FibroTest-ActiTest as a non-invasive marker of liver fibrosis

被引:86
作者
Halfon, Philippe [1 ]
Munteanu, Mona [2 ]
Poynard, Thierry [3 ,4 ]
机构
[1] Hop Ambroise Pare, Lab Alphabio, Dept Virol, F-13006 Marseille, France
[2] BioPredict Paris, Paris, France
[3] Univ Paris 05, Grp Hosp Pitie Salpetriere, Paris, France
[4] Univ Paris 06, Grp Hosp Pitie Salpetriere, Paris, France
来源
GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE | 2008年 / 32卷
关键词
Fibrotest-Actitest; Non-invasive marker of liver fibrosis; Hepatite C; CHB; ALD; NAFLD;
D O I
10.1016/S0399-8320(08)73991-5
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
FibroTest (FT) is a biomarker of liver fibrosis initially validated in patients with chronic hepatitis C (CHC) and subsequently assessed in other frequent Liver diseases, including chronic hepatitis B (CHB), alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD). The primary aim of the present study was to update a previous meta-analysis of FT diagnostic value, and to summarize its advantages and limitations. The secondary aim was to provide an overview of the prognostic value of FT in CHC, CHB and ALD. For diagnostic value, the main endpoint was the FT area under the ROC curves (AUROCs) for the diagnosis of bridging fibrosis (F2/F3/F4 vs F0/F1), standardized for the spectrum of fibrosis. Sensitivity analysis integrated the non-standardized observed AUROCs, the independency of authors, size (length) of biopsy, prospective design, correctness of procedures, co-morbidities, and timelag between biopsy and serum sampling. For prognostic value, the main endpoint was the FT AUROC for the prognostic value of Liver complications or death related to Liver disease. A total of 38 diagnostic studies were included, which pooled 7985 subjects who had undergone both FT and biopsy (4600 HCV, 1580 HBV, 267 NAFLD, 524 ALD and 1014 mixed). The mean standardized AUROC was 0.84 (95% Cl, 0.83-0.86), with no differences in terms of causes of liver disease: HCV 0.84 (0.82-0.87); HBV 0.81 (0.780.83); NAFLD 0.84 (0.76-0.92); ALD 0.87 (0.82-0.92); and mixed 0.85 (0.81-0.89). Three prognostic studies were also included. FT was found to have higher or similar prognostic value compared with biopsy in patients with CHC, CHB or ALD. FibroTest is an effective alternative to biopsy in patients with chronic hepatitis C or B, ALD or NAFLD. Indeed, the prognostic performance of FibroTest was at least as accurate as that of biopsy in patients with chronic hepatitis C or B, or ALD. (C) 2008 Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:22 / 39
页数:18
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