Diagnostic Value Of Fibroscan For Liver Fibrosis In Patients With Chronic Hepatitis B

Objective:To testify the diagnostic value of Fibroscan for liver fibrosis in patients with CHB. Research the relevance between Fibroscan and other parameters like pathological examination,ultrosonic testing and TGF-β1.Method:1.94CHB patients treated in NingXia medical university general hospital were enrolled in this study,30cases of normal control group were healthy people from physical examination center;2.A the94patients were carried out Fibroscan assay,and the stiffne value were recorded;3.All the94patients were carried out liver puncture biopsy pathology examination;4.Examine every patient with ultrasound examination.And mark the USG for semiquantitative score through indexes and prehensive integral method;5.66patients and30cases of control group were carried out serum TGF-β1level detection.6.Statical analysis was performed by SPSS software version19.0,continuous variables were expressed as mean±SD. One way ANOVA were used for means comparision.Application of Spearman’s correlation or Pearson coefficient of production moment correlation analysis correlation.Results:1.Liver stiffness test results:mean liver stiffness test value was15.98士11.79kpa,at stage SO, the mean liver stiffness test value was11.23±9.66kpa (2.8～56.0kpa);at stage S1,the mean liver stiffness test value was13.20±4.31kpa (5.1～23.lkpa);at stage S2,the mean liver stiffness test value was18.96±10.09kpa (6.1～37.4kpa);at stage S3,the mean liver stiffness test value was26.28±14.83kpa (6.8～59.4kpa);at stage S4mean liver stiffness test value was 33.25±16.29kpa (13.6-51.4kpa).The stiffness of each liver fibrosis stage is significantly different, P<0.001.2.The stiffness parameter and the final score of hepatic parenchyma coming from ultrasonic examination to observe the liver’s biopsy, capsule,edge and vein, have a relatively good correlation with pathology the degree of liver fibrosis, and the related coefficient(r=0.65、0.52、0.41、0.50、0.562、0.60,P<0.05),and all of these,the correlation between the liver stiffness parameter is the best;3.The ROC curve analysis showed that the areas under the curve for stiffness, hepatic parenchyma to observe the liver’s biopsy, capsule, edge and vein and theirs total score are0.769、0.640、0.573、0.690、0、718.0.753,and the area of the stiffness parameter is larger than otlhers,so,it is the most valuable to be used to diagnosis.4.The patients’serum levels of TGF-β1is higher than the control group.5.Although the serum levels of TGF-β1has correlation with the liver stiffness,it has no correlation with the liver’s biopsy.Conclusion:1.Fibroscan is a quantitative liver fibrosis detection means,and it can be used alone or combined with other ways in liver firbrosis to give an accurate evaluation.Because there is good correlation with stiffness parameter pathology the degree of liver fibrosis and we can get a standard and accurate result;2.Fibroscan is a reasonable noninvasive tool for the assessment of liver fibrosis,better than ultrasonography;3.Compared with TGF-β1,the relevance between Fibroscan and staging of liver fibrosis is more evident,so Fibroscan is more accurate in the diagnosis of liber fibrosis.4.Fibroscan is a tool of testing liver fibrosis that is noninvasive、high stability、high reliability and repeatability.And ti can quantify the liver fibrosis degree,there,Fibroscan have a certain advantage in diagnosis of liver fibrosis.With ultrasonic inspection,such as joint detection can improve the diagnosis of liver fibrosis.