title: Diagnostic and prognostic values of noninvasive biomarkers of fibrosis in patients with alcoholic liver disease.
abstract: FibroTest has been validated as a biomarker of fibrosis in patients with chronic viral hepatitis, with a similar prognostic value as biopsy. The aim of the study was to compare the diagnostic and prognostic values of FibroTest versus the recently patented biomarkers, FibrometerA, and Hepascore. A total of 218 consecutive patients with ALD and available liver biopsy examination were included. Biomarkers were compared using univariate area under the ROC curves (AUROC) and multivariate analysis (logistic regression and Cox). The median follow-up was 8.2 years. Eighty-five patients died, including 42 deaths related to liver complications. The diagnostic values of FibrometerA and Hepascore did not differ from that of FibroTest for advanced fibrosis (all AUROC = 0.83 +/- 0.03) and cirrhosis (FibroTest and FibrometerA = 0.94 +/- 0.02, Hepascore = 0.92 +/- 0.02), and were significantly greater than those of nonpatented biomarkers (APRI, Forns, FIB4; P < 0.01). In multivariate analysis the most significant was FibroTest (P = 0.001), without independent diagnostic value for FibrometerA (P = 0.19), and Hepascore (P = 0.40). The prognostic values of FibroTest (AUROC for survival or non liver disease-related death = 0.79 +/- 0.04), FibrometerA (0.80 +/- 0.04), Hepascore (0.78 +/- 0.04), did not differ from that of biopsy fibrosis staging (0.77 +/- 0.04). In multivariate analysis the most significant were FibroTest (P = 0.004) and biopsy (P = 0.03), without independent prognostic values for FibrometerA (P = 0.41) and Hepascore (P = 0.28). In patients with alcoholic liver disease, FibrometerA and Hepascore did not improve the diagnostic and prognostic values of FibroTest.
authors.affiliation: Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Antoine Béclère, Service d'Hépato-gastroenterologie, Clamart, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Naveau
authors.forename: Guillaume
authors.initials: G
authors.lastname: Gaudé
authors.forename: Amani
authors.initials: A
authors.lastname: Asnacios
authors.forename: Hélène
authors.initials: H
authors.lastname: Agostini
authors.forename: Annie
authors.initials: A
authors.lastname: Abella
authors.forename: Nadège
authors.initials: N
authors.lastname: Barri-Ova
authors.forename: Barbara
authors.initials: B
authors.lastname: Dauvois
authors.forename: Sophie
authors.initials: S
authors.lastname: Prévot
authors.forename: Yen
authors.initials: Y
authors.lastname: Ngo
authors.forename: Mona
authors.initials: M
authors.lastname: Munteanu
authors.forename: Axel
authors.initials: A
authors.lastname: Balian
authors.forename: Micheline
authors.initials: M
authors.lastname: Njiké-Nakseu
authors.forename: Gabriel
authors.initials: G
authors.lastname: Perlemuter
authors.forename: Thierry
authors.initials: T
authors.lastname: Poynard
mesh_terms: D015415:Biomarkers / Q000032:analysis*; D001706:Biopsy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008099:Liver / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis* / Q000401:mortality; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D011933:Reagent Kits, Diagnostic; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D011933:Reagent Kits, Diagnostic