Abstract: Objective The aim of this study was to investigate assessment of liver fibrosis by Yang’s modules in combination with serum liver fibrosis markers in patients with chronic hepatitis B (CHB). Methods A total of 116 patients with CHB were encountered in our hospital between March 2022 and March 2025, and all underwent liver biopsies. Serum hyaluronic acid (HA), laminin (LN), N-terminal propeptide of type Ⅲ procollagen (PⅢNP) and type Ⅳ collagen (CⅣ) levels were detected routinely. Yang’s modules was measured by shear wave elastography. Multivariate Logistic regression analysis was used to find impacting factors for liver fibrosis, and receiver operating characteristic (ROC) curve was adopted to evaluate the diagnostic efficacy of liver fibrosis in patients with CHB. Results Of the 116 patients with CHB, liver histopathological examination proved liver fibrosis S0 in 35 cases, S1 in 16 cases [e.g., non-significant liver fibrosis (NSLF) in 51 cases], S2[(significant liver fibrosis(SLF)in 35 cases], S3 [advanced liver fibrosis (AdLF) in 22 cases and S4(liver cirrhosis) in 8 cases; Yang’s modules in patients with liver cirrhosis was (20.6±4.0)kPa,much greater than [(17.2±2.5)kPa,P＜0.05] in patients with AdLF or [(15.6±3.8)kPa,P＜0.05] in those with SLF or [(10.9±2.2)kPa,P＜0.05] in those with NSLF;serum HA, CⅣ and/or PⅢNP levels in patients with SLF or AdLF elevated greatly(P＜0.05);multivariate Logistic regression analysis showed that increases serum liver fibrosis markers and Yang’s modules were impacting factors for SLF in patients with CHB (P＜0.05);ROC analysis demonstrated that the predicting performance for SLF by Yang’s modules in combination with at least two increased serum liver fibrosis markers was satisfactory, with accuracy of 98.8% in patients with CHB. Conclusion Serum liver fibrosis markers could play an auxiliary role to Yang’s modules in predicting liver fibrosis in patients with CHB.

Key words: Hepatitis B, Liver fibrosis, Liver fibrosis markers, Shear wave elastography, Diagnosis