کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6105261 | 1211146 | 2012 | 8 صفحه PDF | دانلود رایگان |
Background & AimsBlood tests and transient elastography (Fibroscanâ¢) have been developed as alternatives to liver biopsy. This ANRS HCEP-23 study compared the diagnostic accuracy of nine blood tests and transient elastography (Fibroscanâ¢) to assess liver fibrosis, vs. liver biopsy, in untreated patients with chronic hepatitis C (CHC).MethodsThis was a multicentre prospective independent study in 19 French University hospitals of consecutive adult patients having simultaneous liver biopsy, biochemical blood tests (performed in a centralized laboratory) and Fibroscanâ¢. Two experienced pathologists independently reviewed the liver biopsies (mean length = 25 ± 8.4 mm). Performance was assessed using ROC curves corrected by Obuchowski's method.ResultsFibroscan⢠was not interpretable in 113 (22%) patients. In the 382 patients having both blood tests and interpretable Fibroscanâ¢, Fibroscan⢠performed similarly to the best blood tests for the diagnosis of significant fibrosis and cirrhosis. Obuchowski's measure showed Fibrometer® (0.86), Fibrotest® (0.84), Hepascore® (0.84), and interpretable Fibroscan⢠(0.84) to be the most accurate tests. The combination of Fibrotest®, Fibrometer®, or Hepascore® with Fibroscan⢠or Apri increases the percentage of well classified patients from 70-73% to 80-83% for significant fibrosis, but for cirrhosis a combination offers no improvement. For the 436 patients having all the blood tests, AUROC's ranged from 0.82 (Fibrometer®) to 0.75 (Hyaluronate) for significant fibrosis, and from 0.89 (Fibrometer® and Hepascore®) to 0.83 (FIB-4) for cirrhosis.ConclusionsContrarily to blood tests, performance of Fibroscan⢠was reduced due to uninterpretable results. Fibrotest®, interpretable Fibroscanâ¢, Fibrometer®, and Hepascore® perform best and similarly for diagnosis of significant fibrosis and cirrhosis.
Journal: Journal of Hepatology - Volume 56, Issue 1, January 2012, Pages 55-62