Observational Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2016; 22(22): 5276-5284
Published online Jun 14, 2016. doi: 10.3748/wjg.v22.i22.5276
Primary biliary cirrhosis degree assessment by acoustic radiation force impulse imaging and hepatic fibrosis indicators
Hai-Chun Zhang, Rong-Fei Hu, Ting Zhu, Ling Tong, Qiu-Qin Zhang
Hai-Chun Zhang, Rong-Fei Hu, Ting Zhu, Ling Tong, Department of Ultrasound, Huashan Hospital Baoshan Branch Affiliated to Fudan University, Shanghai 200431, China
Qiu-Qin Zhang, Department of Gastroenterology, Huashan Hospital Baoshan Branch Affiliated to Fudan University, Shanghai 200431, China
Author contributions: Zhang FC and Hu RF designed the research; Zhu T, Tong L, Zhang QQ, and Zhang HC performed the research; Hu RF contributed new reagents/analytic tools; Zhang HC and Zhu T analyzed data; and Tong L and Zhang QQ wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Huashan Hospital Baoshan Branch Affiliated to Fudan University Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that there are no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Rong-Fei Hu, Chief Physician, Department of Ultrasound, Huashan Hospital Baoshan Branch Affiliated to Fudan University, No. 1999 West Changjiang Road, Baoshan District, Shanghai 200431, China. hurongfei001@sina.com
Telephone: +86-21-56731199
Received: January 24, 2016
Peer-review started: January 25, 2016
First decision: February 18, 2016
Revised: March 2, 2016
Accepted: March 30, 2016
Article in press: March 30, 2016
Published online: June 14, 2016
Processing time: 129 Days and 18.3 Hours
Abstract

AIM: To evaluate the assessment of primary biliary cirrhosis degree by acoustic radiation force impulse imaging (ARFI) and hepatic fibrosis indicators.

METHODS: One hundred and twenty patients who developed liver cirrhosis secondary to primary biliary cirrhosis were selected as the observation group, with the degree of patient liver cirrhosis graded by Child-Pugh (CP) score. Sixty healthy individuals were selected as the control group. The four indicators of hepatic fibrosis were detected in all research objects, including hyaluronic acid (HA), laminin (LN), type III collagen (PC III), and type IV collagen (IV-C). The liver parenchyma hardness value (LS) was then measured by ARFI technique. LS and the four indicators of liver fibrosis (HA, LN, PC III, and IV-C) were observed in different grade CP scores. The diagnostic value of LS and the four indicators of liver fibrosis in determining liver cirrhosis degree with PBC, whether used alone or in combination, were analyzed by receiver operating characteristic (ROC) curve.

RESULTS: LS and the four indicators of liver fibrosis within the three classes (A, B, and C) of CP scores in the observation group were higher than in the control group, with C class > B class > A class; the differences were statistically significant (P < 0.01). Although AUC values of LS within the three classes of CP scores were higher than in the four indicators of liver fibrosis, sensitivity and specificity were unstable. The ROC curves of LS combined with the four indicators of liver fibrosis revealed that: AUC and sensitivity in all indicators combined in the A class of CP score were higher than in LS alone, albeit with slightly decreased specificity; AUC and specificity in all indicators combined in the B class of CP score were higher than in LS alone, with unchanged sensitivity; AUC values (0.967), sensitivity (97.4%), and specificity (90%) of all indicators combined in the C class of CP score were higher than in LS alone (0.936, 92.1%, 83.3%).

CONCLUSION: The diagnostic value of PBC cirrhosis degree in liver cirrhosis degree assessment by ARFI combined with the four indicators of serum liver fibrosis is of satisfactory effectiveness and has important clinical application value.

Keywords: Acoustic radiation force imaging technology; Hepatic fibrosis index; Primary biliary cirrhosis; Diagnostic value

Core tip: One hundred and twenty patients who had developed liver cirrhosis from primary biliary cirrhosis were assessed by ARFI imaging and hepatic fibrosis index alongside sixty healthy individuals. The ROC curves of LS combined with four liver fibrosis indexes showed that the AUC values (0.967), sensitivity (97.4%), and specificity (90%) of all indexes combined in the C grade of CP score were higher than in those of LS alone (0.936, 92.1%, and 83.3%). The diagnostic value of PBC cirrhosis degree in liver cirrhosis degree assessment by ARFI combined with the four indicators of serum liver fibrosis is of satisfactory effectiveness and has important clinical application value.