2013, Number 1
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Ann Hepatol 2013; 12 (1)
Diagnostic value of fibronectin discriminant score for predicting liver fibrosis stages in chronic hepatitis C virus patients
Attallah AM, Abdallah SO, Attallah AA, Omran MM, Farid K, Nasif WA, Shiha GE, Abdel-Aziz AF, Rasafy N, Shaker YM
Language: English
References: 43
Page: 44-53
PDF size: 168.82 Kb.
ABSTRACT
Background. Several noninvasive predictive models were developed to substitute liver biopsy for fibrosis assessment.
Aim. To evaluate the diagnostic value of fibronectin which reflect extracellular matrix metabolism
and standard liver functions tests which reflect alterations in hepatic functions.
Material and
methods. Chronic hepatitis C (CHC) patients (n = 145) were evaluated using ROC curves and stepwise multivariate
discriminant analysis (MDA) and was validated in 180 additional patients. Liver biochemical profile including
transaminases, bilirubin, alkaline phosphatase, albumin, complete blood count were estimated.
Fibronectin concentration was determined using monoclonal antibody and ELISA.
Results. A novel index
named fibronectin discriminant score (FDS) based on fibronectin, APRI and albumin was developed. FDS
produced areas under ROC curves (AUC) of 0.91 for significant fibrosis and 0.81 for advanced fibrosis. The
FDS correctly classified 79% of the significant liver fibrosis patients (F2-F4) with 87% sensitivity and 75% specificity.
The relative risk [odds ratio (OR)] of having significant liver fibrosis using the cut-off values determined
by ROC curve analyses were 6.1 for fibronectin, 4.9 for APRI, and 4.2 for albumin. FDS predicted
liver fibrosis with an OR of 16.8 for significant fibrosis and 8.6 for advanced fibrosis. The FDS had similar
AUC and OR in the validation group to the estimation group without statistically significant difference.
Conclusion. FDS predicted liver fibrosis with high degree of accuracy, potentially decreasing the number
of liver biopsy required.
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