Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis
Background. The hepatitis B virus infection is a global health issue and the stage of liver fibrosis affects the prognosis in patients with chronic hepatitis B (CHB). We performed the meta-analysis describing diagnostic accuracy of transient elastography (TE) for predicting CHB-related fibrosis. Met...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2018/3406789 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832562709818769408 |
|---|---|
| author | Xiaolong Qi Min An Tongwei Wu Deke Jiang Mengyun Peng Weidong Wang Jing Wang Chunqing Zhang on behalf of the CHESS Study Group |
| author_facet | Xiaolong Qi Min An Tongwei Wu Deke Jiang Mengyun Peng Weidong Wang Jing Wang Chunqing Zhang on behalf of the CHESS Study Group |
| author_sort | Xiaolong Qi |
| collection | DOAJ |
| description | Background. The hepatitis B virus infection is a global health issue and the stage of liver fibrosis affects the prognosis in patients with chronic hepatitis B (CHB). We performed the meta-analysis describing diagnostic accuracy of transient elastography (TE) for predicting CHB-related fibrosis. Methods. We performed an adequate literature search to identify studies that assessed the diagnostic accuracy of TE in CHB patients using biopsy as reference standard. Hierarchical summary receiver-operating curves model and the bivariate mixed-effects binary regression model were applied to generate summary receiver-operating characteristic curves and pooled estimates of sensitivity and specificity. Results. The area under the summary receiver-operating curve for significant fibrosis and cirrhosis was 0.86 (95% confidence interval (CI): 0.83–0.89) and 0.92 (95% CI: 0.90–0.94), respectively. The sensitivity, specificity, and diagnostic odds ratio of TE for significant fibrosis were 0.78 (95% CI: 0.73–0.81, p<0.01; I2=85.59%), 0.81 (95% CI: 0.77–0.84, p<0.01; I2=88.20%), and 14.44 (95% CI: 10.80–19.31, p<0.01; I2=100%) and for cirrhosis were 0.84 (95% CI: 0.80–0.88, p<0.01; I2=76.67%), 0.87 (95% CI: 0.84–0.90, p<0.01; I2=90.89%), and 36.63 (95% CI: 25.38–52.87, p<0.01; I2=100%), respectively. The optimal cut-off values of TE were 7.25 kPa for diagnosing significant fibrosis and 12.4 kPa for diagnosing cirrhosis, respectively. Conclusion. TE is of great value in the detection of patients with CHB-related cirrhosis but has a suboptimal accuracy in the detection of significant fibrosis. |
| format | Article |
| id | doaj-art-e635e2266708451d9b1dff607a291ad1 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-e635e2266708451d9b1dff607a291ad12025-02-03T01:21:59ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972018-01-01201810.1155/2018/34067893406789Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-AnalysisXiaolong Qi0Min An1Tongwei Wu2Deke Jiang3Mengyun Peng4Weidong Wang5Jing Wang6Chunqing Zhang7on behalf of the CHESS Study Group8Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, ChinaCHESS, Hepatic Hemodynamic Lab, Institute of Hepatology, Nanfang Hospital, Southern Medical University, Guangdong Provincial Research Center for Liver Fibrosis, Guangzhou, ChinaCHESS, Hepatic Hemodynamic Lab, Institute of Hepatology, Nanfang Hospital, Southern Medical University, Guangdong Provincial Research Center for Liver Fibrosis, Guangzhou, ChinaDepartment of Hepatobiliary Disease, The Affiliated (T.C.M) Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Hepatobiliary Surgery, Shunde Hospital, Southern Medical University, Foshan, ChinaDepartment of Hepatobiliary Disease, The Affiliated (T.C.M) Hospital of Southwest Medical University, Luzhou, ChinaDepartment of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, ChinaCHESS, Hepatic Hemodynamic Lab, Institute of Hepatology, Nanfang Hospital, Southern Medical University, Guangdong Provincial Research Center for Liver Fibrosis, Guangzhou, ChinaBackground. The hepatitis B virus infection is a global health issue and the stage of liver fibrosis affects the prognosis in patients with chronic hepatitis B (CHB). We performed the meta-analysis describing diagnostic accuracy of transient elastography (TE) for predicting CHB-related fibrosis. Methods. We performed an adequate literature search to identify studies that assessed the diagnostic accuracy of TE in CHB patients using biopsy as reference standard. Hierarchical summary receiver-operating curves model and the bivariate mixed-effects binary regression model were applied to generate summary receiver-operating characteristic curves and pooled estimates of sensitivity and specificity. Results. The area under the summary receiver-operating curve for significant fibrosis and cirrhosis was 0.86 (95% confidence interval (CI): 0.83–0.89) and 0.92 (95% CI: 0.90–0.94), respectively. The sensitivity, specificity, and diagnostic odds ratio of TE for significant fibrosis were 0.78 (95% CI: 0.73–0.81, p<0.01; I2=85.59%), 0.81 (95% CI: 0.77–0.84, p<0.01; I2=88.20%), and 14.44 (95% CI: 10.80–19.31, p<0.01; I2=100%) and for cirrhosis were 0.84 (95% CI: 0.80–0.88, p<0.01; I2=76.67%), 0.87 (95% CI: 0.84–0.90, p<0.01; I2=90.89%), and 36.63 (95% CI: 25.38–52.87, p<0.01; I2=100%), respectively. The optimal cut-off values of TE were 7.25 kPa for diagnosing significant fibrosis and 12.4 kPa for diagnosing cirrhosis, respectively. Conclusion. TE is of great value in the detection of patients with CHB-related cirrhosis but has a suboptimal accuracy in the detection of significant fibrosis.http://dx.doi.org/10.1155/2018/3406789 |
| spellingShingle | Xiaolong Qi Min An Tongwei Wu Deke Jiang Mengyun Peng Weidong Wang Jing Wang Chunqing Zhang on behalf of the CHESS Study Group Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis Canadian Journal of Gastroenterology and Hepatology |
| title | Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis |
| title_full | Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis |
| title_fullStr | Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis |
| title_full_unstemmed | Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis |
| title_short | Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis |
| title_sort | transient elastography for significant liver fibrosis and cirrhosis in chronic hepatitis b a meta analysis |
| url | http://dx.doi.org/10.1155/2018/3406789 |
| work_keys_str_mv | AT xiaolongqi transientelastographyforsignificantliverfibrosisandcirrhosisinchronichepatitisbametaanalysis AT minan transientelastographyforsignificantliverfibrosisandcirrhosisinchronichepatitisbametaanalysis AT tongweiwu transientelastographyforsignificantliverfibrosisandcirrhosisinchronichepatitisbametaanalysis AT dekejiang transientelastographyforsignificantliverfibrosisandcirrhosisinchronichepatitisbametaanalysis AT mengyunpeng transientelastographyforsignificantliverfibrosisandcirrhosisinchronichepatitisbametaanalysis AT weidongwang transientelastographyforsignificantliverfibrosisandcirrhosisinchronichepatitisbametaanalysis AT jingwang transientelastographyforsignificantliverfibrosisandcirrhosisinchronichepatitisbametaanalysis AT chunqingzhang transientelastographyforsignificantliverfibrosisandcirrhosisinchronichepatitisbametaanalysis AT onbehalfofthechessstudygroup transientelastographyforsignificantliverfibrosisandcirrhosisinchronichepatitisbametaanalysis |