Diagnostic accuracy of hepatic ifbrosis stage by Real-Time Tissue Elastography with viral hepatitis：a meta-analysis

LIU Gang; LI Mengtian; FENG Jinchun; ZHANG Shijie; WU Xiangwei; SUN Hong; PENG Xinyu

doi:10.13919/j.issn.2095-6274.2016.06.003

Abstract：Objective To evaluate the overall accuracy of real-time tissue elastography (RTE) for the staging of liver fibrosis with viral hepatitis by meta-analysis.Methods Systematic retrieval of domestic and foreign literature database for both original Chinese and English-language articles about RTE for the staging of liver fibrosis with viral hepatitis. The quality of studies included in this study were assessed using the Quality Assessment of Studies of Diagnostic Accuracy included in Systematic Review (QUADAS-2).For each cut-off stage of fibrosis, i.e., F≥1, F≥2, F≥3, and F≥4 (METAVIR), a bivariate random effects model were used to obtain overall sensitivity and specificity, summary receiver operating characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated, the risk of publication bias was judged by funnel plots.Results 1152 articles related were searched,of which 17 studies used in the meta-analysis. A total of 2238 participants were included, the median age was 44.60 and 55.60% of the subjects were men. The chi-square tests of heterogeneity for sensitivity were all significant (χ2=24.38,P=0.0589 for F≥2;χ2=69.53,P<0.001 for F≥3;χ2=35.59,P=0.0003 for F≥4. ), as were the tests for heterogeneity of specificity (χ2=47.76,P<0.001 for F≥2;χ2=83.42,P<0.001 for F≥3;χ2=42.11,P=0.0001 for F≥4). The significant heterogeneity in both sensitivity and specificity warrants the use of a random-effects model. Summary of sensitivity and specificity were 0.79 and 0.76 for F≥2, 0.72 and 0.73 for F≥3, and 0.76 and 0.82 for F≥4, respectively. And the area under curve (AUC) of summary receiver operating characteristic (SROC) curve of F≥2 is 0.866,F≥3,0.859;F≥4,0.864,respectively.Conclusions RTE has certain value for the diagnosis of liver fibrosis grading in chronic hepatitis, but cannot replace liver biopsy technique.