Systematic review and meta-analysis: Transient elastography compared to liver biopsy for staging of liver fibrosis in primary biliary cholangitis
Introduction and Objectives: Primary biliary cholangitis (PBC) is an autoimmune liver disease, with 60% of patients being asymptomatic at diagnosis and 30% progressing rapidly into liver fibrosis. Liver biopsy is standard for staging fibrosis, but performance of non-invasive methods such as transien...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-07-01
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| Series: | Annals of Hepatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268123002119 |
| _version_ | 1797794045321281536 |
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| author | Luis Antonio Manzo-Francisco Jorge Aquino-Matus Dèsirée Vidaña-Pérez Misael Uribe Norberto Chavez-Tapia |
| author_facet | Luis Antonio Manzo-Francisco Jorge Aquino-Matus Dèsirée Vidaña-Pérez Misael Uribe Norberto Chavez-Tapia |
| author_sort | Luis Antonio Manzo-Francisco |
| collection | DOAJ |
| description | Introduction and Objectives: Primary biliary cholangitis (PBC) is an autoimmune liver disease, with 60% of patients being asymptomatic at diagnosis and 30% progressing rapidly into liver fibrosis. Liver biopsy is standard for staging fibrosis, but performance of non-invasive methods such as transient elastography (TE) have not been evaluated. We conducted a meta-analysis of articles up to May 2022 to evaluate the performance of TE compared with liver biopsy in adult patients with PBC. Materials and Methods: Two reviewers performed the search and assessed which articles were included. The quality of each study was evaluated according to QUADAS-2 and NOS. Meta-analysis of sensitivity and specificity was conducted with a bivariate random-effects model. The protocol was registered in PROSPERO, ID CRD42020199915. Results: Four studies involving 377 patients were included. Only stages F3 and F4 were computed in the meta-analysis. TE had a pooled sensitivity of 68% and specificity of 92% for stage F3 and a pooled sensitivity of 90% and specificity of 94% for stage F4. The AUROC curves were 0.91 (95% Confidence Interval (CI) 0.88–0.93) and 0.97 (95% CI 0.96–0.98) for stages F3 and F4, respectively. The mean cut-off points of TE for stage F3 were 9.28 kPa (95% CI 4.98–13.57) and for stage F4 were 15.2 kPa (95% CI 7.02–23.37). Conclusions: TE performance compared with liver biopsy in adult patients with PBC was excellent for staging liver fibrosis and was able to rule out cirrhosis in clinical practice. |
| first_indexed | 2024-03-13T02:57:07Z |
| format | Article |
| id | doaj.art-fb893ea9fbbd4f1b96f01b0d97db9337 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-03-13T02:57:07Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-fb893ea9fbbd4f1b96f01b0d97db93372023-06-28T04:29:14ZengElsevierAnnals of Hepatology1665-26812023-07-01284101107Systematic review and meta-analysis: Transient elastography compared to liver biopsy for staging of liver fibrosis in primary biliary cholangitisLuis Antonio Manzo-Francisco0Jorge Aquino-Matus1Dèsirée Vidaña-Pérez2Misael Uribe3Norberto Chavez-Tapia4Obesity and Digestive Diseases Unit, Medica Sur Hospital, Mexico City, Mexico.Obesity and Digestive Diseases Unit, Medica Sur Hospital, Mexico City, Mexico.Center for Research Evaluation and Surveys, National Institute of Public Health, Mexico City, Mexico.Obesity and Digestive Diseases Unit, Medica Sur Hospital, Mexico City, Mexico.Obesity and Digestive Diseases Unit, Medica Sur Hospital, Mexico City, Mexico.; Corresponding author.Introduction and Objectives: Primary biliary cholangitis (PBC) is an autoimmune liver disease, with 60% of patients being asymptomatic at diagnosis and 30% progressing rapidly into liver fibrosis. Liver biopsy is standard for staging fibrosis, but performance of non-invasive methods such as transient elastography (TE) have not been evaluated. We conducted a meta-analysis of articles up to May 2022 to evaluate the performance of TE compared with liver biopsy in adult patients with PBC. Materials and Methods: Two reviewers performed the search and assessed which articles were included. The quality of each study was evaluated according to QUADAS-2 and NOS. Meta-analysis of sensitivity and specificity was conducted with a bivariate random-effects model. The protocol was registered in PROSPERO, ID CRD42020199915. Results: Four studies involving 377 patients were included. Only stages F3 and F4 were computed in the meta-analysis. TE had a pooled sensitivity of 68% and specificity of 92% for stage F3 and a pooled sensitivity of 90% and specificity of 94% for stage F4. The AUROC curves were 0.91 (95% Confidence Interval (CI) 0.88–0.93) and 0.97 (95% CI 0.96–0.98) for stages F3 and F4, respectively. The mean cut-off points of TE for stage F3 were 9.28 kPa (95% CI 4.98–13.57) and for stage F4 were 15.2 kPa (95% CI 7.02–23.37). Conclusions: TE performance compared with liver biopsy in adult patients with PBC was excellent for staging liver fibrosis and was able to rule out cirrhosis in clinical practice.http://www.sciencedirect.com/science/article/pii/S1665268123002119Liver cirrhosisFibrosis, elasticity imaging techniquesLiver biopsyPrimary biliary cholangitis |
| spellingShingle | Luis Antonio Manzo-Francisco Jorge Aquino-Matus Dèsirée Vidaña-Pérez Misael Uribe Norberto Chavez-Tapia Systematic review and meta-analysis: Transient elastography compared to liver biopsy for staging of liver fibrosis in primary biliary cholangitis Annals of Hepatology Liver cirrhosis Fibrosis, elasticity imaging techniques Liver biopsy Primary biliary cholangitis |
| title | Systematic review and meta-analysis: Transient elastography compared to liver biopsy for staging of liver fibrosis in primary biliary cholangitis |
| title_full | Systematic review and meta-analysis: Transient elastography compared to liver biopsy for staging of liver fibrosis in primary biliary cholangitis |
| title_fullStr | Systematic review and meta-analysis: Transient elastography compared to liver biopsy for staging of liver fibrosis in primary biliary cholangitis |
| title_full_unstemmed | Systematic review and meta-analysis: Transient elastography compared to liver biopsy for staging of liver fibrosis in primary biliary cholangitis |
| title_short | Systematic review and meta-analysis: Transient elastography compared to liver biopsy for staging of liver fibrosis in primary biliary cholangitis |
| title_sort | systematic review and meta analysis transient elastography compared to liver biopsy for staging of liver fibrosis in primary biliary cholangitis |
| topic | Liver cirrhosis Fibrosis, elasticity imaging techniques Liver biopsy Primary biliary cholangitis |
| url | http://www.sciencedirect.com/science/article/pii/S1665268123002119 |
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