Prediction of Compensated Liver Cirrhosis by Ultrasonography and Routine Blood Tests in Patients with Chronic Viral Hepatitis

Overview

Journal Korean J Hepatol

Specialty Gastroenterology

Date 2011 Mar 19

PMID 21415580

Citations 13

Authors

Hong Sub Lee

Jai Keun Kim

Jae Youn Cheong

Eun Jin Han

So Yeon An

Jun Ha Song

Yun Jung Jung

Sung Chan Jeon

Min Wook Jung

Eun Jung Jang

Sung Won Cho

Affiliations

Soon will be listed here.

Abstract

Background/aims: Liver biopsy is a standard method for diagnosis of liver cirrhosis in patients with chronic hepatitis. Because liver biopsy is an invasive method, non-invasive methods have been used for diagnosis of compensated liver cirrhosis in patients with chronic hepatitis. The current study was designed to evaluate the usefulness of ultrasonography and routine blood tests for diagnosis of compensated liver cirrhosis in patients with chronic viral hepatitis.

Methods: Two hundred three patients with chronic viral hepatitis who underwent liver biopsy were included in this study and ultrasonography and routine blood tests were analyzed retrospectively. Ultrasonographic findings, including surface nodularity, parenchyma echogenecity, and spleen size, were evaluated. The diagnostic accuracy of ultrasonography and routine blood tests were examined.

Results: Discriminant analysis with forward stepwise selection of variables showed that liver surface nodularity, platelet count, and albumin level were independently associated with compensated liver cirrhosis (p<0.05). Cross-tabulation revealed that the following 4 variables had >95% specificity: platelet count <100,000 /uL; albumin level <3.5 g/dL; INR >1.3; and surface nodularity. If at least one of the four variables exists in a patient with chronic viral hepatitis, we can predict liver cirrhosis with 90% specificity and 61% sensitivity.

Conclusions: These results suggest that four variables (platelet count <100,000 /uL, albumin level <3.5 g/dL, INR >1.3, and surface nodularity) can be used for identification of liver cirrhosis in patients with chronic viral hepatitis with high specificity.

Citing Articles

Entecavir monotherapy versus de novo combination of lamivudine and adefovir for compensated hepatitis B virus-related cirrhosis: a real-world prospective multicenter cohort study.

Wu X, Zhou J, Xie W, Ding H, Ou X, Chen G Infect Drug Resist. 2019; 12:745-757.

PMID: 31015765 PMC: 6448536. DOI: 10.2147/IDR.S185120.

Characteristics of contrast-enhanced ultrasound in distinguishing small (≤3 cm) hepatocellular carcinoma from intrahepatic cholangiocarcinoma.

Shin S, Choi D, Kim J, Kim Y, Kwon O Medicine (Baltimore). 2018; 97(41):e12781.

PMID: 30313099 PMC: 6203535. DOI: 10.1097/MD.0000000000012781.

Platelet count is associated with sustained virological response rates in treatments for chronic hepatitis C.

Jun B, Park E, Lee W, Jang J, Jeong S, Kim Y Korean J Intern Med. 2018; 34(5):989-997.

PMID: 29529840 PMC: 6718746. DOI: 10.3904/kjim.2017.322.

Role of Shear Wave Elastography in Evaluating the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B.

Jeong J, Sohn J, Sohn W, Park C, Kim T, Won Jun D Gut Liver. 2017; 11(6):852-859.

PMID: 28651307 PMC: 5669602. DOI: 10.5009/gnl16521.

Serum Golgi protein 73 is not a suitable diagnostic marker for hepatocellular carcinoma.

Liu T, Yao M, Liu S, Wang L, Wang L, Hou J Oncotarget. 2017; 8(10):16498-16506.

PMID: 28157705 PMC: 5369980. DOI: 10.18632/oncotarget.14954.

References

Piccinino F, Sagnelli E, Pasquale G, Giusti G . Complications following percutaneous liver biopsy. A multicentre retrospective study on 68,276 biopsies. J Hepatol. 1986; 2(2):165-73. DOI: 10.1016/s0168-8278(86)80075-7. View

Chen Y, Dai L, Wang J, Zhu Y, Feng X, Hou J . Model consisting of ultrasonographic and simple blood indexes accurately identify compensated hepatitis B cirrhosis. J Gastroenterol Hepatol. 2008; 23(8 Pt 1):1228-34. DOI: 10.1111/j.1440-1746.2008.05421.x. View

ANTHONY P, Ishak K, Nayak N, Poulsen H, Scheuer P, Sobin L . The morphology of cirrhosis: definition, nomenclature, and classification. Bull World Health Organ. 1977; 55(4):521-40. PMC: 2366674. View

Kim B, Kim D, Park J, Ahn S, Chon C, Kim J . Validation of FIB-4 and comparison with other simple noninvasive indices for predicting liver fibrosis and cirrhosis in hepatitis B virus-infected patients. Liver Int. 2010; 30(4):546-53. DOI: 10.1111/j.1478-3231.2009.02192.x. View

Alter M . Epidemiology of hepatitis C. Hepatology. 1997; 26(3 Suppl 1):62S-65S. DOI: 10.1002/hep.510260711. View

Colli A, Fraquelli M, Andreoletti M, Marino B, Zuccoli E, Conte D . Severe liver fibrosis or cirrhosis: accuracy of US for detection--analysis of 300 cases. Radiology. 2003; 227(1):89-94. DOI: 10.1148/radiol.2272020193. View

Abdi W, Millan J, Mezey E . Sampling variability on percutaneous liver biopsy. Arch Intern Med. 1979; 139(6):667-9. View

Bedossa P, Dargere D, Paradis V . Sampling variability of liver fibrosis in chronic hepatitis C. Hepatology. 2003; 38(6):1449-57. DOI: 10.1016/j.hep.2003.09.022. View

Kudo M, Zheng R, Kim S, Okabe Y, Osaki Y, Iijima H . Diagnostic accuracy of imaging for liver cirrhosis compared to histologically proven liver cirrhosis. A multicenter collaborative study. Intervirology. 2008; 51 Suppl 1:17-26. DOI: 10.1159/000122595. View

10.

Guechot J, Poupon R, Poupon R . Serum hyaluronan as a marker of liver fibrosis. J Hepatol. 1995; 22(2 Suppl):103-6. View

11.

Shen L, Li J, Zeng M, Lu L, Fan S, Bao H . Correlation between ultrasonographic and pathologic diagnosis of liver fibrosis due to chronic virus hepatitis. World J Gastroenterol. 2006; 12(8):1292-5. PMC: 4124446. DOI: 10.3748/wjg.v12.i8.1292. View

12.

Wai C, Greenson J, Fontana R, Kalbfleisch J, Marrero J, Conjeevaram H . A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003; 38(2):518-26. DOI: 10.1053/jhep.2003.50346. View

13.

Bravo A, Sheth S, Chopra S . Liver biopsy. N Engl J Med. 2001; 344(7):495-500. DOI: 10.1056/NEJM200102153440706. View

14.

Lackner C, Struber G, Liegl B, Leibl S, Ofner P, Bankuti C . Comparison and validation of simple noninvasive tests for prediction of fibrosis in chronic hepatitis C. Hepatology. 2005; 41(6):1376-82. DOI: 10.1002/hep.20717. View

15.

Llovet J, Fuster J, Bruix J . Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology. 1999; 30(6):1434-40. DOI: 10.1002/hep.510300629. View

16.

Ong T, Tan H . Ultrasonography is not reliable in diagnosing liver cirrhosis in clinical practice. Singapore Med J. 2003; 44(6):293-5. View

17.

Paik S . [Goals of treatment, indication, and treatment for chronic hepatitis C]. Korean J Gastroenterol. 2008; 51(6):368-71. View

18.

Gaiani S, Gramantieri L, Venturoli N, Piscaglia F, Siringo S, DErrico A . What is the criterion for differentiating chronic hepatitis from compensated cirrhosis? A prospective study comparing ultrasonography and percutaneous liver biopsy. J Hepatol. 1998; 27(6):979-85. DOI: 10.1016/s0168-8278(97)80140-7. View

19.

Laharie D, Zerbib F, Adhoute X, Boue-Lahorgue X, Foucher J, Castera L . Diagnosis of liver fibrosis by transient elastography (FibroScan) and non-invasive methods in Crohn's disease patients treated with methotrexate. Aliment Pharmacol Ther. 2006; 23(11):1621-8. DOI: 10.1111/j.1365-2036.2006.02929.x. View

20.

Poynard T, Bedossa P, Opolon P . Natural history of liver fibrosis progression in patients with chronic hepatitis C. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups. Lancet. 1997; 349(9055):825-32. DOI: 10.1016/s0140-6736(96)07642-8. View