1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea; Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
BACKGROUND & AIMS:
Liver stiffness (LS) measurement using transient elastography and the FibroTest (FT) are alternatives to liver biopsy (LB) in assessing liver fibrosis. We investigated the prognostic role of the combined use of LS and FT in predicting liver-related events (LREs) in patients with chronic hepatitis B (CHB).
Consecutive patients with CHB who underwent LB, along with LS and FT on the same day from 2007 to 2010 were recruited. LRE was defined as hepatic decompensation, hepatocellular carcinoma (HCC), or liver-related death.
A total of 151 patients (86 male) were analyzed. During follow-up (median 59.9 months), overall 18 (11.9%) patients experienced LREs. The areas under receiver-operating characteristic curves of LS, FT, LS+FT and LSxFT in predicting LRE were 0.701, 0.668, 0.702 and 0.741, respectively. After adjusting for age and histological fibrosis staging, significant variables in univariate analysis (both P<0.05), LS+FT and LSxFT were independent predictors of LREs with hazard ratios (HRs) of 1.080 and 1.126 (all P<0.05), respectively. When subjects were divided into three groups according to quartile stratification (low quartile, interquartile and high quartile) using LS+FT and LSxFT, cumulative LRE development rate significantly increased with a corresponding increase in value among three groups, respectively (log-rank test, all P<0.05).
The combined use of LS and FT significantly predicted forthcoming LRE development, but with only a slight additional benefit compared to LS or FT alone.