Comparison of ELF, FibroTest and FibroScan for the non-invasive assessment of liver fibrosis

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• 作者：Mireen Friedrich-Rust (1)
  William Rosenberg (2)
  Julie Parkes (3)
  Eva Herrmann (4)
  Stefan Zeuzem (1)
  Christoph Sarrazin (1)
  
• 刊名：BMC Gastroenterology
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：10
• 期：1
• 全文大小：478KB
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  35. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-230X/10/103/prepub
  
• 作者单位：Mireen Friedrich-Rust (1)
  William Rosenberg (2)
  Julie Parkes (3)
  Eva Herrmann (4)
  Stefan Zeuzem (1)
  Christoph Sarrazin (1)
  
  1. Department of Internal Medicine 1, J.W. Goethe-University Hospital, Frankfurt, Germany
  2. Centre for Hepatology, Division of Medicine, University College London, London, UK
  3. Department of Public Health and Medical Statistics, University of Southampton, Southampton, UK
  4. Faculty of Medicine, Institute of Biostatistics and Mathematical Modelling, J.W. Goethe-University, Frankfurt
  

文摘

Background FibroTest (FT) is the most frequently used serum fibrosis marker and consists of an algorithm of five fibrosis markers (alfa2-macroglobulin, apolipoproteinA1, haptoglobin, GGT, bilirubin). The Enhanced Liver Fibrosis (ELF) test consists of an algorithm of three fibrosis markers (hyaluronic acid, amino-terminal propeptide-of-type-III-collagen, tissue-inhibitor of matrix-metaloproteinase-1). While a systematic review has shown comparable results for both individual markers, there has been no direct comparison of both markers. Methods In the present study, the ELF-test was analyzed retrospectively in patients with chronic liver disease, who received a liver biopsy, transient elastography (TE) and the FibroTest using histology as the reference method. Histology was classified according to METAVIR and the Ludwig's classification (F0-F4) for patients with chronic hepatitis C and B virus (HCV, HBV) infection and primary biliary cirrhosis (PBC), respectively. Results Seventy-four patients were analysed: 36 with HCV, 10 with HBV, and 28 with PBC. The accuracy (AUROC) for the diagnosis of significant fibrosis (F?) for ELF and FibroTest was 0.78 (95%CI:0.67-0.89) and 0.69 (95%-CI:0.57-0.82), respectively (difference not statistically significant, n.s.). The AUROC for the diagnosis of liver cirrhosis was 0.92 (95%CI:0.83-1,00), and 0.91 (95%CI:0.83-0.99), respectively (n.s.). For 66 patients with reliable TE measurements the AUROC for the diagnosis of significant fibrosis (cirrhosis) for TE, ELF and FT were 0.80 (0.94), 0.76 (0.92), and 0.67 (0.91), respectively (n.s.). Conclusion FibroTest and ELF can be performed with comparable diagnostic accuracy for the non-invasive staging of liver fibrosis. Serum tests are informative in a higher proportion of patients than transient elastography.