Abstract :
Introduction: Chronic liver disease is a disease of the liver that lasts over a period of six months or more, involving a process of progressive destruction and regeneration of the liver parenchyma leading to fibrosis and cirrhosis.In this study, we have compared three main tools to assess liver fibrosis including fibroscan, liver biopsy and non-invasive biomarkers.
Materials and Methods: Inthis prospective study, a total of 30 cases of chronicliver disease were included. Fibrosis stage was assessed using fibroscan. In liver biopsy, Grading of fibrosis was done by modified activity grading system and staging was done using Ishak staging system. Serum markers were analysed using various scoring systems including AST/ALT ratio (AAR), AST/platelet ratio index (APRI), FIB-4 index and Forn Index. The obtained results were analyzed and evaluated using chi square test and area under receiver operator characteristic curve (AUROC) using SPSS version 20.
Results: A significant association was found between fibroscan and Ishak fibrosis stage (p 0.049), fibroscan and APRI (p 0.02) and FIB-4 and liver biopsy (p 0.03). AAR and Forn index did not have any significant association with either fibroscan (p 0.969 and 0.889) or liver biopsy (p 2.56 and 0.98).
Conclusion: The accuracy of fibroscan in evaluating fibrosis is comparable to that of liver biopsy. Thus, liver biopsy can be replaced with fibroscan in the future. Though, the non-invasive biomarkers are useful in assessing fibrosis, a combination of these markers may perform better than each alone.
Keyword :
Chronic liver disease, Liver biopsy, Fibroscan, Non invasive biomarkers.