|
- 现金
- 62111 元
- 精华
- 26
- 帖子
- 30437
- 注册时间
- 2009-10-5
- 最后登录
- 2022-12-28
|
A single blood test adjusted for different liver fibrosis targets improve fibrosis staging and especially cirrhosis diagnosis
Authors
Multicentric groups (SNIFF, ANRS HC 23)
First published: 5 March 2018Full publication history
DOI: 10.1002/hep4.1161 View/save citation
Cited by (CrossRef): 0 articles Check for updates
Article has an altmetric score of 4
Funding Information
Potential conflict of interest: Dr. Calès is the inventor of the FibroMeter tests; Dr. Boursier is a consultant for Echosens. The other authors have nothing to report.
Supported in part by the Agence Nationale de Recherches sur le Sida et les Hepatites Virales through the HC EP 23 Fibrostar study, which furnished a portion of the subjects.
Abstract
A. fibrosis blood tests are usually developed using significant fibrosis, which is a unique diagnostic target; however, these tests are employed for other diagnostic targets, such as cirrhosis. We aim to improve fibrosis staging accuracy by simultaneously targeting biomarkers for several diagnostic targets. Of 3,809 patients were included, including 1,012 individuals with chronic hepatitis C (CHC) into a derivation population and 2,797 individuals into validation populations of different etiologies (CHC, chronic hepatitis B, human immunodeficiency virus/CHC, nonalcoholic fatty liver disease, alcohol) using Metavir fibrosis stages as reference. FibroMeter biomarkers were targeted for different fibrosis-stage combinations into classical scores by logistic regression. Independent scores were combined into a single score reflecting Metavir stages by linear regression and called Multi-FibroMeter Version Second Generation(V2G). The Primary objective was to combine the advantages of a The test targeted for significant fibrosis (FibroMeterV2G) with those of a test targeted for cirrhosis (CirrhoMeterV2G). In the derivation CHC population, we first compared Multi-FibroMeterV2G to FibroMeterV2G and observed significant increases in the cirrhosis area under the receiver operating characteristic curve (AUROC ), Obuchowski index (reflecting all fibrosis-stage AUROCs), and classification metric (six periods expressed as a classified fraction) and a nonsignificant increase in significant fibrosis AUROC. Using, we compared it to CirroMeterV2G and observed a nonsignificant increase in the cirrhosis AUROC. In all 3,809 patients, individual accuracies for Multi-FibroMeterV2G and FibroMeterV2G were the following: cirrhosis AUROC, 0.906 versus 0.878 (P < 0.001; versus CirroMeterV2G, 0.897, P = 0.014); Obuchowski index, 0.795 versus 0.791 (P = 0.059 ); classification, 86.0% versus 82.1% (P < 0.001); significant fibrosis AUROC, 0.833 versus 0.832 (P = 0.366). Multi-Fibro MeterV2G had the highest correlation with the area of portoseptal fibrosis and the highest reproducibility over time. Correct classification rates of Multi-FibroMeter with hyaluronate (V2G, 86.0%) or without (V3G, 86.1%) did not differ (P = 0.938). Conclusion: Multitargeting biomarkers significantly improves fibrosis staging and especially cirrhosis diagnosis compared to classical single-targeted blood tests. (Hepatology Communications 2018)
Abbreviations
ALD
Alcoholic liver disease
AUROC
Area under the receiver operating characteristics
CHB
Chronic hepatitis B
CHC
Chronic hepatitis C
CLD
Chronic liver disease
F
Fibrosis stage
HIV
Human immunodeficiency virus
NAFLD
Nonalcoholic fatty liver disease
PPV
Positive predictive value
V2G
Version second generation
VCTE
Vibration-controlled transient elastometry
|
|
发表于 2018-3-17 19:13
