A. Serban

Comparison between attenuation coefficient computed on the ultrasound image and a biological marker, adiponectin, in the diagnosis of steatosis in non-alcoholic fatty liver disease

The study aimed to identify the presence of steatosis and differentiate between insignificant and significant steatosis in non-alcoholic fatty liver disease (NAFLD). Thirty three patients with NAFLD proven by liver biopsy and evaluated in order to stratify the degree of steatosis were studied. The computerized processing of the data of the ultrasonic image (attenuation coefficient - LS7 slope), and a biological marker (adiponectin) were evaluated. Predictive value and AUROC curves were used to assess the accuracy of the results. Adiponectin levels was found to differentiate between controls (13435.4plusmn741.5 ng/ml) and NAFLD (4552.9plusmn2473 ng/ml) but also between insignificant (9348.4plusmn7368 ng/ml) and significant steatosis (4501plusmn2389.6 ng/ml). The AUROC for adiponectin, was 0.899 and for LS7 slope 0.952 with sensitivity, specificity, positive predictive value and negative predictive value of 84.8; 93.3; 96.5; 73.7, respectively 84.8;100;90.3 and 70.6 for the diagnosis of hepatic steatosis. The simultaneous utilization of these methods could substantial improve the identification of steatosis in NAFLD and the assessment of its grade.

Ultrasonographic diagnosis of nonalcoholic steatohepatitis based on the quantitative evaluation of the ultrasound beam behavior into the liver

Ultrasonography is a simple method in diagnosing nonalcoholic steatohepatitis (NASH), providing useful information, but it is subjective and does not accurately differentiate between steatosis grades. The computerized processing of the data that comprises the ultrasonic image might transform ultrasonography into an objective examination. We aim to study the performance of the quantitative evaluation of the ultrasound beam behavior into the liver in diagnosing NASH and in establishing the fatty load grade.

404 PERFORMANCE OF ACOUSTIC RADIATION FORCE IMPULSE IMAGING IN THE NONINVASIVE ASSESSMENT OF LIVER FIBROSIS, IN COMPARISON TO UNIDIMENSIONAL TRANSIENT ELASTOGRAPHY

Conclusions: The common PNPLA3 polymorphism confers an increased risk of liver fibrosis in patients with chronic liver diseases. This observation can be attributed to the additive harmful effects of hepatic fat accumulation and inflammation in response to chronic liver injury. Our findings point to a novel non-invasive genetic screening strategy to identify patients with chronic liver diseases at risk for cirrhosis.

340 PERFORMANCE OF ACOUSTIC RADIATION FORCE IMPULSE IMAGING IN THE NONINVASIVE ASSESSMENT OF LIVER FIBROSIS, IN COMPARISON TO FIB4 SCORE

cellular mechanisms and utilization of high-throughput functional genomics analysis. We investigated the genomic and functional characteristics of liver tissues in chronic hepatitis B (CHB) patients. Methods: Liver biopsies were utilized in 139 CHB patients and pathological Scheuer stages were defined among the specimens. The Affymetrix GeneChipTM Human Genome U133A microarray, used to establish the gene expression signature. Genomic profiles and data analysis were obtained through GeneSpring 10 software. Gene Ontology annotations were used to assess functional characterization. Results: 1. Samples were clustered according to Scheuer’s stage groups (S0–S4: n =48; 23; 37; 17; 14). 2. Cluster analysis led to result supporting the conclusion that the gene expression profiles robustly reflected the Scheuer’s classification. 3. An Welch t-test, in order to find the significant differentially expressed genes between S1–4 groups and S0 group, generated a list of 1,451 genes (P-value = 5×10−6). Group-based comparisons for S4 versus S0, it showed over 2 times up-regulated genes (n =174) and down-regulated genes (n =45). Among up-regulated 174 genes, genes with function in the structural molecular activity were most frequently up-regulated (n =58, 26.7%), and genes involved in signal transduction (n =26, 12.0%) or cell adhesion (n =24, 11.1%) were less commonly upregulated respectively. (4) A detailed analysis of the pathways related to differentially expressed genes was characterized involved in activation of 164 signaling pathways (P ≤ 0.05) and 15 signaling pathways (P ≤ 0.001). Conclusions: Through analysis of gene expression profiles of liver tissues in CHB patients, we have identified a set of genes and signaling pathways defining a molecular portrait of fibrogenesis. The present study described differentially expressed genes throughout all stages of HBV-related fibrosis and nearly 50% genes of twice up-regulated with functions in structural molecular activity, signal transduction, and cell adhesion. Furthermore, many signaling pathways are activated during the transition to cirrhosis, including inflammatory/immune responses, cell proliferation, and apoptosis pathways.