Performance Of Transient Elastography For The Staging Of Liver Fibrosis In Patients With Chronic Liver Disease-A Meta-Analysis

Background and PurposeChronic liver disease is one of the most common diseases that threat to human’s health in the world.Liver fibrosis is closely related to the diagnosis and treatment of chronic liver diseases.It is quiet important to diagnosis liver fibrosis early and stage properly.Transient elastography technology is widely used in clinical practice now.The purpose of the current study is to compare the accuracy of the clinical "gold standard"-liver biopsy and transient elastography to assess the diagnostic value of transient elastography for liver fibrosis in chronic liver disease.Material and MethodIn this study,meta analysis is used to pool the studies of transient elastography technique for staging of liver fibrosis in patients with chronic liver disease.By extracting the receiver operating characteristic curve(AUROC)and 95%confidence intervals,sensitivity,specificity,positive predictive value,negative predictive value and other indicators of the original estimated fourfold table from significant liver fibrosis(≥F2),the area of advanced fibrosis(≥F3)and cirrhosis(F4)of each study,the study uses bivariate mixed effects model to combine,calculate and analysis.ResultsThe study included 20 articles with a total of 5748 patients.The combined sensitivity,specificity,positive likelihood ratio,negative likelihood ratios,diagnostic odds ratio,area under the receiver operating characteristic curve(AUROC)of significant fibrosis(≥F2)were 0.781(0.735,0.821),0.848(0.802,0.884),5.133(3.861,6.826),0.258(0.208,0.319),19.896(12.750,31.046)and 0.88(0.85,0.91).The combined sensitivity,specificity,positive likelihood ratio,negative likelihood ratios,diagnostic odds ratio,area under the receiver operating characteristic curve(AUROC)of advanced fibrosis(≥F3)were 0.888(0.861,0.911),0.881(0.848,0.907),7.449(5.739,9.670),0.127(0.100,0.162),58.644(36.850,93.327)and 0.94(0.92,0.96)The combined sensitivity,specificity,positive likelihood ratio,negative likelihood ratios,diagnostic odds ratio,area under the receiver operating characteristic curve(AUROC)of cirrhosis(F4)were 0.913(0.858,0.948),0.893(0.866,0.915),8.555(6.840,10.700),0.097(0.059,0.160),88.033(50.220,154.318)and 0.95(0.93,0.97)ConclusionTransient elastography technique has a good diagnostic value in assessing significant fibrosis,advanced fibrosis and cirrhosis in patients with chronic liver disease However,the clinical applicability of transient elastography technique for diagnosis of liver fibrosis need to be studied further.