Performance of transient elastography in assessing liver fibrosis in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome

Table 1 Baseline characteristics of the patients with autoimmune hepatitis- primary biliary cholangitis overlap syndrome n (%)

Characteristic	n = 70
Age	46.6 ± 10.2
Gender
Male	11 (15.7)
Female	59 (84.3)
Autoantibody positive rate	94.3
Liver function test (mean ± SD)
ALT (U/L)	185.6 ± 238.9
AST (U/L)	166.6 ± 190.7
GGT (U/L)	363.2 ± 393.3
ALP (U/L)	318.7 ± 245.9
Total bilirubin (μmol/L)	32.3 ± 33.9
Albumin (g/L)	40.1 ± 8.0
Serum IgG level (g/L)	17.0 ± 5.1
Serum IgM level (g/L)	4.2 ± 6.9
Biochemical score (mean ± SD)
APRI	2.47 ± 3.85
FIB-4	3.22 ± 3.53
GPR	1.93 ± 2.28
Liver biopsy
Fibrosis stage
0	0 (0)
1	9 (12.9)
2	29 (41.4)
3	25 (35.7)
4	7 (10.0)
Hepatic inflammatory activity
0	0 (0)
1	1 (1.4)
2	30 (42.3)
3	39 (55.7)
LSM value (kPa, maean ± SD)	11.3 ± 6.4

AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; APRI: Aspartate aminotransferase-to-platelet ratio index; FIB-4: Fibrosis-4; GGT: Gamma glutamyltransferase; GPR: Gamma glutamyltransferase/platelet ratio; LSM: Liver stiffness measurement.

Table 2 Diagnostic accuracy of liver stiffness measurement in detecting liver fibrosis in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome

Stage	AUROC (95%CI)	Cut-off (kPa)	Sensitivity	Specificity	PPV	NPV	+LR	-LR
F ≥ 2	0.837 (0.729-0.914)	6.55	0.902	0.778	0.965	0.538	4.06	0.13
F ≥ 3	0.910 (0.817-0.965)	10.50	0.844	0.921	0.900	0.875	10.69	0.17
F = 4	0.966 (0.893-0.995)	14.45	1.000	0.889	0.500	1.000	9.00	0.00

AUROC: Areas under the receiver operator characteristic; PPV: Positive predictive value; NPV: Negative predictive value; +LR: Positive likelihood ratio; -LR: Negative likelihood ratio.