Diagnostic accuracy of vibration-controlled transient elastography for staging liver fibrosis in autoimmune liver diseases: A systematic review and meta-analysis
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: The assessment of liver fibrosis is crucial for managing autoimmune liver diseases such as primary biliary cholangitis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC). However, data on the efficacy of noninvasive tests for these diseases are limited. This meta-analysis evaluated the diagnostic accuracy of vibration-controlled transient elastography (VCTE) for staging fibrosis in patients with autoimmune liver disease. Methods: Searches were conducted in PubMed, Embase, CINAHL, Web of Science, and Cochrane Library databases to assess the diagnostic accuracy of VCTE against histology as the reference standard in adult patients with autoimmune liver disease. The summary area under the curve (sAUC) and diagnostic odds ratio were calculated for significant fibrosis (SF), advanced fibrosis (AF), and cirrhosis, according to liver biopsy. Results: Fourteen articles were included, comprising 559 PBC patients from six studies, 388 AIH patients from five studies, and 151 PSC patients from three studies. VCTE demonstrated good performance for fibrosis staging in PBC, AIH, and PSC. In PBC, sAUCs of VCTE were 0.87, 0.89, and 0.99 for staging SF, AF, and cirrhosis, respectively. In AIH, the sAUCs were 0.88, 0.88, and 0.92, respectively, while in PSC, they were 0.88, 0.95, and 0.92, respectively. The cutoff values for AF were 7.5–17.9 kPa in PBC, 8.18–12.1 kPa in AIH, and 9.6 kPa in PSC. Conclusions: VCTE shows high diagnostic accuracy for staging liver fibrosis in patients with autoimmune liver diseases. This non-invasive method serves as a valuable tool for the evaluation and monitoring of fibrosis in these lifelong diseases.
Abstract
Background/Aims: The assessment of liver fibrosis is crucial for managing autoimmune liver diseases such as primary biliary cholangitis (PBC), autoimmune hepatitis (AIH), and primary sclerosing cholangitis (PSC). However, data on the efficacy of noninvasive tests for these diseases are limited. This meta-analysis evaluated the diagnostic accuracy of vibration-controlled transient elastography (VCTE) for staging fibrosis in patients with autoimmune liver disease. Methods: Searches were conducted in PubMed, Embase, CINAHL, Web of Science, and Cochrane Library databases to assess the diagnostic accuracy of VCTE against histology as the reference standard in adult patients with autoimmune liver disease. The summary area under the curve (sAUC) and diagnostic odds ratio were calculated for significant fibrosis (SF), advanced fibrosis (AF), and cirrhosis, according to liver biopsy. Results: Fourteen articles were included, comprising 559 PBC patients from six studies, 388 AIH patients from five studies, and 151 PSC patients from three studies. VCTE demonstrated good performance for fibrosis staging in PBC, AIH, and PSC. In PBC, sAUCs of VCTE were 0.87, 0.89, and 0.99 for staging SF, AF, and cirrhosis, respectively. In AIH, the sAUCs were 0.88, 0.88, and 0.92, respectively, while in PSC, they were 0.88, 0.95, and 0.92, respectively. The cutoff values for AF were 7.5–17.9 kPa in PBC, 8.18–12.1 kPa in AIH, and 9.6 kPa in PSC. Conclusions: VCTE shows high diagnostic accuracy for staging liver fibrosis in patients with autoimmune liver diseases. This non-invasive method serves as a valuable tool for the evaluation and monitoring of fibrosis in these lifelong diseases.
참고문헌 (37)
- European Association for the Study of the Liver, "EASL Clinical Practice Guidelines : The diagnosis and management of patients with primary biliary cholangitis", J Hepatol, 67, pp.145~172 (2017)
- Korean Association for the Study of the Liver(KASL), "KASL clinical practice guidelines for management of autoimmune hepatitis 2022", Clin Mol Hepatol, 29, pp.542~592 (2023)
- European Association for the Study of the Liver, "EASL Clinical Practice Guidelines on sclerosing cholangitis", J Hepatol, 77, pp.761~806 (2022)
- Trivedi PJ, "Recent advances in clinical practice : epidemiology of autoimmune liver diseases", Gut, 70, pp.1989~2003 (2021)
- Hahn JW, "Global incidence and prevalence of autoimmune hepatitis, 1970-2022 : a systematic review and meta-analysis", EClinicalMedicine, 65, pp.102280~ (2023)
- Lv T, "Regional variation and temporal trend of primary biliary cholangitis epidemiology : A systematic review and meta-analysis", J Gastroenterol Hepatol, 36, pp.1423~1434 (2021)
- Trivedi PJ, "Epidemiology, natural history, and outcomes of primary sclerosing cholangitis : A systematic review of population-based studies", Clin Gastroenterol Hepatol, 20, pp.1687~1700 (2022)
- Murillo Perez CF, "Fibrosis stage is an independent predictor of outcome in primary biliary cholangitis despite biochemical treatment response", Aliment Pharmacol Ther, 50, pp.1127~1136 (2019)
- Corpechot C, "Biochemical response to ursodeoxycholic acid and long-term prognosis in primary biliary cirrhosis", Hepatology, 48, pp.871~877 (2008)
- Sharma R, "Increased mortality risk in autoimmune hepatitis : A nationwide population-based cohort study with histopathology", Clin Gastroenterol Hepatol, 19, pp.2636~2647 (2021)
- Muir AJ, "Simtuzumab for primary sclerosing cholangitis : Phase 2 study results with insights on the natural history of the disease", Hepatology, 69, pp.684~698 (2019)
- Neuberger J, "Guidelines on the use of liver biopsy in clinical practice from the British Society of Gastroenterology, the Royal College of Radiologists and the Royal College of Pathology", Gut, 69, pp.1382~1403 (2020)
- Chan J, "Percutaneous medical liver core biopsies : correlation between tissue length and the number of portal tracts", J Clin Pathol, 63, pp.655~656 (2010)
- Colloredo G, "Impact of liver biopsy size on histological evaluation of chronic viral hepatitis : the smaller the sample, the milder the disease", J Hepatol, 39, pp.239~244 (2003)
- Manzo-Francisco LA, "Systematic review and meta-analysis : Transient elastography compared to liver biopsy for staging of liver fibrosis in primary biliary cholangitis", Ann Hepatol, 28, pp.101107~ (2023)
- Chen H, "Diagnostic role of transient elastography in patients with autoimmune liver diseases : A systematic review and meta-analysis", World J Gastroenterol, 29, pp.5503~5525 (2023)
- Corpechot C, "Noninvasive elastography-based assessment of liver fibrosis progression and prognosis in primary biliary cirrhosis", Hepatology, 56, pp.198~208 (2012)
- Floreani A, "Performance and utility of transient elastography and noninvasive markers of liver fibrosis in primary biliary cirrhosis", Dig Liver Dis, 43, pp.887~892 (2011)
- Gómez-Dominguez E, "Transient elastography to assess hepatic fibrosis in primary biliary cirrhosis", Aliment Pharmacol Ther, 27, pp.441~447 (2008)
- Koizumi Y, "Comparison between real-time tissue elastography and vibration-controlled transient elastography for the assessment of liver fibrosis and disease progression in patients with primary biliary cholangitis", Hepatol Res, 47, pp.1252~1259 (2017)
- Milovanović T, "Transient elastography for noninvasive assessment of liver fibrosis in patients with primary biliary cirrhosis", Vojnosanit Pregl, 75, pp.374~379 (2018)
- Osman KT, "Liver stiffness measured by either magnetic resonance or transient elastography is associated with liver fibrosis and is an independent predictor of outcomes among patients with primary biliary cholangitis", J Clin Gastroenterol, 55, pp.449~457 (2021)
- Anastasiou OE, "Performance and utility of transient elastography and non-invasive markers of liver fiibrosis in patients with autoimmune hepatitis : A single centre experience", Hepat Mon, 16, pp.e40737~ (2016)
- Guo L, "Transient elastography(FibroScan)performs better than non-invasive markers in assessing liver fibrosis and cirrhosis in autoimmune hepatitis patients", Med Sci Monit, 23, pp.5106~5112 (2017)
- Hartl J, "Transient elastography in autoimmune hepatitis : Timing determines the impact of inflammation and fibrosis", J Hepatol, 65, pp.769~775 (2016)
- Paranaguá-Vezozzo DC, "Liver elastography can predict degree of advanced fibrosis for autoimmune hepatitis in biochemical remission", JGH Open, 7, pp.272~277 (2023)
- Xu Q, "Evaluation of transient elastography in assessing liver fibrosis in patients with autoimmune hepatitis", J Gastroenterol Hepatol, 32, pp.639~644 (2017)
- Corpechot C, "O84 Liver stiffness assessed by fibroscan is a major prognostic factor in primary sclerosing cholangitis", J Hepatol, 60, pp.S34~ (2014)
- Ehlken H, "Validation of transient elastography and comparison with spleen length measurement for staging of fibrosis and clinical prognosis in primary sclerosing cholangitis", PLoS One, 11, pp.e0164224~ (2016)
- Krawczyk M, "Does transient elastography correlate with liver fibrosis in patients with PSC? Laennec score-based analysis of explanted livers", Scand J Gastroenterol, 52, pp.1407~1412 (2017)
- Roll J, "The prognostic importance of clinical and histologic features in asymptomatic and symptomatic primary biliary cirrhosis", N Engl J Med, 308, pp.1~7 (1983)
- Lindor KD, "Primary biliary cholangitis : 2018 Practice Guidance from the American Association for the Study of Liver Diseases", Hepatology, 69, pp.394~419 (2019)
- European Association for the Study of the Liver, "EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis-2021 update", J Hepatol, 75, pp.659~689 (2021)
- Lam L, "Dynamics of liver stiffness measurement and clinical course of primary biliary cholangitis", Clin Gastroenterol Hepatol (2024)[DOI]
- Kowdley KV, "Efficacy and safety of elafibranor in primary biliary cholangitis", N Engl J Med, 390, pp.795~805 (2024)
- Hartl J, "Usefulness of biochemical remission and transient elastography in monitoring disease course in autoimmune hepatitis", J Hepatol, 68, pp.754~763 (2018)
- Rennebaum F, "Elevated Liver Fibrosis Progression in Isolated PSC Patients and Increased Malignancy Risk in a PSC-IBD Cohort : A Retrospective Study", Int J Mol Sci, 24, pp.15431~ (2023)