A novel panel of blood markers to assess the degree of liver fibrosis.

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Hepatology 2005 Dec;42(6):1373-81.

A novel panel of blood markers to assess the degree of liver

fibrosis.

Laboratoire HIFIH, Angers, France.

The objective was to develop new blood tests to characterize different fibrosis

parameters in viral and alcoholic chronic liver diseases. Measurements included

51 blood markers and Fibrotest, Fibrospect,

ELFG, APRI, and Forns scores. The clinically

significant fibrosis was evaluated via Metavir

staging (F2-F4), and image analysis was used to determine the area of fibrosis.

In an exploratory step in 383 patients with viral hepatitis, the area under the

receiving operator characteristic (AUROC) curve for stages F2-F4 in a test

termed the " Fibrometer " test combining

platelets, prothrombin index, aspartate

aminotransferase, alpha2-macroglobulin (A2M), hyaluronate, urea, and age was 0.883 compared with 0.808

for the Fibrotest (P = .01), 0.820 for the Forns test (P = .005), and 0.794 for the APRI test (P <

10(-4)). The Fibrometer AUROC curve was 0.892 in the

validating step in 120 patients. The AUROC curve for stages F2-F4 in a test

combining prothrombin index, A2M, hyaluronate,

and age was 0.962 in 95 patients with alcoholic liver diseases. The area of

fibrosis was estimated in viral hepatitis by testing for hyaluronate,

gamma-glutamyltransferase, bilirubin,

platelets, and apolipoprotein A1 ((a)R(2) = 0.645), and in alcoholic liver diseases by testing

for hyaluronate, prothrombin

index, A2M, and platelets ((a)R(2) = 0.836). In conclusion, the pathological

staging and area of liver fibrosis can be estimated using different

combinations of blood markers in viral and alcoholic liver diseases. Whereas

the Fibrometer has a high diagnostic accuracy for

clinically significant fibrosis, blood tests for the area of liver fibrosis

provide a quantitative estimation of the amount of fibrosis, which is

especially useful in cirrhosis.

PMID: 16317693 [PubMed - indexed for MEDLINE]

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