Author/Authors :
Qi, Xiaolong Department of Gastroenterology - Shandong Provincial Hospital Afliated to Shandong University, Jinan, China , An, Min Te Second School of Clinical Medicine - Southern Medical University, Guangzhou, China , Wu, Tongwei HESS - Hepatic Hemodynamic Lab - Institute of Hepatology - Nanfang Hospital - Southern Medical University - Guangdong Provincial Research Center for Liver Fibrosis, China , Jiang, Deke CHESS - Hepatic Hemodynamic Lab - Institute of Hepatology - Nanfang Hospital - Southern Medical University - Guangdong Provincial Research Center for Liver Fibrosis, China , Peng, Mengyun Department of Hepatobiliary Disease - Te Afliated (T.C.M) Hospital of Southwest Medical University, Luzhou, China , Wang, Weidong Department of Hepatobiliary Surgery - Shunde Hospital - Southern Medical University, Foshan, China , Wang, Jing Department of Hepatobiliary Disease - Te Afliated (T.C.M) Hospital of Southwest Medical University, Luzhou, China , Zhang, Chunqing Department of Gastroenterology - Shandong Provincial Hospital Afliated to Shandong University, Jinan, China
Abstract :
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
