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RISS 인기검색어
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- 저자 : ( Kwanh-hyub Han ) (검색결과 1 건)
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( Jeong-ju Yoo ),( Yeon Seok Seo ),( Young Seok Kim ),( Soung Won Jeong ),( Jae Young Jang ),( Sang Jun Suh ),( Hyung Joon Yim ),( Ki Tae Suk ),( Dong Joon Kim ),( Kwanh-hyub Han ),( Seung Up Kim ),( 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Transient elastography (TE; Fibroscan) is now almost indispensable tool to estimate liver fibrosis. Although many clinical factors are known as confounding factors of liver stiffness (LS), there is no knowledge of who will achieve an improvement of liver stiffness if they have a similar liver fibrosis stage. The aim of this study is to see whether baseline hepatic inflammation may affect accurate LS measurement and which factors are associated with improvement of LS in Fibroscan. Methods: This retrospective study included consecutive 678 patients who underwent baseline liver biopsy and sequential LS assessment from 2006 to 2016 at 6 tertiary hospitals in Korea. Liver fibrosis and inflammation were graded on the basis of standard guideline proposed by the Korean Study Group for the Pathology of Digestive Diseases. LS measurement was performed at baseline and 1, 3, 5 years. Improvement of LS was defined as decreased LS value compared with baseline. Logistic regression was used to evaluate factors associated with improvement of LS in Fibroscan. Results: Mean age of the patients was 47.12±12.25 years and 48.5% were male. Six hundred 2 patients had viral hepatitis (419 HBV; 183 HCV), 76 non-viral hepatitis. Fibrosis stages 0, 1, 2, 3 and 4 were identified in 13 (1.9%), 96 (14.2%), 132 (19.5%), 186 (27.4%) and 251 (37.0%) patients, inflammation grade 0, 1, 2 and 3 were in 28 (4.1%), 278 (14.0%), 279 (41.2%), and 93 (13.7%), respectively. Baseline inflammation grade was correlated with baseline LSM value, and showed linear correlation with ΔLSM. In addition, as the grade of inflammation increased, the higher percentage of patients showed improvement of LSM. A multivariate analysis showed that higher degree of hepatic inflammation was an independent good predictor for LS improvement (adjusted hazard ratio, 3.33; 95% confidence interval, 1.20-9.26; P=0.021) after adjustment for fibrosis stage, platelet count, total bilirubin and alanine aminotransferase level. The association of LSM and hepatic inflammation was more significant in viral hepatitis compared with non-viral etiology. Conclusions: Baseline hepatic inflammation has significant impact on LS value and improvement of LSM, and should be considered as one of the confounding factors of measuring liver stiffness using Fibroscan.
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