Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2017; 23(2): 297-305
Published online Jan 14, 2017. doi: 10.3748/wjg.v23.i2.297
3-Dimensional liver volume assessment in patients with hepatitis B virus-related liver cirrhosis during long-term oral nucleos(t)ide analogues therapy
Hee Chul Yu, Jae Do Yang, Dae Ghon Kim, Soo Teik Lee, Seung Ok Lee, Sang Wook Kim, Seong Hun Kim, Seung Young Seo, Jin Chang Moon, In Hee Kim, Chang Hun Lee
Chang Hun Lee, In Hee Kim, Jin Chang Moon, Seung Young Seo, Seong Hun Kim, Sang Wook Kim, Seung Ok Lee, Soo Teik Lee, Dae Ghon Kim, Division of Gastroenterology, Department of Internal Medicine, Chonbuk National University Medical School and Hospital, Jeonju 561-180, South Korea
Jae Do Yang, Hee Chul Yu, Department of Surgery, Chonbuk National University Medical School and Hospital, Jeonju 561-180, South Korea
Author contributions: Kim IH designed the study; Lee CH and Moon JC collected and analyzed the data; Seo SY, Kim SH, Kim SW and Lee SO drafted the manuscript; Lee CH and Kim IH revised the manuscript; Yang JD and Yu HC offered the technical or material support; Lee ST and Kim DG supervised the study; all authors have read and approved the final version to be published.
Supported by Chonbuk National University 2013.
Institutional review board statement: This study was conducted in compliance with the World Medical Association Declaration of Helsinki and was approved by the Ethics Committee at Chonbuk National University Hospital. (IRB number: CUH-2016-07-026-001).
Informed consent statement: Due to the retrospective nature of the study, patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to receive examination of abdominal computed tomography by written informed consent.
Conflict-of-interest statement: The authors disclose no competing interests.
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: In Hee Kim, MD, PhD, Department of Internal Medicine, Chonbuk National University Medical School, San 2-20 Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk 561-180, South Korea. ihkimmd@jbnu.ac.kr
Telephone: +82-63-2501677
Received: October 4, 2016
Peer-review started: October 7, 2016
First decision: November 9, 2016
Revised: November 22, 2016
Accepted: December 8, 2016
Article in press: December 8, 2016
Published online: January 14, 2017
Processing time: 100 Days and 5.2 Hours
Abstract
AIM

To assess the effect of long-term oral nucleos(t)ide analogues (NUCs) therapy on liver volume change in patients with suppress hepatitis B virus (HBV)-related liver cirrhosis.

METHODS

We reviewed the data of naïve patients with HBV-related liver cirrhosis, who had taken oral NUCs therapy, between 2003 and 2007 at Chonbuk University Hospital. We analyzed two consecutive sets of abdominal computerized tomography scans-one at the time of treatment initiation and another at the second-year follow-up. Liver volume was calculated by 3-dimensional liver extraction volumetry program.

RESULTS

A total of 55 patients (34 males) were included. There was 114.3 mL ± 167.8 mL (12.9% ± 17.9%) of increase in liver volume during the two years of NUCs therapy (993.8 mL ± 242.8 mL at baseline vs 1108.1 mL ± 263.3 mL at two-year follow-up, P < 0.001). The ratio of the measured baseline liver volume to the estimated standard liver volume was improved from 70.8% to 78.0%. An increase in liver volume was shown not only in patients with compensated cirrhosis (P = 0.046) but also in those with decompensated cirrhosis (P < 0.001). Significant factors for volume increases were Child-Turcotte-Pugh grade and model for end-stage liver disease score improvement without virological breakthrough. In multiple linear regression analysis, delta albumin and delta alanine aminotransferase levels showed a significant association with the increase in liver volume (P = 0.002 and 0.005, respectively).

CONCLUSION

Long-term oral NUCs therapy in patients with HBV-related liver cirrhosis lead to significant increase in liver volume assessed with 3-dimensional liver extraction volumetry program.

Keywords: Antiviral agents; Liver cirrhosis; Liver regeneration; Image processing; Computer-assisted

Core tip: Liver volume change may represent the hepatic functional and regenerative capacity. We inspected the effect of oral nucleos(t)ide analogues (NUCs) on liver volume in patients with hepatitis B virus-related cirrhosis. The result showed the increase in liver volume during two years of NUCs therapy and the volume increase was shown both in compensated and decompensated cirrhosis. The increase in liver volume was well correlated with several markers representing hepatic functional status. More volume increase may be attained regarding aggressive damage at baseline and marked improvement during the treatment period. Our data support the reversal of fibrosis and enhancement of liver regeneration of damaged liver in patients with liver cirrhosis after the treatment with NUCs.