Is laparoscopy an advantage in the diagnosis of cirrhosis in chronic hepatitis C virus infection?

Table 1 Outcome of macroscopic laparoscopic exploration and histological analysis in 72 patients with chronic HCV infection

Histology (fibrosis stage score)	Laparoscopy
	Patients without signs of cirrhosis (n = 51)	Patients with signs of cirrhosis (n = 21)
Fibrosis I	30	3
Fibrosis II	16	4
Fibrosis III	5	6
Cirrhosis	0	8

Absent portal fibrosis was judged as fibrosis score I (HAI^b = 0, no fibrosis), mild to moderate fibrosis as stage II (HAI^b = 1, fibros portal expansion), marked fibrosis as stage III (HAI^b = 3, bridg-ing fibrosis), and complete fibrosis as cirrhosis (HAI^b = 4).

Table 2 Demographic and clinical data of patients with and without laparoscopically diagnosed cirrhosis

	Laparoscopy		P
	Patients with signs of Cirrhosis (n = 21)	Patients without signs of Cirrhosis (n = 51)
Age (years)	56.36 ± 9.42	41.7 ± 11.2	< 0.02a
Duration of disease	23.2 ± 8.3	10.4 ± 5.68	< 0.02a
(years) (n = 44)
Sex ratio (m/f)	10/11	27/24	ns

^aStudent’s t-test (unpaired); ns = not significant, years were showed as mean ± standard deviation. Duration of disease could be evaluated in 44 cases by patients’ history.

Table 3 Laboratory data of patients with and without laparoscopic macroscopic evidence of cirrhosis

Laboratory data	Laparoscopy		P
	Patients with evidence of cirrhosis (n = 21)	Patients without evidence of cirrhosis (n = 51)
AST (U/l)	59.7 ± 54.2	29.3 ± 19.6	< 0.02
ALT (U/l)	82.5 ± 70.3	72.6 ± 47.2	ns
γ-GT (U/l)	72.6 ± 78.4	34.1 ± 38.2	< 0.02
AP (U/l)	129.8 ± 48.9	137.5 ± 49.6	ns
Bilirubin (mg/dl)	1.1 ± 0.93	1.86 ± 6.23	ns
CHE (U/l)	5114 ± 1331	5910 ± 1001	ns
Prothrombin index (%)	93.8 ± 12.6	102.2 ± 6.3	< 0.02
γ-globuline fraction (%)	19.9 ± 6.5	13.7 ± 2.9	< 0.02
Platelet count (cell/µl)	172940 ± 65068	253230 ± 57096	< 0.02

All data were showed as mean ± standard deviation. Statisti-cal analysis was performed by applying Mann-Whitney test. ns = not significant.

Table 4 Comparing laboratory data of patients with macro-scopic laparoscopic signs of cirrhosis

Laboratory data	Histological analysis		P
	No cirrhosis (n = 13)	Cirrhosis (n = 8)
AST (U/l)	35.9 ± 24.9	87.7 ± 67.8	< 0.02
ALT (U/l)	64.9 ± 72.2	97.0 ± 66.34	ns
γ-GT (U/l)	51.64 ± 39.78	103.0 ± 104.6	< 0.02
AP (U/l)	126.3 ± 54.6	144.6 ± 39.6	ns
Bilirubin (mg/dl)	0.36 ± 0.5	1.4 ± 3.438	ns
CHE (U/l)	5129 ± 1861	4685 ± 1773	ns
Prothrombin index (%)	95.8 ± 10.6	90.7 ± 14.3	ns
γ-globuline fraction (%)	16.3 ± 3.2	19.6 ± 10.6	ns
Platelet count (cells/µl)	180700 ± 56240	167000 ± 77110	ns

All data were showed as mean ± standard deviation, statisti-cal analysis were performed by Mann-Whitney test. ns = not significant.

Table 5 Comparisons in pretreatment parameters between patients with sustained response and patients with non-re-sponse to interferon treatment (n = 39)

	Sustained-responders	Non-responders	P
Number (%)	14 (35.9%)	25 (64.1%)
Age (years)	50.6 ± 13.9	47.2 ± 10.6	ns
Genotype 1b (%)	5 (35.7%)	18 (72%)	< 0.02a
Fibrosis staging score (%)
I	7 (50.0%)	9 (36.0%)
II	3 (21.4%)	8 (32.0%)
III	3 (21.4%)	3 (12.0%)
Cirrhosis	1 (7.0%)	5 (20.0%)	ns
Laparoscopic evidence	2 (14.2%)	9 (36.0%)	< 0.02a
of cirrhosis (%)

Data of age were showed as mean ± standard deviation;

^aChi-square test, ns = not significant.