한빛사논문
- 조회294
Mi Na Kim1,2, Jihyun An3, Eun Hwa Kim4, Hee Yeon Kim5, Han Ah Lee6, Jung Hwan Yu7, Young-Joo Jin7, Young Eun Chon8, Seung Up Kim1,2, Dae Won Jun9, Ji Won Han10, Miyoung Choi11
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
2Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
3Department of Gastroenterology and Hepatology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
4Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
5Department of Internal Medicine, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
6Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea
7Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Republic of Korea
8Department of Internal Medicine, Institute of Gastroenterology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
9Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Republic of Korea
10Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
11Division of Health Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency (NECA), Seoul, Republic of Korea
*Mi Na Kim and Jihyun An contributed equally to this work.
Correspondence : Ji Won Han, Miyoung Choi
Abstract
Background and aims: Accurate diagnosis of significant liver fibrosis in patients with chronic hepatitis B (CHB) is crucial when determining whether to initiate antiviral treatment (AVT). We conduct a meta-analysis to assess the diagnostic performance of transient elastography (TE) for significant liver fibrosis in AVT-naïve CHB patients with serum alanine transaminase (ALT) levels within 5-fold the upper limit of normal (ULN).
Methods: The Ovid-Medline, EMBASE, Cochrane, and KoreaMed databases were searched to identify studies that compared the performance of TE and liver biopsy (reference standard) when diagnosing significant liver fibrosis (≥ F2) in AVT-naïve CHB patients with ALT within 5-fold the ULN. A hierarchical summary receiver operating characteristic curve (HSROC) and bivariate model were performed to evaluate the diagnostic performance of TE in the meta-analysis.
Results: Eight studies (2,003 patients) were included. The summary sensitivity and specificity for diagnosis of significant liver fibrosis were 0.78 [95% confidence interval (CI), 0.66-0.86] and 0.72 (95% CI, 0.60-0.82), respectively. The HSROC for the diagnosis of significant liver fibrosis was 0.81 (95% CI, 0.72-0.86). The optimal cut-off value of TE for diagnosis of significant liver fibrosis was 7.7 kPa with a sensitivity of 0.64 (95% CI, 0.50-0.76) and specificity of 0.83 (95% CI, 0.72-0.90).
Conclusions: Our study demonstrated that TE has an acceptable diagnostic performance for significant liver fibrosis in AVT-naïve CHB patients with ALT within 5-fold the ULN.
논문정보
- Research article
- 2024년 07월 (BRIC 등록일 2024-07-25)
- 국내 연구진
- 의약학 > 응용의학
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