Study On The Relationship Between Direct Determination Of Liver Stiffness Value And Severity Of Cirrhosis

OBJECTIVE: To directly measure the liver stiffness value(LSV,unit: HC)by hardness tester,analyze the relationship between LSV and severity of cirrhosis,and explore the clinical value of LSV in assessing the severity of cirrhosis.METHODS: A total of 113 patients underwent open surgery from November 2017 to August 2018 in our center.The LX-C Shore hardness tester was used to directly measure LSV.Postoperative liver tissue samples were evaluated for the results of pathological grading of cirrhosis by Laennec classification.ROC curves of different pathological grades of cirrhosis were drawn,and the area under the ROC curve(AUC)was calculated to evaluate the diagnostic value of LSV for assessing the severity of cirrhosis.The liver siffness was classified into grade I liver stiffness(LSV: 2-6 HC),grade II liver stiffness(LSV: 7-11 HC),and grade III liver stiffness(LSV: 12-16 HC)according to the range of LSV distribution.To analyze the correlation between liver stiffness grading(LSG)and pathological grade of cirrhosis,and to determine both of them the consistency of assessing the severity of cirrhosis.RESULTS: 1.There were 52 cases(46%)without cirrhosis、LSV: 4.69±1.35 HC,34 cases(30%)with mild cirrhosis、LSV: 8.18±1.88 HC,22 cases(19.5%)with moderate cirrhosis、LSV:10.68 ±2.23 HC,severe cirrhosis in 5(4.5%)、 LSV: 13.70±3.03 HC,the difference of LSV between different grades was statistically significant(F=83.224;P<0.001);there was a significant correlation between LSV and pathological grading of cirrhosis(rs=0.743,P<0.05).2.LSV assessed AUC of mild,moderate,and severe cirrhosis of 0.94(95% CI 0.90,0.99),0.82(95% CI 0.71,0.94),and 0.73(95% CI 0.45,1.00),respectively.3.Grade I liver stiffness was 52(46%),grade II liver stiffness was 48(42%),and grade III liver stiffness was 13(12%).There was a significant correlation between LSG and pathological grade of cirrhosis(rs=0.789,P <0.05),the Kappa value was 0.64.Conclusion: LSV has a certain accuracy in the diagnosis of mild,moderate and severe cirrhosis.LSG has a significant correlation with the pathological grade of cirrhosis,both of them have a good agreement on assessing the severity of cirrhosis.