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Performance of transient elastography in assessing liver fibrosis in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome.

Performance of transient elastography in assessing liver fibrosis in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome.
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Wu HM, Sheng L, Wang Q, Bao H, Miao Q, Xiao X, Guo CJ, Li H, Ma X, Qiu DK, Hua J,


Wu HM, Sheng L, Wang Q, Bao H, Miao Q, Xiao X, Guo CJ, Li H, Ma X, Qiu DK, Hua J, (click to view)

Wu HM, Sheng L, Wang Q, Bao H, Miao Q, Xiao X, Guo CJ, Li H, Ma X, Qiu DK, Hua J,

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World journal of gastroenterology 24(6) 737-743 doi 10.3748/wjg.v24.i6.737

Abstract
AIM
To investigate the performance of transient elastography (TE) for diagnosis of fibrosis in patients with autoimmune hepatitis-primary biliary cholangitis (AIH-PBC) overlap syndrome.

METHODS
A total of 70 patients with biopsy-proven AIH-PBC overlap syndrome were included. Spearman correlation test was used to analyze the correlation of liver stiffness measurement (LSM) and fibrosis stage. Independent samples Student’s-test or one-way analysis of variance was used to compare quantitative variables. Receiver operating characteristics (ROC) curve was used to calculate the optimal cut-off values of LSM for predicting individual fibrosis stages. A comparison on the diagnostic accuracy for severe fibrosis was made between LSM and other serological scores.

RESULTS
Patients with AIH-PBC overlap syndrome had higher median LSM than healthy controls (11.3 ± 6.4 kPa4.3 ± 1.4 kPa,< 0.01). LSM was significantly correlated with fibrosis stage (= 0.756,< 0.01). LSM values increased gradually with an increased fibrosis stage. The areas under the ROC curves of LSM for stages F ≥ 2, F ≥ 3, and F4 were 0.837 (95%CI: 0.729-0.914), 0.910 (0.817-0.965), and 0.966 (0.893-0.995), respectively. The optimal cut-off values of LSM for fibrosis stages F ≥ 2, F ≥ 3, and F4 were 6.55, 10.50, and 14.45 kPa, respectively. LSM was significantly superior to fibrosis-4, glutaglumyl-transferase/platelet ratio, and aspartate aminotransferase-to-platelet ratio index scores in detecting severe fibrosis (F ≥ 3) (0.9100.715,< 0.01; 0.9100.649,< 0.01; 0.9100.616,< 0.01, respectively). CONCLUSION
TE can accurately detect hepatic fibrosis as a non-invasive method in patients with AIH-PBC overlap syndrome.

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