Utility of a discriminant score for diagnosing advanced fibrosis or cirrhosis in patients with chronic hepatitis C virus infection.
OBJECTIVE
The aim of the study was to assess the utility of a modified three-parameter cirrhosis discriminant score (CDS) for diagnosing advanced fibrosis or cirrhosis in patients with evidence of chronic hepatitis C.


METHODS
We examined liver tissue from 79 patients. Patients with a histological fibrosis score of 0-2 made up group A, and patients with a score of 3 or 4 (advanced fibrosis or cirrhosis) group B.


RESULTS
The modified CDS (possible total score 0-11) was derived from three laboratory parameters: platelets, ALT/AST ratio, and PT. The total score was significantly lower in group A (4.3 +/- 2.0) than in group B (7.9 +/- 1.4) (p < 0.0001). There was a positive correlation between the CDS and histological fibrosis score (r = 0.64,p < 0.0001). With 8 or above as the cutoff value, the CDS had a sensitivity of 46% and a specificity of 98% for the diagnosis of histological fibrosis scores of 3 or 4.


CONCLUSIONS
We conclude that a three-parameter CDS is useful for identifying patients with hepatitis C and a high likelihood of cirrhosis. Patients with a CDS < or =7 still require histological examination to identify advanced fibrosis or cirrhosis.
Bonacini
M
M
Department of Pathology, Rancho Los Amigos Medical Center, Downey, California, USA.
Hadi
G
G
Govindarajan
S
S
Lindsay
K L
KL
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001706:Biopsy; D006526:Hepatitis C / Q000097:blood / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D010976:Platelet Count
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase