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liver stiffness in hepatocellular carcinoma and chronic hepatitis patients:Hepatitis B virus infection and transaminases should be considered

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World Journal of Hepatology 2024年第7期16卷 1018-1028页

作者： Jia-Yao Huang Jian-Yun Peng Hai-Yi Long Xian Zhong Yu-Hua Xie Lu Yao Xiao-Yan Xie Man-Xia Lin Department of Medical Ultrasonics The First Affiliated HospitalSun Yat-sen UniversityGuangzhou 510080Guangdong ProvinceChina

BACKGROUND liver condition is a crucial prognostic factor for patients with hepatocellular carcinoma(HCC),but a convenient and comprehensive method to assess liver condition is *** stiffness(LS)measured by two-dimensional shear wave elastography may help in assessing liver fibrosis and liver *** hepatitis B(CHB)is an important risk factor for HCC progression,but LS was found to be less reliable in assessing liver fibrosis following hepatitis viral *** hypothesize that the status of hepatitis virus infection would affect the accuracy of LS in assessing the liver *** To test the feasibility and impact factors of using LS to assess liver condition in patients with HCC and *** A total of 284 patients were retrospectively recruited and classified into two groups on the basis of serum CHB virus hepatitis B virus(HBV)-DNA levels[HBV-DNA≥100.00 IU/mL as Pos group(n=200)andliver *** A significant correlation was found between LS and most of the parameters considered to have the ability to evaluate liver condition(Pliver condition indices(P40 U/L),the correlations between LS and liver condition indices were not significant(P>0.05).CONCLUSION LS was significantly correlated with most liver condition indices in patients with CHB and ***,these correlations varied according to differences in HBV-DNA and transaminase concentrations.

关键词： liver function liver stiffness Elastography Chronic hepatitis B Hepatocellular carcinoma

liver stiffness in pregnant women with intrahepatic cholestasis of pregnancy:A case control study

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World Journal of Hepatology 2023年第7期15卷 904-913页

作者： Juliane Nees Franziska J Ammon Johannes Mueller Herbert Fluhr Sebastian Mueller Department of Gynecology and Obstetrics University Hospital HeidelbergHeidelberg 69120Germany Center for Alcohol Research University Hospital HeidelbergHeidelberg 69120Germany Division of Obstetrics Department of Obstetrics and GynecologyMedical University of GrazGraz 8036Austria

BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a rare but severe complication for both the mother and the unborn *** diagnosis is primarily based on elevated serum levels of bile *** a large ICP cohort,we here study in detail liver stiffness(LS)using transient elastography(TE),now widely used to noninvasively screen for liver cirrhosis within *** To specifically explore LS in a large cohort of women with ICP compared to a control group with uncomplicated *** LS and hepatic steatosis marker controlled attenuation parameter(CAP)were measured in 100 pregnant women with ICP using TE(Fibroscan,Echosens,Paris,France)between 2010 and *** 17 cases,LS could be measured postpartum.450 women before and 38 women after delivery with uncomplicated pregnancy served as control *** laboratory,levels of bile acids and apoptosis marker caspase-cleaved cytokeratin 18 fragment(M30)were also *** Women with ICP had significantly elevated transaminases but normal gammaglutamyl transferase(GGT).Mean LS was significantly increased at 7.3±3.0 kPa compared to the control group at 6.2±2.3 kPa(Plivery in the ICP *** acids were mostly correlated with the liver apoptosis marker M30,LS and levels of alanine aminotransferase,aspartate aminotransferase,and *** multivariate analysis,LS remained the sole parameter that was independently associated with elevated bile *** In conclusion,LS is significantly elevated in ICP which is most likely due to toxic bile acid accumulation and hepatocyte *** association with conventional laboratory markers,LS provides additional non-invasive informati

关键词： Intrahepatic cholestasis of pregnancy Transient elastography Bile acids liver stiffness High risk pregnancy

Non-invasive evaluation of liver stiffness after splenectomy in rabbits with CCl_4-induced liver fibrosis

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World Journal of Gastroenterology 2016年第46期22卷 10166-10179页

作者： Ming-Jun Wang Wen-Wu Ling Hong Wang Ling-Wei Meng He Cai Bing Peng Department of Pancreatic Surgery West China Hospital Sichuan University Department of Ultrasound West China Hospital

AIM To investigate the diagnostic performance of liver stiffness measurement(LSM) by elastography point quantification(Elast PQ) in animal models and determine the longitudinal changes in liver stiffness by Elast PQ after splenectomy at different stages of *** liver stiffness was measured in sixty-eight rabbits with CCl4-induced liver fibrosis at different stages and eight healthy control rabbits by Elast PQ. liver biopsies and blood samples were obtained at scheduled time points to assess liver function and degree of fibrosis. Thirty-one rabbits with complete data that underwent splenectomy at different stages of liver fibrosis were then included for dynamic monitoring of changes in liver stiffness by Elast PQ and liver function according to blood *** LSM by Elast PQ was significantly correlated with histologic fibrosis stage(r = 0.85, P liver stiffness by Elast PQ showed that early splenectomy(especially F1) may delay liver fibrosis *** Elast PQ is an available, convenient, objective and non-invasive technique for assessing liver stiffness in rabbits with CCl4-induced liver fibrosis. In addition, liver stiffness measurements using Elast PQ can dynamically monitor the changes in liver stiffness in rabbit models, and in patients, after splenectomy.

关键词： Fibrosis stages Splenectomy Elastography point quantification liver stiffness Non-invasive technique

Longitudinal assessment of liver stiffness by transient elastography for chronic hepatitis C patients

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World Journal of Clinical Cases 2022年第17期10卷 5566-5576页

作者： Anya Mezina Arunkumar Krishnan Tinsay A Woreta Kevin B Rubenstein Eric Watson Po-Hung Chen Carla Rodriguez-Watson Department of Medicine Johns Hopkins School of MedicineBaltimoreMD 21287United States Division of Gastroenterology and Hepatology Johns Hopkins School of MedicineBaltimoreMD 21231United States Mid-Atlantic Permanente Research Institute Kaiser Permanente Mid-Atlantic StatesRockville 20852United States Department of Health Policy and Management Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreMD 21287United States Innovation in Medical Evidence Development and Surveillance(IMEDS)Program Reagan-Udall Foundation for the FDAWashington20036United States

BACKGROUND liver fibrosis is a common pathway of liver injury and is a feature of most chronic liver *** progression varies markedly in patients with hepatitis C virus(HCV).liver stiffness has been recommended as a parameter of fibrosis progression/regression in patients with *** To investigate changes in liver stiffness measured by transient elastography(TE)in a large,racially diverse cohort of United States patients with chronic hepatitis C(CHC).METHODS We evaluated the differences in liver stiffness between patients treated with direct-acting antiviral(DAA)therapy and untreated *** had≥2 TE measurements and no prior DAA *** used linear regression to measure the change in liver stiffness between first and last TE in response to treatment,controlling for age,sex,race,diabetes,smoking status,human immunodeficiency virus status,baseline alanine aminotransferase,and baseline liver *** regression models analyzed the change in liver stiffness as measured by kPa,stratified by cirrhosis *** Of 813 patients,419(52%)initiated DAA *** liver stiffness was 12 kPa in 127(16%).Median time between first and last TE was 11.7 and 12.7 mo among treated and untreated patients,*** was no significant change in liver stiffness observed over time in either the group initiating DAA treatment(0.016 kPa/month;CI:-0.051,0.084)or in the untreated group(0.001 kPa/mo;CI:-0.090,0.092),controlling for covariates.A higher baseline kPa score was independently associated with decreased liver *** DAA treatment was not associated with a differential change in liver stiffness over time in patients with CHC compared to untreated patients.

关键词： Chronic hepatitis C liver stiffness Cirrhosis Transient elastography Direct-acting antiviral therapy

Can liver stiffness measurement accurately predict disease progression and clinical outcome in patients with metabolic dysfunction-associated steatotic liver disease and bridging fibrosis or cirrhosis?

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 912-915页

作者： Diederick J.van Doorn Adriaan G.Holleboom R.Bart Takkenberg Joanne Verheij Marten A.Lantinga Department of Gastroenterology and Hepatology Amsterdam UMCUniversity of AmsterdamAmsterdam Gastroenterology Endocrinology MetabolismAmsterdamThe Netherlands Department of Vascular Medicine Internal MedicineAmsterdam UMCUniversity of AmsterdamAmsterdam Gastroenterology Endocrinology MetabolismAmsterdamThe Netherlands Department of Hepatopancreatobiliary Pathology Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands

Diederick *** Doorn1,Adriaan ***2,*** Takkenberg1,Joanne Verheij3,Marten ***11Department of Gastroenterology and Hepatology,Amsterdam UMC,University of Amsterdam,Amsterdam Gastroenterology Endocrinology Metabolism,Amsterdam,The Netherlands;2Department of Vascular Medicine,Internal Medicine,Amsterdam UMC,University of Amsterdam,Amsterdam Gastroenterology Endocrinology Metabolism,Amsterdam,The Netherlands;3Department of Hepatopanc Metabolic dysfunction-associated steatotic liver disease(MASLD)-until recently termed non-alcoholic fatty liver disease(NAFLD)-is a rising cause of chronic liver disease with an estimated global prevalence of 30%(1).

关键词： Cirrhosis liver stiffness steatotic liver disease

Noninvasive assessment of portal hypertension in cirrhosis:liver stiffness and beyond

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World Journal of Gastroenterology 2014年第45期20卷 16811-16819页

作者： Horia Stefanescu Bogdan Procopet Department of Medical and Surgical Sciences University of Bologna Regional Institute of Gastroenterology and Hepatology liver Hemodynamic Unit Hospital Clinic 3rd Medical Clinic Iuliu Hatieganu University of Medicine and Pharmacy

liver stiffness measurement(LSM)is a good,but still limited tool to noninvasively assess complications and prognosis in patients with advanced liver *** review aims to consider the role of LSM for the diagnosis of portal hypertension-related complications and for assessment of prognosis in cirrhotic patients,and to highlight the drawbacks as well as some alternatives for improving the ***,this field is far from being closed,and deserves more *** is still a place for more carefully designed studies to find new,innovative and reliable approaches.

关键词： liver stiffness Portal hypertension Complication Spleen stiffness Prediction

Primary liver injury and delayed resolution of liver stiffness after alcohol detoxification in heavy drinkers with the PNPLA3 variant I148M

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World Journal of Hepatology 2016年第35期8卷 1547-1556页

作者： Vanessa Rausch Teresa Peccerella Carolin Lackner Eray Yagmur Helmut-Karl Seitz Thomas Longerich Sebastian Mueller Salem Medical Center and Center for Alcohol Research University of Heidelberg Institute for Pathology Medical University Graz Laboratory Diagnostics Center RWTH-University Hospital Aachen Aachen and Medical Care Center Institute of Pathology RWTH-University Hospital Aachen

AIMTo investigate the influence of PNPLA3 genotype in heavy drinkers on serum markers and liver stiffness (LS) during alcohol withdrawal and its association with histology. METHODSCaucasian heavy drinkers (n = 521) with a mean alcohol consumption of 192.1 g/d (median alcohol consumption: 169.0 g/d; 95%CI: 179.0-203.3) were enrolled at the Salem Medical Center, University of Heidelberg. LS was measured by transient elastography (Fibroscan, Echosens SA, Paris, France). LS and serum markers were prospectively studied in these patients with all stages of alcoholic liver disease (steatosis, steatohepatitis, fibrosis) prior and after alcohol detoxification with a mean observation interval of 6.2 ± 3.2 d. A liver biopsy with histological analysis including the Kleiner score was obtained in 80 patients. RESULTSThe PNPLA3 rs738409 genotype distribution for CC, CG and GG was 39.2%, 52.6% and 8.2%. GG genotype primarily correlated with histological steatohepatitis (r = 0.404, P r = 0.319, P r = 0.264, P r = 0.828, P r = 0.516, P r = 0.319, P vs 6%) with 3.8% more CC carriers while 3.7% less were seen in the F4 cirrhosis group. Thus, about 20% of patients with alcoholic liver cirrhosis would be attributable to PNPLA3 G variants. The OR to develop cirrhosis corrected for age, gender and body mass index was 1.295 (95%CI: 0.787-2.131) for CG + GG carriers. CONCLUSIONIn heavy drinkers, PNPLA3 GG primarily correlates with ballooning/steatohepatitis but not steatosis resulting in a delayed inflammation-associated resolution of LS. Consequently, sustained ballooning-associated LS elevation seems to be a potential risk factor for fibrosis progression in PNPLA3 GG carriers.

关键词： liver stiffness Alcoholic liver disease Adiponutrin PNPLA3 Transient elastography Alcohol withdrawal Inflammation

Elevation of serum urokinase plasminogen activator receptor and liver stiffness in postoperative biliary atresia

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World Journal of Hepatology 2016年第33期8卷 1471-1477页

作者： Wanvisa Udomsinprasert Sittisak Honsawek Napaphat Jirathanathornnukul Voranush Chongsrisawat Yong Poovorawan Department of Biochemistry Faculty of MedicineChulalongkorn UniversityKing Chulalongkorn Memorial HospitalThai Red Cross Society Center of Excellence in Clinical Virology Department of PediatricsFaculty of MedicineChulalongkorn UniversityKing Chulalongkorn Memorial HospitalThai Red Cross Society

AIMTo investigate serum urokinase-type plasminogen activator receptor (uPAR) and liver stiffness in biliary atresia (BA) and examine the correlation of circulating uPAR, liver stiffness, and clinical outcomes in postoperative BA children. METHODSEighty-five postKasai BA children and 24 control subjects were registered. Circulating uPAR was measured using enzyme-linked immunosorbent essay. liver stiffness was analyzed using transient elastography. RESULTSBA children had significantly greater circulating uPAR and liver stiffness scores than control subjects (P P r = 0.507, P r = 0.364, P r = 0.559, P r = 0.325, P r = 0.508, P CONCLUSIONCirculating uPAR and liver stiffness values were greater in BA children than healthy controls. The increased circulating uPAR was associated with liver dysfunction in BA. As a consequence, serum uPAR and liver stiffness may be used as noninvasive biomarkers indicating the progression of liver fibrosis in postKasai BA.

关键词： Biliary atresia Jaundice liver stiffness Severity Urokinase plasminogen activator receptor

Transient micro-elastography:A novel non-invasive approach to measure liver stiffness in mice

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World Journal of Gastroenterology 2011年第8期17卷 968-975页

作者： Cécile Bastard Matteo R Bosisio Michèle Chabert Athina D Kalopissis Meriem Mahrouf-Yorgov Hélène Gilgenkrantz Sebastian Mueller Laurent Sandrin Laurent Sandrin Echo-sens Research and Development Department INSERM U930 CNRS ERL3106 Univ Franois Rabelais UPMC Univ Paris 06 UMR 7623 LIP CNRS UMR 7623 Laboratoire d'Imagerie Paramétrique INSERM U872 Centre de Recherche des Cordeliers Equipe 4 UPMC Univ Paris 06 UMR S 872 Equipe 4 Univ Paris Descartes UMR S 872 Equipe 4 EPHE Laboratoire de Pharmacologie Cellulaire Et Moléculaire INSERM U1016 Institut Cochin CNRS UMR8104 Univ Paris Descartes Department of Medicine and Center for Alcohol Research Liver Disease and Nutrition Salem Medical Center University of Heidelberg

AIM:To develop and validate a transient micro-elastography device to measure liver stiffness(LS) in ***:A novel transient micro-elastography(TME) device,dedicated to LS measurements in mice with a range of measurement from 1-170 kPa,was developed using an optimized vibration frequency of 300 Hz and a 2 mm *** novel probe was validated in a classical fibrosis model(CCl4) and in a transgenic murine model of systemic ***:TME could be successfully performed in control mice below the xiphoid cartilage,with a mean LS of 4.4 ± 1.3 kPa,a mean success rate of 88%,and an excellent intra-observer agreement(0.98).Treatment with CCl4 over seven weeks drastically increased LS as compared to controls(18.2 ± 3.7 kPa vs 3.6 ± 1.2 kPa).Moreover,fibrosis stage was highly correlated with LS(Spearman coefficient = 0.88,P 150 *** significantly correlated with the amyloidosis index(0.93,P < 0.0001) and the plasma concentration of mutant hapoA-□(0.62,P < 0.005).CONCLUSION:Here,we have established the first non-invasive approach to measure LS in mice,and have successfully validated it in two murine models of high LS.

关键词： Transient elastography Micro-elastography liver stiffness liver Mice Amyloidosis Fibrosis Ultrasound