Correlation Analysis and Clinical Significance of Various Noninvasive Examinations to Determine the Progression of Chronic Liver Disease

Park, Geun Tae; Jeon, Dae Won; Yoo, Young Jo; Choi, Choon Shik; Jung, Jin Woong; Kim, Jin Bae; Yoon, Byoung Chul; Choi, Ho Sun; Hahm, Joon Soo; Park, Kyoung Nam; Lee, Min Ho; Lee, Jae Won

Abstract

BACKGROUND/AIMS: We aimed to figure out a correlation of non-invasive tests for the diagnosis ochronic active hepatitis (CAH) or liver cirrhosis (LC).
METHODS
We measured the levels of serum albumin, bilirubin, alanine aminotransferase (ALT), asparate aminotransferase (AST), cholesterol prothrombin time, ICG-Rmax and shunt index (heart/liver ratio) in 174 patients with CAH and 80 patients with LC (Child A, 73 patients; Child B, 7 patients). A correlation of these values to evaluat the progression to liver cirrhosis was figured out from the multiple regression analysis.
RESULTS
There were significant differences between CAH patients and LC patients in the ratio of ALT to AST (ALT/AST, 1.45 +/-0.05 vs 0.99 +/-0.05), prothrombin time (93.9 +/-1.2% vs 77.1 +/-2.4%), ICG-Rmax (2.11 +/-0.15 vs 1.07 +/-0.12) and shunt index (0.21 +/-0.00 vs 0.60 +/-0.03). The multiple regression analysis of non-invasive tests yielded a formula, Y=3.3431 ?0.8160 x ALT/AST ?0.0343 x prothrom-bin time +2.6963 x shunt index & p=ey/(ey+1), which can estimate the progression of chronic liver disease. The p value was less than 0.7 in 126 (96.2%) of 131 CAH patients, while 47 (68.1%) o69 LC patients showed p value over 0.7.
CONCLUSIONS
When the p value mentioned above exceed 0.7, CAH is likely to develop into an early LC. These results suggest that the formula inferred from the multiple regression analysis of non-invasive tests may be used to evaluate the progression of chronic liver disease without the repeat of liver biopsy.