Esposto G, Santini P, Galasso L, Mignini I, Ainora ME, Gasbarrini A, Zocco MA. Shear-wave elastography to predict hepatocellular carcinoma after hepatitis C virus eradication: A systematic review and meta-analysis. World J Gastroenterol 2024; 30(10): 1450-1460 [PMID: 38596502 DOI: 10.3748/wjg.v30.i10.1450]
Corresponding Author of This Article
Maria Assunta Zocco, MD, PhD, Researcher, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Catholic University of Rome, Largo gemelli 1, Rome 00168, Italy. mariaassunta.zocco@unicatt.it
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
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/
World J Gastroenterol. Mar 14, 2024; 30(10): 1450-1460 Published online Mar 14, 2024. doi: 10.3748/wjg.v30.i10.1450
Shear-wave elastography to predict hepatocellular carcinoma after hepatitis C virus eradication: A systematic review and meta-analysis
Giorgio Esposto, Paolo Santini, Linda Galasso, Irene Mignini, Maria Elena Ainora, Antonio Gasbarrini, Maria Assunta Zocco
Giorgio Esposto, Linda Galasso, Irene Mignini, Maria Elena Ainora, Maria Assunta Zocco, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Catholic University of Rome, Rome 00168, Italy
Antonio Gasbarrini, Medicina Interna e Gastroenterologia, CEMAD Digestive Disease Center, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome 00168, Italy
Author contributions: Zocco MA, Ainora ME, Gasbarrini A designed the research; Esposto G, Santini P, Galasso L, Mignini I performed the research; Esposto G, Santini P contributed analytical tools; Esposto G, Santini P analyzed the data; Esposto G, Santini P, Galasso L, Zocco MA wrote the paper.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that 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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maria Assunta Zocco, MD, PhD, Researcher, CEMAD Digestive Disease Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Catholic University of Rome, Largo gemelli 1, Rome 00168, Italy. mariaassunta.zocco@unicatt.it
Received: December 27, 2023 Peer-review started: December 27, 2023 First decision: January 5, 2024 Revised: January 13, 2024 Accepted: January 31, 2024 Article in press: January 31, 2024 Published online: March 14, 2024 Processing time: 78 Days and 0.9 Hours
ARTICLE HIGHLIGHTS
Research background
Direct-acting antiviral agents (DAAs) modified the natural history of chronic hepatitis C. However, despite the advancements in sustained virologic response (SVR), some patients remain at risk of developing hepatocellular carcinoma (HCC). In this context, liver stiffness (LS) measurement could serve as a predictor of HCC, allowing for the identification of patients at higher risk.
Research motivation
Identification of SVR patients at higher risk of HCC development could enhance follow-up timing and improve early diagnosis and overall prognosis.
Research objectives
The aim of this meta-analysis is to investigate shear-wave elastography (SWE) as a predictor of HCC occurrence after hepatitis C virus (HCV) clearance with DAAs.
Research methods
We conducted a systematic literature review and planned a qualitative and quantitative synthesis of the evidence through analysis of the Hedges’ g standardized difference of the LS means in those who developed HCC and those who did not. The absence of a predefined LS cut-off prevented us from deriving the effect measures (i.e. hazard ratio or odds ratio).
Research results
LS at baseline and 12 wk follow-up showed a trend towards greater values in those who will develop HCC compared to those who will not [baseline LS standardized mean difference (SMD): 1.15, 95% confidence interval (95%CI): 020-2.50; LS SMD after 12 wk: 0.83, 95%CI: 0.33-1.98]. The standardized mean difference between LS in the two groups at 24 wk follow-up was statistically significant (0.64; 95%CI: 0.04-1.24).
Research conclusions
This study explored the ability of SWE to predict HCC after HCV eradication.
Research perspectives
LS, measured by SWE, looks a promising predictor of HCC occurrence in SVR patients. These results need to be further confirmed by larger cohorts.
