Jiang KP, Li JH, Hu HT, Ren J, Qiu TY, Huang QH, Mao RJ. FibroScan
vs hepatic histopathology for diagnosis of liver fibrosis in chronic hepatitis B patients with liver stagnation and spleen deficiency syndrome or damp and heat accumulation syndrome.
Shijie Huaren Xiaohua Zazhi 2014;
22:2768-2773. [DOI:
10.11569/wcjd.v22.i19.2768]
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Abstract
AIM: To assess the application of FibroScan, a new non-invasive diagnostic technique, in the diagnosis of liver fibrosis in chronic hepatitis B (CHB) patients with liver stagnation and spleen deficiency syndrome or damp and heat accumulation syndrome.
METHODS: According to the clinical diagnosis of CHB and the TCM diagnostic criteria, we selected 180 CHB patients with damp and heat accumulation syndrome and 159 CHB patients with liver stagnation and spleen deficiency syndrome. The liver fibrosis stage was assessed by the liver stiffness measurement (LSM) evaluated by FibroScan, and the pathological diagnosis of liver fibrosis was determined using the METAVIR scoring system.
RESULTS: The total incidence rates of liver fibrosis exceeding F2 diagnosed by pathology in CHB patients with liver stagnation and spleen deficiency syndrome and those with damp and heat accumulation syndrome were 65.56% and 62.89%, with no significant difference (P > 0.05). The incidence rate of F4 liver fibrosis in CHB patients with damp and heat accumulation syndrome was 25.56%, which was significantly higher than that in patients with liver stagnation and spleen deficiency syndrome (16.35%) (χ2 = 4.2748, P < 0.05). The incidence rate of F4 liver fibrosis determined by FibroScan in CHB patients with damp and heat accumulation syndrome was 15%, which was significantly higher than that in patients with liver stagnation and spleen deficiency syndrome (5.67%) (χ2 = 7.7586, P < 0.01). Based on the "gold standard" diagnosis by hepatic histopathology, the total accuracy rates for diagnosis of liver fibrosis from ≥ F2 to F4 by FibroScan in CHB patients with liver stagnation and spleen deficiency syndrome and those with damp and heat accumulation syndrome were 75.42% and 66%, respectively, with no significant difference (P > 0.05). The accracy rate for diagnosis of liver fibrosis ≥ F2 by FibroScan in CHB patients with damp and heat accumulation syndrome was significantly higher than that in patients with liver stagnation and spleen deficiency syndrome (84.85% vs 63.04%, χ2 = 4.5396, P < 0.05), while the accuracy rate for liver fibrosis ≥ F3 or F4 was similar between the two groups (P > 0.05).
CONCLUSION: There is a high incidence rate of liver fibrosis in CHB patients with liver stagnation and spleen deficiency syndrome or damp and heat accumulation syndrome. CHB patients with damp and heat accumulation syndrome are more susceptible to F4 liver fibrosis (cirrhosis). FibroScan can be used for non-invasive diagnosis of liver fibrosis in CHB patients with liver stagnation and spleen deficiency syndrome or damp and heat accumulation syndrome, especially for the initial stage of liver fibrosis in CHB patients with damp and heat accumulation syndrome.
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