dae Kwon, Bora Keum, Yong Sik Kim, Yoon Tae Jeen, Hoon Jai Chun, Chang Duck Kim, Ho Sang Ryu, Soon Ho Um
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한양대학교 의과대학 호흡기내과
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- Abstract
- Background/Aims : Accurate assessment of liver fibrosis is very important for predicting the prognosis of patients with chronic liver diseases. Liver biopsy is still considered the gold-standard for assessing liver fibrosis. However, it is an invasive procedure with several limitations such as its questionable outcomes. Recent studies have suggested that liver stiffness measurement (LSM) using Fibroscan is noninvasive and useful for assessing liver fibrosis. This study was performed to evaluate the efficacy of LSM for evaluating liver fibrosis in patients with chronic liver diseases.
Methods : We prospectively enrolled 93 patients with chronic liver diseases, as confirmed by liver biopsy. The patients underwent liver biopsy and LSM. The METAVIR liver fibrosis stages of the biopsy specimens were assessed by an experienced pathologist. LSM was performed by Fibroscan. The efficacy of LSM and the optimal cutoff values for assessment of the fibrosis stage were determined by a receiver-operating characteristics (ROC) curve analysis.
Results : LSM was well correlated with the fibrosis stage (Kendall correlation coefficient: 0.58; p<0.001). The areas under the ROC curves were 0.871 (95% CI, 0.715-0.924) for the patients with significant fibrosis (F≥2), 0.874 (0.761-0.929) for the patients with severe fibrosis (F≥3) and 0.894 (0.792-0.956) for the patients with cirrhosis (F=4). The optimal LSM cutoff values for F ≥2, F ≥3 and F=4 were 6.9, 11.75 and 14.5 kPa, respectively.
Conclusions : LSM was a simple, effective method for assessing liver fibrosis in patients with chronic liver diseases. Its use for the follow up and management of these patients could be of great interest and so further investigation is required. (Korean J Med 74:264-270, 2008)
Keywords :Liver, Fibrosis, Fibroscan, Stiffness
