Noninvasive serum markers in the diagnosis of structural liver damage in chronic hepatitis C virus infection

Parise, Edison Roberto; Oliveira, Ana Cláudia de; Figueiredo-Mendes, Cláudio; Lanzoni, Valéria Pereira; Martins, João Roberto Maciel; Nader, Helena B.; Ferraz, Maria Lúcia Gomes

doi:10.1111/j.1478-3231.2006.01356.x

Cited by 59 publications

(51 citation statements)

References 30 publications

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“…The APRI cutoff value of ≥1.59 (ULN 40 U/l) was consistent with the findings by Parise et al, who reported the cutoff value of >1.5 (16).…”

Section: Discussionsupporting

confidence: 81%

Non-invasive serum markers and transient elastography in staging advanced chronic hepatitis C

Buivydienė¹,

Basytė²,

Valantinas³

2016

AML

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Objectives. In the past decade researchers are presenting indirect non-invasive serum markers for liver fibrosis and cirrhosis evaluation. Our aim was to evaluate effectiveness in staging advanced liver disease when using transient elastography and nine non-invasive serum markers: APRI, FIB-4, ASPRI, LSPS, P2/MS, FibroQ, Fibro-α, Pohl, CDR. Methods. 162 patients with hepatitis C infection were included in this study. Patients were divided in two groups, regarding histopathologic results: advanced liver fibrosis and cirrhosis. The following laboratory measures were obtained in all patients: ALT, AST, albumin, total bilirubin, alkaline phosphatase, gamma glutamyl transferase, INR, hemoglobin, platelet count, alfa fetoprotein, segmented neutrophils count and percentage and monocytes percentage. Transient elastography and nine non-invasive serum markers – APRI, FIB-4, ASPRI, LSPS, P2/MS, FibroQ, Fibro-α, Pohl, CDR – were compared with the results of the histopathological examination. A statistical analysis was done using the Student t-test, the Spearman’s rank correlation and the area under receiver-operating characteristic curves (AUROCs). Results. All nine non-invasive markers correlated significantly with the liver fibrosis stage (P < 0.001). Patients with liver cirrhosis had significantly higher ASPRI, LSPS, FIB-4, FibroQ, APRI, Fibro-α, Pohl and transient elastography scores in comparison with significant fibrosis (P < 0.05). The Pohl score indicated cirrhosis in 45.6% of cirrhotic patients, whereas it was positive in only 5.7% of non-cirrhotic patients (P < 0.05). P2/MS and CDR markers showed no significant difference between fibrosis and cirrhosis groups. The LSPS non-invasive marker showed the highest diagnostic efficiency for liver cirrhosis diagnosis, when using the cutoff score ≥0.99 (sensitivity 86.96%, specificity 85.71%, positive predictive value 88.9%, negative predictive value 83.3%). Transient elastography also showed high efficiency for liver cirrhosis diagnosis: using a cutoff value of ≥12 (kPa), sensitivity, specificity, positive and negative predictive values were 84.78, 80.00, 84.8 and 80.0%, respectively. Conclusions. In our study the most efficient for liver cirrhosis diagnosis were the LSPS non-invasive serum marker and transient elastography.

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“…The APRI cutoff value of ≥1.59 (ULN 40 U/l) was consistent with the findings by Parise et al, who reported the cutoff value of >1.5 (16).…”

Section: Discussionsupporting

confidence: 81%

Non-invasive serum markers and transient elastography in staging advanced chronic hepatitis C

Buivydienė¹,

Basytė²,

Valantinas³

2016

AML

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“…Em estudo semelhante, Parise et al (15) aplicaram o índice APRI na avaliação de pacientes com HCC e determinaram, pela curva ROC, que a sensibilidade e especificidade desse índice no diagnóstico de fibrose hepática avançada foram 85% e 66%, respectivamente (APRI ≥ 0,70). A área sob a curva ROC (AUC) foi 0,82, à semelhança do nosso resultado, cujo valor foi 0,85.…”

Section: Discussionunclassified

“…Vários estudos têm utilizado o AH como preditor de fibrose nos pacientes com HCC (7,12,13,15,27) . Nossos achados corroboram os de Halfon et al (7) , que reuniram 405 portadores de HCC para avaliar a acurácia desse marcador em predizer o estádio da fibrose hepática, e concluíram que o AH poderia ser usado clinicamente como marcador não-invasivo para fibrose e/ou cirrose.…”

Section: Discussionunclassified

Valor preditivo de marcadores séricos de fibrose hepática em pacientes portadores de hepatite crônica viral C

Lima¹,

Martins

Nader

et al. 2008

J. Bras. Patol. Med. Lab.

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Introdução: Os marcadores séricos têm sido empregados na avaliação da fibrose hepática em pacientes portadores de hepatite crônica C (HCC). Objetivos: Avaliar a capacidade do índice aspartato aminotransferase (AST)/alanina aminotransferase (ALT), dos níveis séricos de gama-glutamiltransferase (GGT), contagem de plaquetas, do índice AST/plaquetas (APRI) e do ácido hialurônico (AH) em predizer a intensidade da fibrose hepática na HCC e a variação desses marcadores após tratamento com interferon. Pacientes e métodos: Em 72 pacientes portadores de hepatite C determinamos no soro o índice AST/ALT, GGT, plaquetas, índice APRI (obtido pelo quociente AST/plaquetas) e o AH, que foram comparados ao estadiamento histológico, segundo os critérios de METAVIR. Receberam tratamento com interferon e ribavirina 65 pacientes. Os indivíduos que concluíram o tratamento (n = 33) realizaram nova dosagem dos marcadores séricos de fibrose para comparar com os níveis pré-tratamento. Resultados: Observamos que a GGT, a contagem de plaquetas, o índice APRI e o AH se correlacionaram com estádio de doença hepática (p < 0,01), exceto o índice AST/ALT. A análise das áreas sob as curvas ROC (AUC) evidenciaram que a melhor associação com estadiamento hepático foi para o índice APRI e a dosagem sérica do AH: AUC (APRI) = 0,85 e AUC (AH) = 0,86. Na avaliação pós-terapia com interferon, apenas a GGT e o índice APRI apresentaram redução de seus níveis (p < 0,05). Conclusão: O AH e o índice APRI apresentaram maior acurácia no estadiamento da fibrose, podendo ser aplicados como métodos diagnósticos alternativos na HCC. abstract resumo Introduction: Serum markers have been used in the assessment of liver fibrosis in patients with chronic hepatitis C (CHC). Aims: We evaluated the capacity of aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, gama-glutamyltransferase (GGT) levels, platelet count, the AST to platelet ratio index (APRI) and serum hyaluronic acid (HA) to predict the intensity of hepatic fibrosis in patients with CHC and the variation of these markers after therapy with interferon. Patients and methods: In 72 patients with hepatitis C, AST/ALT ratio, GGT levels, platelet count, the APRI index (calculated as the ratio of AST to platelets) and

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“…Recently, the pathogenesis of liver fibrosis in CHB was suggested to be different from that of CHC (13) (20). In addition, ALT is associated with sex and body mass index (20,21 …”

Section: Discussionmentioning

confidence: 99%

Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

et al. 2008

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Noninvasive serum markers in the diagnosis of structural liver damage in chronic hepatitis C virus infection

Cited by 59 publications

References 30 publications

Non-invasive serum markers and transient elastography in staging advanced chronic hepatitis C

Non-invasive serum markers and transient elastography in staging advanced chronic hepatitis C

Valor preditivo de marcadores séricos de fibrose hepática em pacientes portadores de hepatite crônica viral C

Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

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