Combination of transient elastography with serum-based non-invasive tests improves prediction of liver fibrosis in patients with chronic hepatitis C: a prospective cohort study
The work was carried out at the Lithuanian University of Health Sciences Hospital Kaunas Clinics. Background. To date, there is not enough data to conclude whether the combination of different non-invasive liver fibrosis tests could improve the accuracy in prediction of liver fibrosis. The aim of t...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Vilnius University Press
2015-08-01
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| Series: | Acta Medica Lituanica |
| Subjects: | |
| Online Access: | https://www.journals.vu.lt/AML/article/view/21372 |
| _version_ | 1828734464442761216 |
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| author | Romanas Zykus Laimas Jonaitis Vitalija Petrenkienė Inga Gudinavičienė Limas Kupčinskas |
| author_facet | Romanas Zykus Laimas Jonaitis Vitalija Petrenkienė Inga Gudinavičienė Limas Kupčinskas |
| author_sort | Romanas Zykus |
| collection | DOAJ |
| description | The work was carried out at the Lithuanian University of Health Sciences Hospital Kaunas Clinics.
Background. To date, there is not enough data to conclude whether the combination of different non-invasive liver fibrosis tests could improve the accuracy in prediction of liver fibrosis. The aim of this study was to assess correlation between transient elastography (TE), aspartate aminotransferase to platelet ratio index (APRI), fibrosis 4 score (FIB4) and histological stage of fibrosis (F).
Materials and methods. In this prospective study the correlation of TE, APRI and FIB4 with the stage of fibrosis was assessed in 140 patients with chronic HCV hepatitis. TE, APRI and FIB4 were measured the same day before biopsy. Fibrosis was evaluated using the METAVIR score. Cut-off values were established by applying the ROC curve analysis. All non-invasive tests were combined into pairs in order to evaluate the accuracy of fibrosis prediction.
Results. The stage of fibrosis correlated with TE (R-0.74), FIB4 (R-0.67) and APRI (R-0.58). To detect F4 TE cut-off value 12.1 kPa had 93.8% sensitivity and 85% specificity; APRI cut-off value 1.42 (84.4/81.1) and FIB4 cutoff value 2.89 (84.4/84.0) were established. To determine F ≥ 3 – 10.3 kPa (91.1/83.9), 1.28 (77.8/78.5), 2.28 (84.4/81.7); F ≥ 2 8.5 kPa (80.9/74.3), 1.12 (72.1/78.6), 1.63 (82.4/75.7); F ≥ 1 5.35 kPa (85.4/100), 0.45 (89.2/87.5), 0.89 (87.7/75). Significant increase of accuracy was observed in TE/APRI (p – 0.008) and FIB4/APRI (p – 0.02) groups to predict F ≥ 1, and TE/FIB4 to predict F ≥ 2 (p – 0.04) and F ≥ 1 (p – 0.04).
Conclusions. Combined use of TE/APRI, FIB4/APRI increased the accuracy to predict F ≥ 1, and TE/FIB4 combination increased the accuracy to predict F ≥ 2 and F ≥ 1. |
| first_indexed | 2024-04-12T22:48:34Z |
| format | Article |
| id | doaj.art-e8561976f24c4283a694ce1fe7cadd70 |
| institution | Directory Open Access Journal |
| issn | 1392-0138 2029-4174 |
| language | English |
| last_indexed | 2024-04-12T22:48:34Z |
| publishDate | 2015-08-01 |
| publisher | Vilnius University Press |
| record_format | Article |
| series | Acta Medica Lituanica |
| spelling | doaj.art-e8561976f24c4283a694ce1fe7cadd702022-12-22T03:13:28ZengVilnius University PressActa Medica Lituanica1392-01382029-41742015-08-0122210.6001/actamedica.v22i2.3122Combination of transient elastography with serum-based non-invasive tests improves prediction of liver fibrosis in patients with chronic hepatitis C: a prospective cohort studyRomanas ZykusLaimas JonaitisVitalija PetrenkienėInga GudinavičienėLimas KupčinskasThe work was carried out at the Lithuanian University of Health Sciences Hospital Kaunas Clinics. Background. To date, there is not enough data to conclude whether the combination of different non-invasive liver fibrosis tests could improve the accuracy in prediction of liver fibrosis. The aim of this study was to assess correlation between transient elastography (TE), aspartate aminotransferase to platelet ratio index (APRI), fibrosis 4 score (FIB4) and histological stage of fibrosis (F). Materials and methods. In this prospective study the correlation of TE, APRI and FIB4 with the stage of fibrosis was assessed in 140 patients with chronic HCV hepatitis. TE, APRI and FIB4 were measured the same day before biopsy. Fibrosis was evaluated using the METAVIR score. Cut-off values were established by applying the ROC curve analysis. All non-invasive tests were combined into pairs in order to evaluate the accuracy of fibrosis prediction. Results. The stage of fibrosis correlated with TE (R-0.74), FIB4 (R-0.67) and APRI (R-0.58). To detect F4 TE cut-off value 12.1 kPa had 93.8% sensitivity and 85% specificity; APRI cut-off value 1.42 (84.4/81.1) and FIB4 cutoff value 2.89 (84.4/84.0) were established. To determine F ≥ 3 – 10.3 kPa (91.1/83.9), 1.28 (77.8/78.5), 2.28 (84.4/81.7); F ≥ 2 8.5 kPa (80.9/74.3), 1.12 (72.1/78.6), 1.63 (82.4/75.7); F ≥ 1 5.35 kPa (85.4/100), 0.45 (89.2/87.5), 0.89 (87.7/75). Significant increase of accuracy was observed in TE/APRI (p – 0.008) and FIB4/APRI (p – 0.02) groups to predict F ≥ 1, and TE/FIB4 to predict F ≥ 2 (p – 0.04) and F ≥ 1 (p – 0.04). Conclusions. Combined use of TE/APRI, FIB4/APRI increased the accuracy to predict F ≥ 1, and TE/FIB4 combination increased the accuracy to predict F ≥ 2 and F ≥ 1.https://www.journals.vu.lt/AML/article/view/21372transient elastograhyAPRIFIB4liver fibrosiscombinations |
| spellingShingle | Romanas Zykus Laimas Jonaitis Vitalija Petrenkienė Inga Gudinavičienė Limas Kupčinskas Combination of transient elastography with serum-based non-invasive tests improves prediction of liver fibrosis in patients with chronic hepatitis C: a prospective cohort study Acta Medica Lituanica transient elastograhy APRI FIB4 liver fibrosis combinations |
| title | Combination of transient elastography with serum-based non-invasive tests improves prediction of liver fibrosis in patients with chronic hepatitis C: a prospective cohort study |
| title_full | Combination of transient elastography with serum-based non-invasive tests improves prediction of liver fibrosis in patients with chronic hepatitis C: a prospective cohort study |
| title_fullStr | Combination of transient elastography with serum-based non-invasive tests improves prediction of liver fibrosis in patients with chronic hepatitis C: a prospective cohort study |
| title_full_unstemmed | Combination of transient elastography with serum-based non-invasive tests improves prediction of liver fibrosis in patients with chronic hepatitis C: a prospective cohort study |
| title_short | Combination of transient elastography with serum-based non-invasive tests improves prediction of liver fibrosis in patients with chronic hepatitis C: a prospective cohort study |
| title_sort | combination of transient elastography with serum based non invasive tests improves prediction of liver fibrosis in patients with chronic hepatitis c a prospective cohort study |
| topic | transient elastograhy APRI FIB4 liver fibrosis combinations |
| url | https://www.journals.vu.lt/AML/article/view/21372 |
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