Optimization and robustness of blood tests for liver fibrosis and cirrhosis

被引：34

作者：

Cales, Paul ^{[1
,2
]}

Boursier, Jerome ^{[1
,2
]}

Bertrais, Sandrine ^{[2
]}

Oberti, Frederic ^{[1
,2
]}

Gallois, Yves ^{[2
,3
]}

Fouchard-Hubert, Isabelle ^{[1
,2
]}

Dib, Nina ^{[1
,2
]}

Zarski, Jean-Pierre ^{[5
,6
]}

Rousselet, Marie Christine ^{[2
,4
]}

机构：

[1] CHU Angers, Serv Hepatogastroenterol, F-49933 Angers 09, France

[2] Univ Angers, IFR 132, UPRES 3859, Lab HIFIH, Angers, Pres Unam, France

[3] CHU Angers, Dept Pathol Cellulaire & Tissulaire, Angers, France

[4] CHU Angers, Lab Biochim & Biol Mol, Angers, France

[5] CHU Grenoble, Pole Digestif DUNE, Clin Hepatogastroenterol, F-38043 Grenoble, France

[6] IAB, IAPC, INSERM UJF U823, Grenoble, France

来源：

CLINICAL BIOCHEMISTRY | 2010年 / 43卷 / 16-17期

关键词：

Liver fibrosis; Liver biopsy; Diagnostic accuracy; Blood test; Fibroscan; Hepatitis C; Diagnosis; Bootstrap; CHRONIC HEPATITIS-C; DIAGNOSTIC-ACCURACY; SERUM MARKERS; VIRUS-INFECTION; REPRODUCIBILITY; PERFORMANCE; ELASTOGRAPHY; METAANALYSIS; PROGRESSION; BIOMARKERS;

D O I：

10.1016/j.clinbiochem.2010.08.010

中图分类号：

R446 [实验室诊断]; R-33 [实验医学、医学实验];

学科分类号：

1001 ;

摘要：

Objectives: To optimize the performance and feasibility of fibrosis blood tests and evaluate their robustness. Design and methods: The derivation population included 1056 HCV patients with liver biopsy and blood markers. Validation populations included 984 patients with various viral hepatitis causes, and Fibroscan and/or liver biopsy and/or blood markers. Results: The bootstrap method validated the markers of the original FibroMeter(2G), but not those of Fibrotest and Hepascore, and provided a hyaluronate-free FibroMeter(3G). AUROCs for significant fibrosis were: FibroMeter(2G): 0.853 vs. FibroMeter(3G): 0.851, p = 0.489. Compared to FibroMeter(2G), FibroMeter(3G) had a significantly higher patient rate with predictive values >= 90% for significant fibrosis. Accuracy for fibrosis stage classification was: Fibrotest: 37.9%, FibroMeter(2G): 74.9%, and FibroMeter(3G): 86.9% (p<10(-3)). Conclusion: The bootstrap method validated FibroMeter(2G) and provided a cheaper and more feasible hyaluronate-free FibroMeter(3G) with comparable performance. Compared to binary diagnosis, fibrosis stage classification increased discrimination, with an increased accuracy to 87% for FibroMeter(3G). (C) 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

引用

页码：1315 / 1322

页数：8

共 34 条

[11] A novel panel of blood markers to assess the degree of liver fibrosis [J].