Comparison of blood tests for liver fibrosis specific or not to NAFLD
Comparison of blood tests for liver fibrosis specific or not to NAFLD
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DOI：
10.1016/j.jhep.2008.07.035
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发表时间：
2009-01-01
影响因子：
25.7
通讯作者：
Lunel, Francoise
中科院分区：
文献类型：
--
作者：
Cales, Paul;Laine, Fabrice;Lunel, Francoise
背景/目的：为了比较NAFLD特异性肝纤维化的血液检测：FibroMeter NAFLD和NAFLD纤维化评分（NFSA）与非特异性检测APRI。方法：来自两个独立中心的235名具有肝Metavir分期和血液标志物的NAFLD患者被随机分配到检测人群（n = 121）或验证人群（n = 114）。使用FibroMeter获得了显著纤维化的最高准确度- 91%，其（i）AUROC（0.943）显著高于NFSA（0.884，p = 0.008）和APRI（0.866，p < 10（-3）; P = 0.309 vs NFSA）;（ii）错误分类率（9%）显著低于NFSA（14%，p = 0.04）和APRI（16%，p = 0.002），并且根据中心没有变化（14 vs 7%，p = 0.07），不像NFSA（25 vs 9%，p = 0.001）和APRI（29 vs 11%，P < 10（-3））。通过使用90%预测值的阈值，大多数患者可以避免肝活检：FibroMeter：97.4% vs NFSA：86.8%（p < 10（-3））和APRL 80.0%（p < 10（-3））。一种新的分类提供了三个可靠的诊断区间：F0/1，F0/1/2，F2/3/4，91.4%，准确度为FibroMeter，避免活检在所有patient.Conclusions：FibroMeter NAFLD具有高性能，并提供了可靠的诊断为显着纤维化，显着优于NFSA和APRI。(C)2008年欧洲肝脏研究协会。Elsevier B. V.出版，保留所有权利。
Background/Aims:To compare blood tests of liver fibrosis specific for NAFLD: the FibroMeter NAFLD and the NAFLD fibrosis score (NFSA) with a non-specific test, APRI.Methods:Two hundred and thirty-five NAFLD patients with liver Metavir staging and blood markers from two independent centres were randomly assigned to a test (n = 121) or a validation population (n = 114).Results: The highest accuracy - 91% - for significant fibrosis was obtained with the FibroMeter whose (i) AUROC (0.943) was significantly higher than those of NFSA (0.884, p = 0.008) and APRI (0.866, p < 10(-3); P = 0.309 vs NFSA) in the whole population, and (ii) misclassification rate (9%) was significantly lower than those of NFSA (14%), p = 0.04) and APRI (16%, p = 0.002) and did not vary according to centre (14 vs 7%, p = 0.07), unlike those of NFSA (25 vs 9%, p = 0.001) and APRI (29 vs 11%, P < 10(-3)). By using thresholds of 90% predictive values, liver biopsy could have been avoided in most patients: FibroMeter: 97.4% vs NFSA: 86.8% (p < 10(-3)) and APRL 80.0% (p < 10(-3)). A new classification provided three reliable diagnosis intervals: F0/1, F0/1/2, F2/3/4 with 91.4%, accuracy for FibroMeter, avoiding biopsy in all patients.Conclusions: FibroMeter NAFLD had high performance and provided reliable diagnosis for significant fibrosis, significantly outperforming NFSA and APRI. (C) 2008 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.