Liver stiffness measurement in patients with cirrhosis and hepatocellular carcinoma: a case-control study

A wide range in values of liver stiffness measurement (LSM) is observed among cirrhotic patients. These variations reflect the extent of fibrosis and might influence the risk of hepatocellular carcinoma (HCC) occurrence.

We compared LSM in 66 Child-Pugh A patients with HCC and alcoholic (n=23) or HCV-related cirrhosis (n=43) referred for radiofrequency ablation and in 199 Child-Pugh A with alcoholic (n=69) or HCV-related cirrhosis (n=130) without HCC.

Patients with HCC had higher LSM than patients without HCC [35.3 kPa (22.8-52.6) vs. 19.0 kPa (12.4-29.2), P<0.0001]. In multivariate analysis, HCC was associated with higher LSM [odds ratio=1.051 (1.030-1.072) (by 1 kPa increase), P<0.0001] and with age [odds ratio=1.075 (1.043-1.107) (by 1 year increase), P<0.0001]. In patients without HCC, LSM was not correlated with age but with decreased prothrombin activity, serum albumin, platelet count, and increased serum bilirubin level. Alcoholic patients had higher LSM compared with HCV-infected patients [22.1 kPa (14.0-36.5) vs. 15.9 kPa (10.8-21.9), P<0.0001] and LSM in the latter varied according to antiviral treatment response.

In patients with Child-Pugh A cirrhosis, a wide range of LSM is observed according to the cause underlying liver disease and the presence of HCC is associated with higher values in these patients.