Meta-analyses of FibroTest diagnostic value in chronic liver disease

<p>Abstract</p> <p>Background</p> <p>FibroTest (FT) is a biomarker of liver fibrosis initially validated in patients with chronic hepatitis C (CHC).</p> <p>The aim was to test two hypotheses, one, that the FT diagnostic value was similar in the three other f...

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Main Authors: Bourliere Marc, Zoulim Fabien, Lebrec Didier, Thabut Dominique, Naveau Sylvie, Imbert-Bismut Françoise, Castera Laurent, Ratziu Vlad, Halfon Philippe, Morra Rachel, Poynard Thierry, Cacoub Patrice, Messous Djamila, Munteanu Mona, de Ledinghen Victor
Format: Article
Language:English
Published: BMC 2007-10-01
Series:BMC Gastroenterology
Online Access:http://www.biomedcentral.com/1471-230X/7/40
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author Bourliere Marc
Zoulim Fabien
Lebrec Didier
Thabut Dominique
Naveau Sylvie
Imbert-Bismut Françoise
Castera Laurent
Ratziu Vlad
Halfon Philippe
Morra Rachel
Poynard Thierry
Cacoub Patrice
Messous Djamila
Munteanu Mona
de Ledinghen Victor
author_facet Bourliere Marc
Zoulim Fabien
Lebrec Didier
Thabut Dominique
Naveau Sylvie
Imbert-Bismut Françoise
Castera Laurent
Ratziu Vlad
Halfon Philippe
Morra Rachel
Poynard Thierry
Cacoub Patrice
Messous Djamila
Munteanu Mona
de Ledinghen Victor
author_sort Bourliere Marc
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>FibroTest (FT) is a biomarker of liver fibrosis initially validated in patients with chronic hepatitis C (CHC).</p> <p>The aim was to test two hypotheses, one, that the FT diagnostic value was similar in the three other frequent fibrotic diseases: chronic hepatitis B (CHB), alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD); and the other, that the FT diagnostic value was similar for intermediate and extreme fibrosis stages.</p> <p>Methods</p> <p>The main end points were the FT area under the ROC curves (AUROCs) for the diagnosis of bridging fibrosis (F2F3F4 vs. F0F1), standardized for the spectrum of fibrosis stages, and the comparison of FT AUROCs between adjacent stages. Two meta-analyses were performed: one combining all the published studies (random model), and one of an integrated data base combining individual data. Sensitivity analysis integrated the independency of authors, lenght of biopsy, prospective design, respect of procedures, comorbidities, and duration between biopsy and serum sampling.</p> <p>Results</p> <p>A total of 30 studies were included which pooled 6,378 subjects with both FT and biopsy (3,501 HCV, 1,457 HBV, 267 NAFLD, 429 ALD, and 724 mixed). Individual data were analyzed in 3,282 patients. The mean standardized AUROC was 0.84 (95% CI, 0.83–0.86), without differences between causes of liver disease: HCV 0.85 (0.82–0.87), HBV 0.80 (0.77–0.84), NAFLD 0.84 (0.76–0.92), ALD 0.86 (0.80–0.92), mixed 0.85 (0.80–0.93). The AUROC for the diagnosis of the intermediate adjacent stages F2 vs. F1 (0.66; 0.63–0.68, n = 2,055) did not differ from that of the extreme stages F3 vs. F4 (0.69; 0.65–0.72, n = 817) or F1 vs. F0 (0.62; 0.59–0.65, n = 1788).</p> <p>Conclusion</p> <p>FibroTest is an effective alternative to biopsy in patients with chronic hepatitis C and B, ALD and NAFLD. The FT diagnostic value is similar for the diagnosis of intermediate and extreme fibrosis stages.</p>
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spelling doaj.art-5e490e9b6b244b8ba88c4e3f3dd3bdbc2022-12-22T03:21:40ZengBMCBMC Gastroenterology1471-230X2007-10-01714010.1186/1471-230X-7-40Meta-analyses of FibroTest diagnostic value in chronic liver diseaseBourliere MarcZoulim FabienLebrec DidierThabut DominiqueNaveau SylvieImbert-Bismut FrançoiseCastera LaurentRatziu VladHalfon PhilippeMorra RachelPoynard ThierryCacoub PatriceMessous DjamilaMunteanu Monade Ledinghen Victor<p>Abstract</p> <p>Background</p> <p>FibroTest (FT) is a biomarker of liver fibrosis initially validated in patients with chronic hepatitis C (CHC).</p> <p>The aim was to test two hypotheses, one, that the FT diagnostic value was similar in the three other frequent fibrotic diseases: chronic hepatitis B (CHB), alcoholic liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD); and the other, that the FT diagnostic value was similar for intermediate and extreme fibrosis stages.</p> <p>Methods</p> <p>The main end points were the FT area under the ROC curves (AUROCs) for the diagnosis of bridging fibrosis (F2F3F4 vs. F0F1), standardized for the spectrum of fibrosis stages, and the comparison of FT AUROCs between adjacent stages. Two meta-analyses were performed: one combining all the published studies (random model), and one of an integrated data base combining individual data. Sensitivity analysis integrated the independency of authors, lenght of biopsy, prospective design, respect of procedures, comorbidities, and duration between biopsy and serum sampling.</p> <p>Results</p> <p>A total of 30 studies were included which pooled 6,378 subjects with both FT and biopsy (3,501 HCV, 1,457 HBV, 267 NAFLD, 429 ALD, and 724 mixed). Individual data were analyzed in 3,282 patients. The mean standardized AUROC was 0.84 (95% CI, 0.83–0.86), without differences between causes of liver disease: HCV 0.85 (0.82–0.87), HBV 0.80 (0.77–0.84), NAFLD 0.84 (0.76–0.92), ALD 0.86 (0.80–0.92), mixed 0.85 (0.80–0.93). The AUROC for the diagnosis of the intermediate adjacent stages F2 vs. F1 (0.66; 0.63–0.68, n = 2,055) did not differ from that of the extreme stages F3 vs. F4 (0.69; 0.65–0.72, n = 817) or F1 vs. F0 (0.62; 0.59–0.65, n = 1788).</p> <p>Conclusion</p> <p>FibroTest is an effective alternative to biopsy in patients with chronic hepatitis C and B, ALD and NAFLD. The FT diagnostic value is similar for the diagnosis of intermediate and extreme fibrosis stages.</p>http://www.biomedcentral.com/1471-230X/7/40
spellingShingle Bourliere Marc
Zoulim Fabien
Lebrec Didier
Thabut Dominique
Naveau Sylvie
Imbert-Bismut Françoise
Castera Laurent
Ratziu Vlad
Halfon Philippe
Morra Rachel
Poynard Thierry
Cacoub Patrice
Messous Djamila
Munteanu Mona
de Ledinghen Victor
Meta-analyses of FibroTest diagnostic value in chronic liver disease
BMC Gastroenterology
title Meta-analyses of FibroTest diagnostic value in chronic liver disease
title_full Meta-analyses of FibroTest diagnostic value in chronic liver disease
title_fullStr Meta-analyses of FibroTest diagnostic value in chronic liver disease
title_full_unstemmed Meta-analyses of FibroTest diagnostic value in chronic liver disease
title_short Meta-analyses of FibroTest diagnostic value in chronic liver disease
title_sort meta analyses of fibrotest diagnostic value in chronic liver disease
url http://www.biomedcentral.com/1471-230X/7/40
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