Stepwise combination algorithms of non-invasive markers to diagnose significant fibrosis in chronic hepatitis C
In chronic hepatitis C, biopsy is the gold standard for assessment of liver fibrosis. Non-invasive markers have been proposed but their use is limited by diagnostic accuracy. Our aim was to increase the diagnostic performance of non-invasive markers of liver fibrosis by combining them in sequential...
Gespeichert in:
| Veröffentlicht in: | Journal of hepatology 2006-04, Vol.44 (4), p.686-693 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 693 |
|---|---|
| container_issue | 4 |
| container_start_page | 686 |
| container_title | Journal of hepatology |
| container_volume | 44 |
| creator | Sebastiani, Giada Vario, Alessandro Guido, Maria Noventa, Franco Plebani, Mario Pistis, Roberta Ferrari, Alessia Alberti, Alfredo |
| description | In chronic hepatitis C, biopsy is the gold standard for assessment of liver fibrosis. Non-invasive markers have been proposed but their use is limited by diagnostic accuracy. Our aim was to increase the diagnostic performance of non-invasive markers of liver fibrosis by combining them in sequential algorithms.
One hundred and ninety patients with chronic hepatitis C were evaluated for AST to platelets ratio (APRI), Forns' index and Fibrotest at the time of liver biopsy and stepwise combination algorithms were developed and validated prospectively in 100 additional patients.
Three algorithms were developed: (1) significant fibrosis (
F≥2 by METAVIR) was identified with high diagnostic performance (>94% accuracy) using APRI as screening test, followed by Fibrotest in APRI non-classified cases and restricting liver biopsy to patients classified F0–F1 by non-invasive tests. (2) A slightly modified algorithm had similar performance when applied to hepatitis C carriers with normal ALT. (3) Identification of cirrhosis (95% accuracy) was achieved using a dedicated algorithm with different cut-off, reducing by 60–70% the liver biopsies needed.
Stepwise combination of non-invasive markers of liver fibrosis improves the diagnostic performance in chronic hepatitis C. Need for liver biopsy is reduced by 50–70% but cannot be completely avoided. |
| doi_str_mv | 10.1016/j.jhep.2006.01.007 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67757907</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0168827806000298</els_id><sourcerecordid>67757907</sourcerecordid><originalsourceid>FETCH-LOGICAL-c494t-8e6e7408d4eda61334bf08495e3325c9bc6b140817f8a1649ecc7a251d88da2a3</originalsourceid><addsrcrecordid>eNp9kEGP0zAQhS0EYrsLf4AD8gVuCePEjR2JC6pgQVqJA3C2HGfSTknsYrtF_HtcWmlvnEaa-d7Tm8fYKwG1ANG929f7HR7qBqCrQdQA6glbiQ6ggk6Kp2xVIF3pRukbdpvSHgBa6OVzdiM62UPZr1j4lvHwmxJyF5aBvM0UPLfzNkTKuyXxMHEffEX-ZBOdkC82_sSYeA58JLv1oUgTbT1N5KzPfKIhhkSJk-duF4Mnx0vK4pvLcvOCPZvsnPDldd6xH58-ft98rh6-3n_ZfHionOxlrjR2qCToUeJoO9G2cphAy36NbdusXT-4bhDlLtSk7fkbdE7ZZi1GrUfb2PaOvb34HmL4dcSUzULJ4Txbj-GYTKfUWvWgCthcQFdip4iTOUQqT_4xAsy5ZrM355rNuWYDwsA_0eur-3FYcHyUXHstwJsrYJOz8xStd5QeOaWg7xso3PsLh6WLE2E0yRF6hyNFdNmMgf6X4y-1lZ1E</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>67757907</pqid></control><display><type>article</type><title>Stepwise combination algorithms of non-invasive markers to diagnose significant fibrosis in chronic hepatitis C</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Sebastiani, Giada ; Vario, Alessandro ; Guido, Maria ; Noventa, Franco ; Plebani, Mario ; Pistis, Roberta ; Ferrari, Alessia ; Alberti, Alfredo</creator><creatorcontrib>Sebastiani, Giada ; Vario, Alessandro ; Guido, Maria ; Noventa, Franco ; Plebani, Mario ; Pistis, Roberta ; Ferrari, Alessia ; Alberti, Alfredo</creatorcontrib><description>In chronic hepatitis C, biopsy is the gold standard for assessment of liver fibrosis. Non-invasive markers have been proposed but their use is limited by diagnostic accuracy. Our aim was to increase the diagnostic performance of non-invasive markers of liver fibrosis by combining them in sequential algorithms.
One hundred and ninety patients with chronic hepatitis C were evaluated for AST to platelets ratio (APRI), Forns' index and Fibrotest at the time of liver biopsy and stepwise combination algorithms were developed and validated prospectively in 100 additional patients.
Three algorithms were developed: (1) significant fibrosis (
F≥2 by METAVIR) was identified with high diagnostic performance (>94% accuracy) using APRI as screening test, followed by Fibrotest in APRI non-classified cases and restricting liver biopsy to patients classified F0–F1 by non-invasive tests. (2) A slightly modified algorithm had similar performance when applied to hepatitis C carriers with normal ALT. (3) Identification of cirrhosis (95% accuracy) was achieved using a dedicated algorithm with different cut-off, reducing by 60–70% the liver biopsies needed.
Stepwise combination of non-invasive markers of liver fibrosis improves the diagnostic performance in chronic hepatitis C. Need for liver biopsy is reduced by 50–70% but cannot be completely avoided.</description><identifier>ISSN: 0168-8278</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2006.01.007</identifier><identifier>PMID: 16490278</identifier><identifier>CODEN: JOHEEC</identifier><language>eng</language><publisher>Oxford: Elsevier B.V</publisher><subject>Adult ; Algorithms ; Aspartate Aminotransferases - blood ; Biological and medical sciences ; Biomarkers ; Biopsy ; Blood Platelets - enzymology ; Chronic hepatitis C ; Female ; Fibrosis - blood ; Fibrosis - diagnosis ; Fibrosis - etiology ; Fibrosis - pathology ; Gastroenterology. Liver. Pancreas. Abdomen ; Hepatitis C, Chronic - blood ; Hepatitis C, Chronic - complications ; Hepatitis C, Chronic - pathology ; Human viral diseases ; Humans ; Infectious diseases ; Liver - pathology ; Liver biopsy ; Liver fibrosis ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Medical sciences ; Middle Aged ; Non-invasive markers ; Other diseases. Semiology ; Predictive Value of Tests ; Sensitivity and Specificity ; Stepwise combination algorithms ; Viral diseases ; Viral hepatitis</subject><ispartof>Journal of hepatology, 2006-04, Vol.44 (4), p.686-693</ispartof><rights>2006 European Association for the Study of the Liver</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c494t-8e6e7408d4eda61334bf08495e3325c9bc6b140817f8a1649ecc7a251d88da2a3</citedby><cites>FETCH-LOGICAL-c494t-8e6e7408d4eda61334bf08495e3325c9bc6b140817f8a1649ecc7a251d88da2a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jhep.2006.01.007$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17709920$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16490278$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sebastiani, Giada</creatorcontrib><creatorcontrib>Vario, Alessandro</creatorcontrib><creatorcontrib>Guido, Maria</creatorcontrib><creatorcontrib>Noventa, Franco</creatorcontrib><creatorcontrib>Plebani, Mario</creatorcontrib><creatorcontrib>Pistis, Roberta</creatorcontrib><creatorcontrib>Ferrari, Alessia</creatorcontrib><creatorcontrib>Alberti, Alfredo</creatorcontrib><title>Stepwise combination algorithms of non-invasive markers to diagnose significant fibrosis in chronic hepatitis C</title><title>Journal of hepatology</title><addtitle>J Hepatol</addtitle><description>In chronic hepatitis C, biopsy is the gold standard for assessment of liver fibrosis. Non-invasive markers have been proposed but their use is limited by diagnostic accuracy. Our aim was to increase the diagnostic performance of non-invasive markers of liver fibrosis by combining them in sequential algorithms.
One hundred and ninety patients with chronic hepatitis C were evaluated for AST to platelets ratio (APRI), Forns' index and Fibrotest at the time of liver biopsy and stepwise combination algorithms were developed and validated prospectively in 100 additional patients.
Three algorithms were developed: (1) significant fibrosis (
F≥2 by METAVIR) was identified with high diagnostic performance (>94% accuracy) using APRI as screening test, followed by Fibrotest in APRI non-classified cases and restricting liver biopsy to patients classified F0–F1 by non-invasive tests. (2) A slightly modified algorithm had similar performance when applied to hepatitis C carriers with normal ALT. (3) Identification of cirrhosis (95% accuracy) was achieved using a dedicated algorithm with different cut-off, reducing by 60–70% the liver biopsies needed.
Stepwise combination of non-invasive markers of liver fibrosis improves the diagnostic performance in chronic hepatitis C. Need for liver biopsy is reduced by 50–70% but cannot be completely avoided.</description><subject>Adult</subject><subject>Algorithms</subject><subject>Aspartate Aminotransferases - blood</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Biopsy</subject><subject>Blood Platelets - enzymology</subject><subject>Chronic hepatitis C</subject><subject>Female</subject><subject>Fibrosis - blood</subject><subject>Fibrosis - diagnosis</subject><subject>Fibrosis - etiology</subject><subject>Fibrosis - pathology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hepatitis C, Chronic - blood</subject><subject>Hepatitis C, Chronic - complications</subject><subject>Hepatitis C, Chronic - pathology</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Liver - pathology</subject><subject>Liver biopsy</subject><subject>Liver fibrosis</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Non-invasive markers</subject><subject>Other diseases. Semiology</subject><subject>Predictive Value of Tests</subject><subject>Sensitivity and Specificity</subject><subject>Stepwise combination algorithms</subject><subject>Viral diseases</subject><subject>Viral hepatitis</subject><issn>0168-8278</issn><issn>1600-0641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEGP0zAQhS0EYrsLf4AD8gVuCePEjR2JC6pgQVqJA3C2HGfSTknsYrtF_HtcWmlvnEaa-d7Tm8fYKwG1ANG929f7HR7qBqCrQdQA6glbiQ6ggk6Kp2xVIF3pRukbdpvSHgBa6OVzdiM62UPZr1j4lvHwmxJyF5aBvM0UPLfzNkTKuyXxMHEffEX-ZBOdkC82_sSYeA58JLv1oUgTbT1N5KzPfKIhhkSJk-duF4Mnx0vK4pvLcvOCPZvsnPDldd6xH58-ft98rh6-3n_ZfHionOxlrjR2qCToUeJoO9G2cphAy36NbdusXT-4bhDlLtSk7fkbdE7ZZi1GrUfb2PaOvb34HmL4dcSUzULJ4Txbj-GYTKfUWvWgCthcQFdip4iTOUQqT_4xAsy5ZrM355rNuWYDwsA_0eur-3FYcHyUXHstwJsrYJOz8xStd5QeOaWg7xso3PsLh6WLE2E0yRF6hyNFdNmMgf6X4y-1lZ1E</recordid><startdate>20060401</startdate><enddate>20060401</enddate><creator>Sebastiani, Giada</creator><creator>Vario, Alessandro</creator><creator>Guido, Maria</creator><creator>Noventa, Franco</creator><creator>Plebani, Mario</creator><creator>Pistis, Roberta</creator><creator>Ferrari, Alessia</creator><creator>Alberti, Alfredo</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20060401</creationdate><title>Stepwise combination algorithms of non-invasive markers to diagnose significant fibrosis in chronic hepatitis C</title><author>Sebastiani, Giada ; Vario, Alessandro ; Guido, Maria ; Noventa, Franco ; Plebani, Mario ; Pistis, Roberta ; Ferrari, Alessia ; Alberti, Alfredo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c494t-8e6e7408d4eda61334bf08495e3325c9bc6b140817f8a1649ecc7a251d88da2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adult</topic><topic>Algorithms</topic><topic>Aspartate Aminotransferases - blood</topic><topic>Biological and medical sciences</topic><topic>Biomarkers</topic><topic>Biopsy</topic><topic>Blood Platelets - enzymology</topic><topic>Chronic hepatitis C</topic><topic>Female</topic><topic>Fibrosis - blood</topic><topic>Fibrosis - diagnosis</topic><topic>Fibrosis - etiology</topic><topic>Fibrosis - pathology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hepatitis C, Chronic - blood</topic><topic>Hepatitis C, Chronic - complications</topic><topic>Hepatitis C, Chronic - pathology</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Liver - pathology</topic><topic>Liver biopsy</topic><topic>Liver fibrosis</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Non-invasive markers</topic><topic>Other diseases. Semiology</topic><topic>Predictive Value of Tests</topic><topic>Sensitivity and Specificity</topic><topic>Stepwise combination algorithms</topic><topic>Viral diseases</topic><topic>Viral hepatitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sebastiani, Giada</creatorcontrib><creatorcontrib>Vario, Alessandro</creatorcontrib><creatorcontrib>Guido, Maria</creatorcontrib><creatorcontrib>Noventa, Franco</creatorcontrib><creatorcontrib>Plebani, Mario</creatorcontrib><creatorcontrib>Pistis, Roberta</creatorcontrib><creatorcontrib>Ferrari, Alessia</creatorcontrib><creatorcontrib>Alberti, Alfredo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sebastiani, Giada</au><au>Vario, Alessandro</au><au>Guido, Maria</au><au>Noventa, Franco</au><au>Plebani, Mario</au><au>Pistis, Roberta</au><au>Ferrari, Alessia</au><au>Alberti, Alfredo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stepwise combination algorithms of non-invasive markers to diagnose significant fibrosis in chronic hepatitis C</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2006-04-01</date><risdate>2006</risdate><volume>44</volume><issue>4</issue><spage>686</spage><epage>693</epage><pages>686-693</pages><issn>0168-8278</issn><eissn>1600-0641</eissn><coden>JOHEEC</coden><abstract>In chronic hepatitis C, biopsy is the gold standard for assessment of liver fibrosis. Non-invasive markers have been proposed but their use is limited by diagnostic accuracy. Our aim was to increase the diagnostic performance of non-invasive markers of liver fibrosis by combining them in sequential algorithms.
One hundred and ninety patients with chronic hepatitis C were evaluated for AST to platelets ratio (APRI), Forns' index and Fibrotest at the time of liver biopsy and stepwise combination algorithms were developed and validated prospectively in 100 additional patients.
Three algorithms were developed: (1) significant fibrosis (
F≥2 by METAVIR) was identified with high diagnostic performance (>94% accuracy) using APRI as screening test, followed by Fibrotest in APRI non-classified cases and restricting liver biopsy to patients classified F0–F1 by non-invasive tests. (2) A slightly modified algorithm had similar performance when applied to hepatitis C carriers with normal ALT. (3) Identification of cirrhosis (95% accuracy) was achieved using a dedicated algorithm with different cut-off, reducing by 60–70% the liver biopsies needed.
Stepwise combination of non-invasive markers of liver fibrosis improves the diagnostic performance in chronic hepatitis C. Need for liver biopsy is reduced by 50–70% but cannot be completely avoided.</abstract><cop>Oxford</cop><pub>Elsevier B.V</pub><pmid>16490278</pmid><doi>10.1016/j.jhep.2006.01.007</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0168-8278 |
| ispartof | Journal of hepatology, 2006-04, Vol.44 (4), p.686-693 |
| issn | 0168-8278 1600-0641 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_67757907 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Algorithms Aspartate Aminotransferases - blood Biological and medical sciences Biomarkers Biopsy Blood Platelets - enzymology Chronic hepatitis C Female Fibrosis - blood Fibrosis - diagnosis Fibrosis - etiology Fibrosis - pathology Gastroenterology. Liver. Pancreas. Abdomen Hepatitis C, Chronic - blood Hepatitis C, Chronic - complications Hepatitis C, Chronic - pathology Human viral diseases Humans Infectious diseases Liver - pathology Liver biopsy Liver fibrosis Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Medical sciences Middle Aged Non-invasive markers Other diseases. Semiology Predictive Value of Tests Sensitivity and Specificity Stepwise combination algorithms Viral diseases Viral hepatitis |
| title | Stepwise combination algorithms of non-invasive markers to diagnose significant fibrosis in chronic hepatitis C |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-22T06%3A26%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Stepwise%20combination%20algorithms%20of%20non-invasive%20markers%20to%20diagnose%20significant%20fibrosis%20in%20chronic%20hepatitis%20C&rft.jtitle=Journal%20of%20hepatology&rft.au=Sebastiani,%20Giada&rft.date=2006-04-01&rft.volume=44&rft.issue=4&rft.spage=686&rft.epage=693&rft.pages=686-693&rft.issn=0168-8278&rft.eissn=1600-0641&rft.coden=JOHEEC&rft_id=info:doi/10.1016/j.jhep.2006.01.007&rft_dat=%3Cproquest_cross%3E67757907%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=67757907&rft_id=info:pmid/16490278&rft_els_id=S0168827806000298&rfr_iscdi=true |