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Enhanced liver fibrosis panel as a predictor of liver fibrosis in chronic hepatitis C patients.
Fernandes, Flavia F; Ferraz, Maria L; Andrade, Luiz E; Dellavance, Alessandra; Terra, Carlos; Pereira, Gustavo; Pereira, João L; Campos, Frederico; Figueiredo, Fátima; Perez, Renata M.
Afiliação
  • Fernandes FF; *Gastroenterology Department, University of the State of Rio de Janeiro †Department of Gastroenterology, Bonsucesso Federal Hospital §D'Or Institute for Research and Education #Internal Medicine Department, Federal University of Rio de Janeiro, Rio de Janeiro ‡Gastroenterology Department, Federal University of São Paulo ∥Rheumatology Division, Universidade Federal de São Paulo, UNIFESP, São Paulo ¶Department of Research and Development, Fleury Group, Brazil.
J Clin Gastroenterol ; 49(3): 235-41, 2015 Mar.
Article em En | MEDLINE | ID: mdl-24714186
BACKGROUND: Evaluation of fibrosis is crucial in the assessment of chronic hepatitis C (CHC). The enhanced liver fibrosis (ELF) is a serological panel including hyaluronic acid (HA), tissue inhibitor of matrix metalloproteinases-1 (TIMP-1), and amino-terminal propeptide of type III procollagen (PIIINP) that has shown good results in predicting liver fibrosis in distinct scenarios of chronic liver diseases. AIMS: We aimed to assess the performance of ELF on the detection of fibrosis and cirrhosis in a CHC patient cohort and to compare the results of ELF and transient elastography (TE-Fibroscan) using liver biopsy as reference. PATIENTS AND METHODS: One hundred twenty patients were prospectively evaluated by TE and ELF using an ADVIA Centaur automated system. The ELF score was calculated using the manufacturer's algorithm. Biopsies were classified according to the METAVIR score. Receiver operator characteristic curve analyses were performed to evaluate the accuracy of ELF and TE. RESULTS: The area under the receiver operator characteristic curve (AUROC) of ELF for the diagnosis of significant fibrosis was 0.81 [95% confidence interval (CI), 0.73-0.87], for advanced fibrosis was 0.82 (95% CI, 0.74-0.88), and for cirrhosis was 0.78 (95% CI, 0.70-0.85). Using the proposed cutoffs, ELF overestimated fibrosis in 66% (81/120) of cases and underestimated in 3% (3/120). We found no statistically significant difference when comparing the AUROC of ELF and TE for diagnosing fibrosis or cirrhosis. CONCLUSIONS: ELF panel is a good noninvasive fibrosis marker and showed similar results to TE in CHC patients. However, new cutoff points need to be established to improve its performance on patients with CHC.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fragmentos de Peptídeos / Ensaio de Imunoadsorção Enzimática / Pró-Colágeno / Hepatite C Crônica / Inibidor Tecidual de Metaloproteinase-1 / Ácido Hialurônico / Cirrose Hepática Tipo de estudo: Diagnostic_studies / Etiology_studies / Evaluation_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Gastroenterol Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fragmentos de Peptídeos / Ensaio de Imunoadsorção Enzimática / Pró-Colágeno / Hepatite C Crônica / Inibidor Tecidual de Metaloproteinase-1 / Ácido Hialurônico / Cirrose Hepática Tipo de estudo: Diagnostic_studies / Etiology_studies / Evaluation_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Gastroenterol Ano de publicação: 2015 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos