Non invasive prediction of severe fibrosis in patients with alcoholic liver disease.
OBJECTIVE
The aim of this study was to assess the diagnostic accuracy of noninvasive markers of liver fibrosis in alcoholic liver disease.


METHODS
Fifty-four clinical and biochemical parameters including serum fibrosis markers (hyaluronate and transforming growth factor beta1) were analyzed in 146 consecutive heavy drinkers (106 men, 40 women; mean age 49.2 years). Following liver biopsy, fibrosis was evaluated using a semi-quantitative scoring system (no fibrosis (0) to severe fibrosis (3 + )). Multivariate analysis was performed to determine the markers that were best correlated with the fibrosis score.


RESULTS
Fifty-nine patients (40.4 %) had severe fibrosis (3 +) while 87 (59.6 %) had no fibrosis or moderate fibrosis (0 to 2 +). In multivariate analysis, serum hyaluronate and the prothrombin index were the best markers for the prediction of severe fibrosis. Hyaluronate and the prothrombin index had a diagnostic accuracy of 91.1 % and 89.7 %, respectively in the whole population. Finally, a significant negative correlation was found between hyaluronate and the prothrombin index (r =- 0.86, P <0.0001).


CONCLUSIONS
Using only hyaluronate and the prothrombin index, 9 out of 10 alcoholic patients can be correctly classified according to the severity of liver fibrosis.
Tran
A
A
Service d'Hépato-Gastroentérologie, Hôpital de l'Archet 2, Nice.
Hastier
P
P
Barjoan
E M
EM
Demuth
N
N
Pradier
C
C
Saint-Paul
M C
MC
Guzman-Granier
E
E
Chevallier
P
P
Tran
C
C
Longo
F
F
Schneider
S
S
Piche
T
T
Hebuterne
X
X
Benzaken
S
S
Rampal
P
P
D000328:Adult; D016632:Apolipoprotein A-I / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D008099:Liver / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011516:Prothrombin / Q000032:analysis; D012372:ROC Curve; D016212:Transforming Growth Factor beta / Q000097:blood
D016632:Apolipoprotein A-I; D015415:Biomarkers; D016212:Transforming Growth Factor beta; D011516:Prothrombin; D006820:Hyaluronic Acid