Shear wave elastography and fibrosis-4 index for assessing liver fibrosis after hepatectomy in cirrhotic patients

doi:10.4240/wjgs.120623

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Aug 27, 2026; 18(8): 120623
Published online Aug 27, 2026. doi: 10.4240/wjgs.120623

Table 1 Baseline characteristics overview, n (%)/mean ± SD

Grouping	Significant post-resection fibrosis group (n = 85)	Non-significant post-resection fibrosis group (n = 43)	t/χ²	P value
Age (years)	54.42 ± 7.24	54.30 ± 6.73	0.092	0.927
Gender			1.006	0.316
male	58 (68.24)	33 (76.74)
female	27 (31.76)	10 (23.26)
BMI (kg/m²)	23.87 ± 3.76	25.09 ± 4.23	1.662	0.099
Cirrhosis etiology			1.298	0.730
Viral hepatitis	58 (68.24)	27 (62.79)
Alcohol-related	12 (14.12)	7 (16.28)
MASLD	7 (8.23)	6 (13.95)
Other/mixed	8 (9.41)	3 (6.98)
Indication for hepatectomy			0.307	0.858
Hepatocellular carcinoma	70 (82.35)	34 (79.07)
Benign lesions	9 (10.59)	6 (13.95)
Other malignancies	6 (7.06)	3 (6.98)
Extent of resection			1.493	0.222
Major hepatectomy (≥ 3 segments)	33 (38.82)	12 (27.91)
Minor hepatectomy (< 3 segments)	52 (61.18)	31 (72.09)
Child-Pugh class			2.102	0.147
A	59 (69.41)	35 (81.40)
B	26 (30.59)	8 (18.60)
TBIL (μmol/L)	18.75 ± 2.13	17.09 ± 1.91	4.304	< 0.001
AST (U/L)	137.21 ± 38.84	92.30 ± 35.96	6.331	< 0.001
ALT (U/L)	105.07 ± 25.58	96.32 ± 25.41	1.831	0.069
ALP (U/L)	112.11 ± 20.43	102.50 ± 16.80	2.660	0.009
GGT (U/L)	57.96 ± 14.21	58.10 ± 10.10	0.064	0.949
PLT (× 10⁹/L)	325.87 ± 35.66	339.51 ± 30.20	2.148	0.034
WBC (× 10⁹/L)	7.95 ± 2.42	6.90 ± 1.80	2.515	0.013
AAR	1.29 ± 0.68	0.94 ± 0.18	12.316	< 0.001
APRI	1.03 ± 0.19	0.66 ± 0.21	10.084	< 0.001
FIB-4	2.20 ± 0.35	1.44 ± 0.32	12.030	< 0.001
SWE (KPa)	11.50 ± 3.10	6.80 ± 2.80	8.356	< 0.001

BMI: Body mass index; MASLD: Metabolic dysfunction-associated steatotic liver disease; TBIL: Total bilirubin; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transferase; PLT: Platelet count; WBC: White blood cell count; AAR: Aspartate aminotransferase to alanine aminotransferase ratio; APRI: Aspartate aminotransferase to platelet ratio index; FIB-4: Fibrosis-4 index; SWE: Shear wave elastography.

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Table 2 Univariate logistic regression results

Variable	β	SE	Wald	OR (95%CI)	P value
TBIL	0.440	0.205	4.622	1.553 (1.040-2.321)	0.032
ALP	-0.006	0.021	0.084	0.994 (0.955-1.035)	0.771
WBC	0.039	0.221	0.030	1.039 (0.674-1.604)	0.861
FIB-4	1.594	0.452	12.437	4.923 (2.030-11.940)	< 0.001
SWE	0.510	0.165	9.590	1.664 (1.206-2.298)	0.002
Constant	-16.936	3.914	18.723	< 0.001	< 0.001

OR: Odds ratio; CI: Confidence interval; TBIL: Total bilirubin; ALP: Alkaline phosphatase; WBC: White blood cell count; FIB-4: Fibrosis-4 index; SWE: Shear wave elastography.

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Table 3 Multivariate logistic regression results

Variable	β	SE	Wald	OR (95%CI)	P value
TBIL	0.434	0.202	4.598	1.543 (1.038-2.294)	0.032
FIB-4	1.551	0.431	12.950	4.716 (2.026-10.977)	< 0.001
SWE	0.506	0.161	9.929	1.659 (1.211-2.273)	0.002
Constant	-17.070	3.934	18.828	< 0.001	< 0.001

OR: Odds ratio; CI: Confidence interval; TBIL: Total bilirubin; FIB-4: Fibrosis-4 index; SWE: Shear wave elastography.

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Table 4 Results of the receiver operating characteristic curve

Variable	AUC	Youden index	Optimal cutoff value	Sensitivity (%)	Specificity (%)	95%CI	P value
TBIL	0.718	0.379	18.37	56.47	81.40	0.631-0.794	< 0.001
FIB-4	0.952	0.789	1.86	85.88	93.02	0.899-0.982	< 0.001
SWE	0.870	0.601	10.38	67.06	93.02	0.799-0.923	< 0.001
Model 1	0.979	0.836	0.842	85.88	97.67	0.937-0.996	< 0.001
Model 2	0.985	0.882	0.847	88.24	99.40	0.946-0.998	< 0.001

AUC: Area under the curve; CI: Confidence interval; TBIL: Total bilirubin; FIB-4: Fibrosis-4 index; SWE: Shear wave elastography.

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Citation: Fang Y, Ye L, Wu HR, Du ZS. Shear wave elastography and fibrosis-4 index for assessing liver fibrosis after hepatectomy in cirrhotic patients. World J Gastrointest Surg 2026; 18(8): 120623
URL: https://www.wjgnet.com/1948-9366/full/v18/i8/120623.htm
DOI: https://dx.doi.org/10.4240/wjgs.120623

Fang Y, Ye L, Wu HR, Du ZS. Shear wave elastography and fibrosis-4 index for assessing liver fibrosis after hepatectomy in cirrhotic patients. World J Gastrointest Surg 2026; 18(8): 120623 [DOI: 10.4240/wjgs.120623]

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