{"title":"Performance of FibroScan in grading steatosis and fibrosis in patients with nonalcoholic fatty liver disease: A meta-analysis","authors":"Xiaotong Xu, Jinglan Jin, Yuwei Liu","doi":"10.1016/j.ajg.2023.08.003","DOIUrl":null,"url":null,"abstract":"<div><p><strong>Objective:</strong><span><span> Biopsy remains the gold standard for the diagnosis of Non-alcoholic fatty liver disease (NAFLD). To investigate the diagnostic value of FibroScan based on biopsy and range of cut-offs for </span>steatosis and fibrosis, we explored the grade of steatosis and fibrosis. </span><strong>Method:</strong><span><span> A simultaneous search was performed on cohort studies published earlier than October 8, 2020,in the PubMed, Web of Science, Sinomed, CNKI, </span>VIP, and WanFang databases. Next,we screened qualified studies. The data were mainly analysed in RevMan and complemented in STATA. </span><strong>Results:</strong> The area under the receiver operating characteristic of FibroScan in identifying the stage of steatosis for ≥ S1 was 0.90 (sensitivity:89%; specificity:92%), that for ≥ S2 was 0.82 (sensitivity:89%;specificity:70%) and that for S3 was 0.79 (sensitivity:83%; specificity:63%).The area under the receiver operating characteristic of FibroScan in identifying the stage of fibrosis for ≥ F1 was 0.86 (sensitivity:81%;specificity:77%),that for ≥ F2 was 0.80 (sensitivity: 75%; specificity:82%), that for ≥ F3 was 0.94 (sensitivity:87%; specificity: 89%) and that for F4 was 0.97 (sensitivity: 94%; specificity:91%). <strong>Conclusion:</strong><span> FibroScan, a promising and cost-effective technique, can provide an accurate noninvasive approach for quantifying and staging hepatic steatosis and fibrosis in NAFLD, particularly for advanced fibrosis and cirrhosis. Further studies are needed to explore the relationship between steatosis and fibrosis based on the same group. Additionally, NASH is the key stage of NAFLD. Early diagnosis and intervention can help reduce the incidence of liver cirrhosis. However, no large study has investigated the significance of FibroScan in the diagnosis of NASH confirmed by pathology.</span></p></div>","PeriodicalId":48674,"journal":{"name":"Arab Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arab Journal of Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1687197923000606","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Biopsy remains the gold standard for the diagnosis of Non-alcoholic fatty liver disease (NAFLD). To investigate the diagnostic value of FibroScan based on biopsy and range of cut-offs for steatosis and fibrosis, we explored the grade of steatosis and fibrosis. Method: A simultaneous search was performed on cohort studies published earlier than October 8, 2020,in the PubMed, Web of Science, Sinomed, CNKI, VIP, and WanFang databases. Next,we screened qualified studies. The data were mainly analysed in RevMan and complemented in STATA. Results: The area under the receiver operating characteristic of FibroScan in identifying the stage of steatosis for ≥ S1 was 0.90 (sensitivity:89%; specificity:92%), that for ≥ S2 was 0.82 (sensitivity:89%;specificity:70%) and that for S3 was 0.79 (sensitivity:83%; specificity:63%).The area under the receiver operating characteristic of FibroScan in identifying the stage of fibrosis for ≥ F1 was 0.86 (sensitivity:81%;specificity:77%),that for ≥ F2 was 0.80 (sensitivity: 75%; specificity:82%), that for ≥ F3 was 0.94 (sensitivity:87%; specificity: 89%) and that for F4 was 0.97 (sensitivity: 94%; specificity:91%). Conclusion: FibroScan, a promising and cost-effective technique, can provide an accurate noninvasive approach for quantifying and staging hepatic steatosis and fibrosis in NAFLD, particularly for advanced fibrosis and cirrhosis. Further studies are needed to explore the relationship between steatosis and fibrosis based on the same group. Additionally, NASH is the key stage of NAFLD. Early diagnosis and intervention can help reduce the incidence of liver cirrhosis. However, no large study has investigated the significance of FibroScan in the diagnosis of NASH confirmed by pathology.
目的:活检仍然是非酒精性脂肪性肝病(NAFLD)诊断的金标准。为了探讨纤维扫描基于活检和脂肪变性和纤维化切断范围的诊断价值,我们探讨了脂肪变性和纤维化的分级。方法:同时检索PubMed、Web of Science、Sinomed、CNKI、VIP和万方数据库中2020年10月8日之前发表的队列研究。接下来,我们筛选合格的研究。数据主要在RevMan中进行分析,在STATA中进行补充。结果:纤维扫描识别≥S1脂肪变性分期的受者工作特征下面积为0.90(灵敏度:89%;特异性:92%),≥S2为0.82(敏感性:89%,特异性:70%),S3为0.79(敏感性:83%;特异性:63%)。≥F1时,FibroScan识别纤维化分期的受者操作特征下面积为0.86(灵敏度:81%,特异性:77%),≥F2时,该面积为0.80(灵敏度:75%;特异性:82%),≥F3为0.94(敏感性:87%;特异性:89%),F4为0.97(敏感性:94%;特异性:91%)。结论:FibroScan是一种很有前景且成本低廉的技术,可以提供一种准确的无创方法来量化和分期NAFLD的肝脂肪变性和纤维化,特别是晚期纤维化和肝硬化。需要进一步的研究来探讨脂肪变性和纤维化之间的关系。此外,NASH是NAFLD的关键阶段。早期诊断和干预有助于减少肝硬化的发生。然而,尚未有大型研究调查纤维扫描在病理证实的NASH诊断中的意义。
期刊介绍:
Arab Journal of Gastroenterology (AJG) publishes different studies related to the digestive system. It aims to be the foremost scientific peer reviewed journal encompassing diverse studies related to the digestive system and its disorders, and serving the Pan-Arab and wider community working on gastrointestinal disorders.