Accuracy of cytokeratin 18 (M30 and M65) in detecting non-alcoholic steatohepatitis and fibrosis: A systematic review and meta-analysis

Autor: Quentin M. Anstee, Yasaman Vali, Patrick M.M. Bossuyt, Kevin L. Duffin, Jenny Lee, M. Julia Brosnan, Mohammad Hadi Zafarmand, Jérôme Boursier, Koos H. Zwinderman, Joanne Verheij
Přispěvatelé: University of Denver, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), VU University Medical Center [Amsterdam], Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC - Academic medical center, Newcastle University [Newcastle], University of Amsterdam [Amsterdam] (UvA), Epidemiology and Data Science, Graduate School, Pathology, APH - Methodology, APH - Personalized Medicine, APH - Aging & Later Life, ARD - Amsterdam Reproduction and Development, ACS - Atherosclerosis & ischemic syndromes
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Liver Cirrhosis
Male
Epidemiology
Physiology
Biopsy
[SDV]Life Sciences [q-bio]
lcsh:Medicine
Gastroenterology
Biochemistry
0302 clinical medicine
Mathematical and Statistical Techniques
Fibrosis
Non-alcoholic Fatty Liver Disease
Medicine and Health Sciences
lcsh:Science
ComputingMilieux_MISCELLANEOUS
Multidisciplinary
medicine.diagnostic_test
Cell Death
Liver Diseases
Fatty liver
Statistics
Middle Aged
Metaanalysis
Research Assessment
3. Good health
Liver
Physiological Parameters
030220 oncology & carcinogenesis
Meta-analysis
Liver biopsy
Physical Sciences
Biomarker (medicine)
Medicine
030211 gastroenterology & hepatology
Female
Research Article
Adult
medicine.medical_specialty
Systematic Reviews
Science
Surgical and Invasive Medical Procedures
Gastroenterology and Hepatology
Research and Analysis Methods
03 medical and health sciences
Cytokeratin
Internal medicine
medicine
Humans
Obesity
Statistical Methods
Keratin-18
business.industry
Body Weight
lcsh:R
Biology and Life Sciences
medicine.disease
Peptide Fragments
Morbid Obesity
Fatty Liver
Medical Risk Factors
Hepatocytes
lcsh:Q
Steatohepatitis
business
Mathematics
Biomarkers
Developmental Biology
Zdroj: PLoS ONE, Vol 15, Iss 9 (2020)
PLoS ONE, Vol 15, Iss 9, p e0238717 (2020)
PLoS ONE
PLoS ONE, Public Library of Science, 2020, 15 (9), pp.e0238717. ⟨10.1371/journal.pone.0238717⟩
PLoS ONE, 15(9 September):e0238717. Public Library of Science
PLOS ONE
ISSN: 1932-6203
Popis: IntroductionAssociation between elevated cytokeratin 18 (CK-18) levels and hepatocyte death has made circulating CK-18 a candidate biomarker to differentiate non-alcoholic fatty liver from non-alcoholic steatohepatitis (NASH). Yet studies produced variable diagnostic performance. We aimed to provide summary estimates with increased precision for the accuracy of CK-18 (M30, M65) in detecting NASH and fibrosis among non-alcoholic fatty liver disease (NAFLD) adults.MethodsWe searched five databases to retrieve studies evaluating CK-18 against a liver biopsy in NAFLD adults. Reference screening, data extraction and quality assessment (QUADAS-2) were independently conducted by two authors. Meta-analyses were performed for five groups based on the CK-18 antigens and target conditions, using one of two methods: linear mixed-effects multiple thresholds model or bivariate logit-normal random-effects model.ResultsWe included 41 studies, with data on 5,815 participants. A wide range of disease prevalence was observed. No study reported a pre-defined cut-off. Thirty of 41 studies provided sufficient data for inclusion in any of the meta-analyses. Summary AUC [95% CI] were: 0.75 [0.69-0.82] (M30) and 0.82 [0.69-0.91] (M65) for NASH; 0.73 [0.57-0.85] (M30) for fibrotic NASH; 0.68 (M30) for significant (F2-4) fibrosis; and 0.75 (M30) for advanced (F3-4) fibrosis. Thirteen studies used CK-18 as a component of a multimarker model.ConclusionsFor M30 we found lower diagnostic accuracy to detect NASH compared to previous meta-analyses, indicating a limited ability to act as a stand-alone test, with better performance for M65. Additional external validation studies are needed to obtain credible estimates of the diagnostic accuracy of multimarker models.
Databáze: OpenAIRE
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