New multi protein patterns differentiate liver fibrosis stages and hepatocellular carcinoma in chronic hepatitis C serum samples

Göbel, Thomas; Vorderwülbecke, Sonja; Hauck, Katarzyna; Fey, Holger; Häussinger, Dieter; Erhardt, Andreas

doi:10.3748/wjg.v12.i47.7604

Cited by 42 publications

(20 citation statements)

References 42 publications

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“…Thirty-three studies examined the APRI in patients with chronic hepatitis C. Ultimately, 11 studies were excluded for duplication of data (n ϭ 1), 38 insufficient data (n ϭ 5), 11,[39][40][41][42] small sample size (n ϭ 2), 43,44 or failure to use biopsy as the reference test (n ϭ 3). [45][46][47] Thus, our final data set for the meta-analysis included 22 studies (Table 1).…”

Section: Search Resultsmentioning

confidence: 99%

Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C–related fibrosis: A systematic review

2007

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The development of noninvasive markers of liver fibrosis is a clinical and research priority. The aspartate aminotransferase-to-platelet ratio index (APRI) is a promising tool with limited expense and widespread availability. Our objective was to systematically review the performance of the APRI in hepatitis C virus (HCV)-infected patients. Random effects meta-analyses and areas under summary receiver operating characteristic curves (AUC) were examined to characterize APRI accuracy for significant fibrosis (stages 2-4) and cirrhosis. In 22 studies (n ‫؍‬ 4,266), the summary AUCs of the APRI for significant fibrosis and cirrhosis were 0.76 [95% confidence interval (CI), 0.74-0.79] and 0.82 (95%CI, 0.79-0.86), respectively. For significant fibrosis, an APRI threshold of 0.5 was 81% sensitive and 50% specific. At a 40% prevalence of significant fibrosis, this threshold had a negative predictive value (NPV) of 80%, but could reduce the necessity of liver biopsy by only 35%. For cirrhosis, a threshold of 1.0 was 76% sensitive and 71% specific. At a 15% cirrhosis prevalence, the NPV of this threshold was 91%. Higher APRI thresholds had suboptimal positive predictive values except in settings with a high prevalence of cirrhosis. APRI accuracy was not affected by the prevalence of advanced fibrosis, or study and biopsy quality. However, the accuracy for cirrhosis was greater in studies including human immunodeficiency virus (HIV)/HCV-co-infected patients. Conclusion: The major strength of the APRI is the exclusion of significant HCV-related fibrosis. Future studies of novel markers should demonstrate improved accuracy and cost-effectiveness compared with this economical and widely available index. (HEPATOLOGY 2007;46:912-921.)

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Section: Search Resultsmentioning

confidence: 99%

Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C–related fibrosis: A systematic review

2007

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“…HCC has several interesting epidemiologic features including dynamic temporal trends, marked variations among geographic regions, variation between racial and ethnic groups, variation between men and women and the presence of several well-documented environmental potentially preventable risk factors. Moreover, there is a growing understanding on the molecular mechanisms inducing hepatocarcinogenesis, which almost never occurs in healthy liver, but the cancer risk increases sharply in response to chronic liver injury at the cirrhosis stage [6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Expression and clinical significance of NET-1 and PCNA in hepatocellular carcinoma

Shen

Zhu

et al. 2008

Med Oncol

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“…However, the F4 stage of cirrhosis is almost incurable and diagnosis of fibrosis at an earlier stage is desirable. The biology after F4 (cirrhosis) has been well studied, due to the interest in diagnosis and therapy for hepatocellular carcinoma (HCC), www.wjgnet.com but progression to HCC may begin in the early stage of fibrosis in hepatitis C [2] . Prevention of HCC and inhibition of fibrosis in the early phase is important, but the detailed hepatic biological changes corresponding to the F stage are unclear.…”

Section: Introductionmentioning

confidence: 99%

Serial changes in expression of functionally clustered genes in progression of liver fibrosis in hepatitis C patients

Takahara¹,

Takahashi²,

Zhang³

et al. 2008

WJG

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New multi protein patterns differentiate liver fibrosis stages and hepatocellular carcinoma in chronic hepatitis C serum samples

Cited by 42 publications

References 42 publications

Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C–related fibrosis: A systematic review

Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C–related fibrosis: A systematic review

Expression and clinical significance of NET-1 and PCNA in hepatocellular carcinoma

Serial changes in expression of functionally clustered genes in progression of liver fibrosis in hepatitis C patients

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