Effects of liver inflammation on FibroScan diagnosis of hepatic fibrosis in patients with chronic hepatitis B

Objective To investigate the influence of liver inflammation on the ability of the FibroScan non-invasive elastrography scanner to diagnose hepatic fibrosis in patients with chronic hepatitis B(CHB).Methods A total of 124 CHB patients who received liver biopsy and concomitant liver stiffness measurement(LSM) by FibroScan between June 2011 and February 2012 were enrolled in the study.The liver puncture biopsies were subjected to histological analysis to determine fibrosis stage(S1 to S4,mild fibrosis to severe fibrosis or cirrhosis) and inflammation grade(G1 to G4,low to high extent of inflammation).Differences between groups were assessed by Kruskal-Wallis H test or Mann-Whitney U test.The correlations between LSM and fibrosis stages and inflammation grades were evaluated by Spearman's rank correlation coefficient.Results The progressive fibrosis stages were accompanied by increased inflammatory grades,such that the significant majority of S1 samples showed G1 inflammation(81.8%,n=55;P0.01),of S2 showed G2 inflammation(54.2%,n=13;P0.01),of S3 showed G3 inflammation(47.4%,n=9;P0.05),and of S4 showed G3 and G4 inflammation(40.0%,n=6 and 33.4%,n=5;both P0.01).LSM and inflammation grade were positively correlated within each fibrosis stage group(P0.01),suggesting that the degree of liver inflammation affects the FibroScan measured value.Conclusion Liver inflammation influences LSM by FibroScan and may impact the ability of this technology to diagnose hepatic fibrosis,with more severe inflammatory activity affecting the LSM to a greater extent.