2011 Jan;23(1):41–44. Y WU,1 M WELTMAN,1 GD ESLICK2 1Department of Gastroenterology and Hepatology, Nepean Hospital, Sydney, NSW, Australia, 2Discipline of Surgery, The University of Sydney, Sydney Medical School, Sydney, NSW, Australia Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is as wide spectrum of diseases with various degrees of fibrosis,

from simple steatosis to cirrhosis. Currently the gold standard in evaluating for fibrosis is liver biopsy, but this is invasive. Two non-invasive methods, Transient Elastography (TE) and NAFLD fibrosis score have been proposed to separate NAFLD patients with and without Severe Fibrosis (fibrosis stage 3 or greater). The aim VX-770 supplier of this study is to compare the utility of these methods in the same group of patients. Methods: A retrospective cohort study of patients with biopsy-proven NAFLD patients between 2010–13 was conducted at Nepean Hospital. All patients received a measurement of their liver stiffness with TE within 3 months of the biopsy. The cut-off for liver stiffness predicting severe fibrosis was pre-determined to be 8.7 kpa.1 A NAFLD fibrosis scores was calculated for each patient. NAFLD fibrosis score <−1.455 is predicted to exclude severe fibrosis

and a score >0.676 predicts severe fibrosis. KPT-330 order An intermediate score is defined as indeterminate.2 Results: 17 patients (52% male) were included in the study. The mean body mass index was 31. The XL Transient Elastography probe was used in 65%. Out of the 14 patients with Liver stiffness >8.7 ka, 6 patients had histological evidence of severe fibrosis, 8 patients did not. Out of the 3 patients with liver stiffness <8.7 kpa, all patients had a fibrosis stage less than 2 on biopsy. This translates to a sensitivity of 100%, specificity of 28%, Positive Predictive Value (PPV) of 43% and Negative Predictive Value (NPV) of 100% in predicting severe fibrosis. Using the NAFLD fibrosis score, 7 of the 8 patients categorized as low risk for severe fibrosis had congruent histology.

All 2 patients with a NAFLD fibrosis score predicting severe fibrosis had a histological stage 3 or higher. 7 (41%) patients had indeterminate scores. This equates to a sensitivity of 67%, specificity of 100%, PPV of 100% and NPV of 88%. Conclusion: NAFLD fibrosis score appears to be a more accurate test than MCE公司 TE in predicting severe fibrosis in our cohort. One of the drawbacks of NAFLD fibrosis score is that 41% of patients were categorised as indeterminate. Larger, longitudinal study would be valuable to clarify the use of these non-invasive tests. 1. Wong VW, Vergniol J, Wong GL, Foucher J, Chan HL, Le Bail B, Choi PC. Diagnosis of fibrosis and cirrhosis using liver stiffness measurement in nonalcoholic fatty liver disease. Hepatology. 2010 Feb;51(2):454–462 2. Angulo P1, Hui JM, Marchesini G, Bugianesi E, George J, Farrell GC, Enders F, Saksena S. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD.