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Fibrosis Staging (fibrosis + staging)
Selected AbstractsTransient elastography: Applications and limitationsHEPATOLOGY RESEARCH, Issue 11 2008Kentaro Yoshioka Transient elastgraphy with use of FibroScan is one of most accurate methods for assessment of liver fibrosis. FibroScan can be readily used with an operator with a short training. In many different studies, liver stiffness measured by transient elastgraphy correlates well with fibrosis stages, and cutoff values of liver stiffness for fibrosis staging are similar even among different diseases. However there is wide variation of stiffness values in the same fibrosis stage, and some overlap between the adjacent stages. In addition, inflammatory activity and size of nodule of cirrhosis affect the liver stiffness values. The reproducibility may be reduced by age, obesity, steatosis, narrow intercostal space and lower degrees of hepatic fibrosis in patients. Thus the estimation of fibrosis stages from liver stiffness should be cautiously done. To improve the accuracy of liver fibrosis staging, the combination of transient elastography with other noninvasive methods such as FibroTest should be required. [source] Conformational anti-cytochrome P4502E1 (CYP2E1) auto-antibodies contribute to necro-inflammatory injury in chronic hepatitis CJOURNAL OF VIRAL HEPATITIS, Issue 10 2010S. Sutti Summary., Circulating auto-antibodies against cytochrome P4502E1 (CYP2E1) have been observed in a significant fraction of patients with chronic hepatitis C (CHC). This study investigated the clinical significance of these auto-antibodies in relation to their antigen specificity. The presence of anti-CYP2E1 IgG was investigated in 137 consecutive patients with biopsy-proven CHC. Anti-CYP2E1 IgG above control threshold levels was detected in 52 (38%) subjects. By combined immunoprecipitation and western blotting, we observed that among anti-CYP2E1 IgG-positive sera, 23 (44%) were unreactive towards denaturated CYP2E1, indicating a prevalent recognition of conformational CYP2E1 antigens. Conformational anti-CYP2E1 auto-antibodies were unrelated to circulating gamma-globulins, alcohol intake or infection by specific HCV genotypes. The presence of anti-CYP2E1 auto-antibodies was associated with an 11-fold (OR 10.9 95%CI 1.4,86.6 P = 0.008) increased prevalence of necro-inflammatory grading ,4 (Ishack's criteria) and 4-fold (OR 4.0; 95%CI 1.3-11-7: P = 0.014) increased prevalence of fibrosis staging ,2, respectively. Multivariate analysis confirmed conformational anti-CYP2E1 IgG (P = 0.005) and age (P = 0.033) as independent predictors of necro-inflammatory grading ,4. The development of anti-CYP2E1 auto-antibodies targeting conformational CYP2E1 epitopes is associated with more severe liver damage in CHC. [source] Noninvasive assessment of liver fibrosis in thalassaemia major patients by transient elastography (TE) , lack of interference by iron depositionBRITISH JOURNAL OF HAEMATOLOGY, Issue 3 2010Vito Di Marco Summary The correlation between liver stiffness, measured by transient elastography, liver fibrosis, using the histological METAVIR score, and iron overload, measured by atomic absorption spectrometry was evaluated in 56 homozygous-,-thalassaemics. Liver stiffness increased proportionally to liver fibrosis staging (r = 0·70; P > 0·001) independently of liver iron concentration (r = 0·01; P = 0·932). The area under the receiver-operating characteristic curve for prediction of cirrhosis was 0·997 (95% confidence interval [CI]: 0·925,1·000) with cut-off of 13 kPa with 100% sensitivity (95% CI: 69·0,100·0) and 95% specificity (95% CI: 84·2,99·3). Transient elastography is a reliable non-invasive tool for diagnosing advanced liver fibrosis in homozygous-,-thalassaemics, regardless of the degree of iron overload. [source] | ||||||||||