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.

Cales P, Oberti F, Michalak S, Hubert-Fouchard I, Rousselet MC, Konate A,

Gallois Y, Ternisien C, Chevailler A, Lunel F.

Laboratoire HIFIH, UPRES 3859, IFR 132, Universite, Angers, France.

paul.cales@...

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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