Can J Gastroenterol Hepatol. 2018 May 24;2018:3406789. doi: 10.1155/2018/3406789. eCollection 2018.
Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis.
Qi X1,2, An M3, Wu T2, Jiang D2, Peng M4, Wang W5, Wang J4, Zhang C1, Chess Study Group OBOT2.
Author information
1
Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China.
2
CHESS, Hepatic Hemodynamic Lab, Institute of Hepatology, Nanfang Hospital, Southern Medical University, Guangdong Provincial Research Center for Liver Fibrosis, Guangzhou, China.
3
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
4
Department of Hepatobiliary Disease, The Affiliated (T.C.M) Hospital of Southwest Medical University, Luzhou, China.
5
Department of Hepatobiliary Surgery, Shunde Hospital, Southern Medical University, Foshan, China.
Abstract
Background:
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.
Methods:
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.
Results:
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, p < 0.01; I2 = 85.59%), 0.81 (95% CI: 0.77-0.84, p < 0.01; I2 = 88.20%), and 14.44 (95% CI: 10.80-19.31, p < 0.01; I2 = 100%) and for cirrhosis were 0.84 (95% CI: 0.80-0.88, p < 0.01; I2 = 76.67%), 0.87 (95% CI: 0.84-0.90, p < 0.01; I2 = 90.89%), and 36.63 (95% CI: 25.38-52.87, p < 0.01; I2 = 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.
Conclusion:
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.