期刊
LIVER INTERNATIONAL
卷 34, 期 9, 页码 1340-1348出版社
WILEY
DOI: 10.1111/liv.12525
关键词
hepatic decompensation; hepatocellular carcinoma (HCC); portal hypertension (PHT); transient elastography
资金
- Chang Gung Memorial Hospital [CMRPG 880361]
Background & AimsLiver stiffness measurement (LSM) using transient elastography is useful in prediction of significant portal hypertension (PHT). To evaluate the usefulness of baseline and serial LSM in predicting clinical disease progression (CDP) for patients with compensated hepatic cirrhosis. MethodsConsecutive patients with compensated cirrhosis and without hepatocellular carcinoma (HCC) were prospectively enrolled. Baseline LSM was assessed at enrolment, then at a 6- to 12-month interval. Esophagogastroduodenoscopy and ultrasonography were performed regularly for surveillance of varices and HCC, while CDP including HCC development and PHT progression was recorded. ResultsTwo hundred and twenty patients were enrolled. In a median follow-up of 36.9months, CDP were detected in 49 patients including 30 PHT progression and 19 HCC developments. The cumulative incidence of CDP, PHT progression and HCC development at 3years was 20.7%, 12.8% and 9.1% respectively. Multivariate analyses showed that baseline LSM was an independent predictor of PHT progression and CDP, however, not of HCC occurrence. The performance of baseline LSM in predicting PHT progression, varices growth/development and hepatic decompensation was 0.744, 0.638 and 0.929. With 17, 12 and 21.1kPa as the cut-off, the negative predictive value was 92, 94 and 99% respectively. Patients with baseline LSM 17kPa without serial changes had higher risk of PHT progression. ConclusionFor patients with compensated cirrhosis, LSM was an independent predictor of PHT progression and CDP, but not of HCC occurrence. Baseline LSM was useful to exclude PHT progression. Patients with baseline and serial LSM 17kPa had higher risk of PHT progression.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据