Diagnostic value of transient elastography combined with noninvasive scores for the detection of advanced liver fibrosis in chronic hepatitis B patients

Introduction: To explore whether a noninvasive scores could improve the diagnosis value of liver stiffness measurement (LSM) with transient elastography (TE) for detecting advanced liver fibrosis in patients with chronic hepatitis B. Methods: LSM by TE, APRI, FIB-4 and BARD scores were conducted in 93 chronic hepatitis B patients. And liver biopsy was recognized as gold standard to identify the histopathological type of tissue samples. The area under the receiver operating curve (AUROC) was used to assess the diagnostic value. Results: No or insignificant fibrosis (fibrosis stage <= 2) was found in seventy patients (75.27%); advanced fibrosis (stage > 2) was found in 23 patients (24.73%). The sensitivity of LSM by TE, APRI, BARD and FIB-4 scores for advanced fibrosis was 78.3, 73.9, 78.3, and 69.9%, respectively, and the specificity was 91.4, 75.7, 72.9, and 81.4%, respectively. Even though the AUROC of LSM combined with noninvasive scores was larger than LSM alone, there have no significant statistical difference between LSM alone and LSM combined with noninvasive scores. Conclusion: In the present study, both LSM by TE and noninvasive indices/scores (APRI, BARD and FIB-4 scores) were discovered to be similarly reliability for noninvasive diagnosis of advanced hepatic fibrosis of chronic hepatitis B. However, their combination cannot significantly improve the diagnostic accuracy of LSM by TE.