Accuracy of blood-based biomarkers for staging liver fibrosis in chronic liver disease: A systematic review supporting the AASLD Practice Guideline.

Autor:	Patel K; Department of Medcine, Division of Gastroenterology and Hepatology, University Health Network, University of Toronto, Toronto, Ontario, Canada., Asrani SK; Department of Medicine, Division of Hepatology, Baylor University Medical Center, Dallas, Texas, USA., Fiel MI; Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Levine D; Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA., Leung DH; Department of Pediatrics, Baylor College of Medicine and Division of Gastroenterology, Hepatology and Nutrition, Texas Children's Hospital, Houston, Texas, USA., Duarte-Rojo A; Division of Gastroenterology and Hepatology, Northwestern Medicine and Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA., Dranoff JA; Yale School of Medicine, Department of Internal Medicine, Section of Digestive Diseases, New Haven, Connecticut, USA.; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Nayfeh T; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Hasan B; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Taddei TH; Yale School of Medicine, Department of Internal Medicine, Section of Digestive Diseases, New Haven, Connecticut, USA.; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Alsawaf Y; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Saadi S; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Majzoub AM; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Manolopoulos A; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Alzuabi M; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Ding J; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Sofiyeva N; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Murad MH; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA., Alsawas M; Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota, USA.; Department of Medicine, Section of Hepatology, Virginia Commonwealth University, Richmond, Virginia, USA., Rockey DC; Department of Medicine, Digestive Disease Research Center, Medical University of South Carolina, Charleston, South Carolina, USA., Sterling RK; Department of Medicine, Section of Hepatology, Virginia Commonwealth University, Richmond, Virginia, USA.
Jazyk:	angličtina
Zdroj:	Hepatology (Baltimore, Md.) [Hepatology] 2024 Mar 15. Date of Electronic Publication: 2024 Mar 15.
DOI:	10.1097/HEP.0000000000000842
Abstrakt:	Background and Aims: Blood-based biomarkers have been proposed as an alternative to liver biopsy for noninvasive liver disease assessment in chronic liver disease. Our aims for this systematic review were to evaluate the diagnostic utility of selected blood-based tests either alone, or in combination, for identifying significant fibrosis (F2-4), advanced fibrosis (F3-4), and cirrhosis (F4), as compared to biopsy in chronic liver disease. Approach and Results: We included a comprehensive search of databases including Ovid MEDLINE(R), EMBASE, Cochrane Database, and Scopus through to April 2022. Two independent reviewers selected 286 studies with 103,162 patients. The most frequently identified studies included the simple aspartate aminotransferase-to-platelet ratio index and fibrosis (FIB)-4 markers (with low-to-moderate risk of bias) in HBV and HCV, HIV-HCV/HBV coinfection, and NAFLD. Positive (LR+) and negative (LR-) likelihood ratios across direct and indirect biomarker tests for HCV and HBV for F2-4, F3-4, or F4 were 1.66-6.25 and 0.23-0.80, 1.89-5.24 and 0.12-0.64, and 1.32-7.15 and 0.15-0.86, respectively; LR+ and LR- for NAFLD F2-4, F3-4, and F4 were 2.65-3.37 and 0.37-0.39, 2.25-6.76 and 0.07-0.87, and 3.90 and 0.15, respectively. Overall, the proportional odds ratio indicated FIB-4 <1.45 was better than aspartate aminotransferase-to-platelet ratio index <0.5 for F2-4. FIB-4 >3.25 was also better than aspartate aminotransferase-to-platelet ratio index >1.5 for F3-4 and F4. There was limited data for combined tests. Conclusions: Blood-based biomarkers are associated with small-to-moderate change in pretest probability for diagnosing F2-4, F3-4, and F4 in viral hepatitis, HIV-HCV coinfection, and NAFLD, with limited comparative or combination studies for other chronic liver diseases. (Copyright © 2024 American Association for the Study of Liver Diseases.)
Databáze:	MEDLINE
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