Concordance of non-invasive mechanical and serum tests for liver fibrosis evaluation in chronic hepatitis C
| Autor: | Suzane K. Ono, Taisa Grotta Ragazzo, Venâncio Avancini Ferreira Alves, Lucas Souto Nacif, Renata Moutinho, Denise Cerqueira Paranaguá-Vezozzo, Vinícius Santana Nunes, Flair José Carrilho, Daniel Ferraz de Campos Mazo, Adriana Ribas Andrade, Ana Luiza Vilar Guedes |
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| Rok vydání: | 2017 |
| Předmět: |
Pathology
medicine.medical_specialty Hepatitis C virus Concordance Liver fibrosis Observational Study medicine.disease_cause Serum markers BIOMARCADORES 03 medical and health sciences 0302 clinical medicine Chronic hepatitis Liver stiffness medicine Hepatology medicine.diagnostic_test business.industry Non invasive Liver biopsy 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Elastography business |
| Zdroj: | World Journal of Hepatology Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| ISSN: | 1948-5182 |
| Popis: | AIM To determine the sensitivity and specificity of liver stiffness measurement (LSM) and serum markers (SM) for liver fibrosis evaluation in chronic hepatitis C. METHODS Between 2012 and 2014, 81 consecutive hepatitis C virus (HCV) patients had METAVIR score from liver biopsy compared with concurrent results from LSM [transient elastography (TE) [FibroScan®/ARFI technology (Virtual Touch®)] and SM [FIB-4/aspartate aminotransferase-to-platelet ratio index (APRI)]. The diagnostic performance of these tests was assessed using receiver operating characteristic curves. The optimal cut-off levels of each test were chosen to define fibrosis stages F ≥ 2, F ≥ 3 and F = 4. The Kappa index set the concordance analysis. RESULTS Fifty point six percent were female and the median age was 51 years (30-78). Fifty-six patients (70%) were treatment-naïve. The optimal cut-off values for predicting F ≥ 2 stage fibrosis assessed by TE were 6.6 kPa, for acoustic radiation force impulse (ARFI) 1.22 m/s, for APRI 0.75 and for FIB-4 1.47. For F ≥ 3 TE was 8.9 kPa, ARFI was 1.48 m/s, APRI was 0.75, and FIB-4 was 2. For F = 4, TE was 12.2 kPa, ARFI was 1.77 m/s, APRI was 1.46, and FIB-4 was 3.91. The APRI could not distinguish between F2 and F3, P = 0.92. The negative predictive value for F = 4 for TE and ARFI was 100%. Kappa index values for F ≥ 3 METAVIR score for TE, ARFI and FIB-4 were 0.687, 0.606 and 0.654, respectively. This demonstrates strong concordance between all three screening methods, and moderate to strong concordance between them and APRI (Kappa index = 0.507). CONCLUSION Given the costs and accessibility of LSM methods, and the similarity with the outcomes of SM, we suggest that FIB-4 as well as TE and ARFI may be useful indicators of the degree of liver fibrosis. This is of particular importance to developing countries. |
| Databáze: | OpenAIRE |
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