title: A novel panel of blood markers to assess the degree of liver fibrosis.
abstract: The objective was to develop new blood tests to characterize different fibrosis parameters in viral and alcoholic chronic liver diseases. Measurements included 51 blood markers and Fibrotest, Fibrospect, ELFG, APRI, and Forns scores. The clinically significant fibrosis was evaluated via Metavir staging (F2-F4), and image analysis was used to determine the area of fibrosis. In an exploratory step in 383 patients with viral hepatitis, the area under the receiving operator characteristic (AUROC) curve for stages F2-F4 in a test termed the "Fibrometer" test combining platelets, prothrombin index, aspartate aminotransferase, alpha2-macroglobulin (A2M), hyaluronate, urea, and age was 0.883 compared with 0.808 for the Fibrotest (P = .01), 0.820 for the Forns test (P = .005), and 0.794 for the APRI test (P < 10(-4)). The Fibrometer AUROC curve was 0.892 in the validating step in 120 patients. The AUROC curve for stages F2-F4 in a test combining prothrombin index, A2M, hyaluronate, and age was 0.962 in 95 patients with alcoholic liver diseases. The area of fibrosis was estimated in viral hepatitis by testing for hyaluronate, gamma-glutamyltransferase, bilirubin, platelets, and apolipoprotein A1 ((a)R(2) = 0.645), and in alcoholic liver diseases by testing for hyaluronate, prothrombin index, A2M, and platelets ((a)R(2) = 0.836). In conclusion, the pathological staging and area of liver fibrosis can be estimated using different combinations of blood markers in viral and alcoholic liver diseases. Whereas the Fibrometer has a high diagnostic accuracy for clinically significant fibrosis, blood tests for the area of liver fibrosis provide a quantitative estimation of the amount of fibrosis, which is especially useful in cirrhosis.
authors.affiliation: Laboratoire HIFIH, UPRES 3859, IFR 132, Université, Angers, France. paul.cales@univ-angers.fr
authors.forename: Paul
authors.initials: P
authors.lastname: Calès
authors.forename: Frédéric
authors.initials: F
authors.lastname: Oberti
authors.forename: Sophie
authors.initials: S
authors.lastname: Michalak
authors.forename: Isabelle
authors.initials: I
authors.lastname: Hubert-Fouchard
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Rousselet
authors.forename: Anselme
authors.initials: A
authors.lastname: Konaté
authors.forename: Yves
authors.initials: Y
authors.lastname: Gallois
authors.forename: Catherine
authors.initials: C
authors.lastname: Ternisien
authors.forename: Alain
authors.initials: A
authors.lastname: Chevailler
authors.forename: Françoise
authors.initials: F
authors.lastname: Lunel
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase