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

Comparison of ELF, FibroTest and FibroScan for the non-invasive assessment of liver fibrosis
Comparison of ELF, FibroTest and FibroScan for the non-invasive assessment of liver fibrosis
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?2) 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.
1-22
Friedrich-Rust, Mireen
b12e2adc-75fd-4319-807f-6e3c4ea951ac
Rosenberg, William
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Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Herrmann, Eva
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Zeuzem, Stefan
91c98bc6-9093-4c0e-993c-078803a484c5
Sarrazin, Christopher
c082d474-ead2-4c5c-b5a6-8548d32c516b
Friedrich-Rust, Mireen
b12e2adc-75fd-4319-807f-6e3c4ea951ac
Rosenberg, William
cea47565-06a3-4622-931c-aa5a7686865c
Parkes, Julie
59dc6de3-4018-415e-bb99-13552f97e984
Herrmann, Eva
bf9f6c1c-6e2a-4304-ab60-de17dc0f46e4
Zeuzem, Stefan
91c98bc6-9093-4c0e-993c-078803a484c5
Sarrazin, Christopher
c082d474-ead2-4c5c-b5a6-8548d32c516b

Friedrich-Rust, Mireen, Rosenberg, William, Parkes, Julie, Herrmann, Eva, Zeuzem, Stefan and Sarrazin, Christopher (2010) Comparison of ELF, FibroTest and FibroScan for the non-invasive assessment of liver fibrosis. BMC Gastroenterology, 10 (103), 1-22. (doi:10.1186/1471-230X-10-103).

Record type: Article

Abstract

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?2) 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.

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Published date: 9 September 2010

Identifiers

Local EPrints ID: 164115
URI: http://eprints.soton.ac.uk/id/eprint/164115
PURE UUID: 64697692-bc8d-4b6f-9b3a-467d67b58a53
ORCID for Julie Parkes: ORCID iD orcid.org/0000-0002-6490-395X

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Date deposited: 20 Sep 2010 12:42
Last modified: 08 Jan 2022 02:48

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Contributors

Author: Mireen Friedrich-Rust
Author: William Rosenberg
Author: Julie Parkes ORCID iD
Author: Eva Herrmann
Author: Stefan Zeuzem
Author: Christopher Sarrazin

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