title: Comparison of surrogate serum markers and transient elastography (Fibroscan) for assessing cirrhosis in patients with chronic viral hepatitis.
abstract: BACKGROUND
  Progressive hepatic fibrosis with development of cirrhosis is a feature of almost all chronic liver diseases.
  
  
  OBJECTIVE
  We assessed the performance of Fibroscan in patients with chronic viral hepatitis, and in comparison with and combined with several surrogate serum markers for predicting cirrhosis.
  
  
  METHODS
  In this prospective multicenter cohort study, a novel panel of serum markers was constructed and serum levels of surrogate markers of liver fibrosis and Fibroscan were compared with the stage of fibrosis in the liver biopsy specimens obtained from 121 subjects with chronic viral hepatitis. Another 159 patients were enrolled to validate the diagnostic accuracy of this novel panel.
  
  
  RESULTS
  Multivariate analysis identified platelet count and procollagen III N-terminal peptide (PIIINP) as independent predictors of liver cirrhosis. The PP score (combining of platelet count and PIIINP) showed significantly better diagnostic accuracy (areas under the receiver operating characteristic curves, AUROC: 0.885) than that of previously reported serologic tests, including APRI, Forns fibrosis index, FIB-4 index and ELF algorithm, in the validation group (AUROC: 0.792, 0.740, 0.800, and 0.775, respectively). The AUROC of Fibroscan was 0.743 and the best performance was obtained by combining Fibroscan, platelet count and PIIINP, with an AUROC of 0.826. However, there was no significant difference among the AUROCs of Fibroscan alone, PP score, the combination of Fibroscan and PP score, and previously reported serologic tests in the estimation group.
  
  
  CONCLUSIONS
  Fibroscan and surrogate serum markers had similar accuracy for predicting cirrhosis, and combining Fibroscan and serum markers did not improve the accuracy.
authors.affiliation: Department of Gastroenterology, Ajou University School of Medicine, San-5 Wonchon-Dong, Youngtoung-Ku, Suwon 442-721, South Korea. yourfellow@hanmail.net
authors.forename: Myoung Hee
authors.initials: MH
authors.lastname: Lee
authors.forename: Jae Youn
authors.initials: JY
authors.lastname: Cheong
authors.forename: Soon Ho
authors.initials: SH
authors.lastname: Um
authors.forename: Yeon Seok
authors.initials: YS
authors.lastname: Seo
authors.forename: Dong Joon
authors.initials: DJ
authors.lastname: Kim
authors.forename: Seong Gyu
authors.initials: SG
authors.lastname: Hwang
authors.forename: Jin Mo
authors.initials: JM
authors.lastname: Yang
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Cho
mesh_terms: D000328:Adult; D019540:Area Under Curve; D002908:Chronic Disease; D054459:Elasticity Imaging Techniques; D005260:Female; D006521:Hepatitis, Chronic / Q000150:complications; D006525:Hepatitis, Viral, Human / Q000150:complications; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010446:Peptide Fragments / Q000097:blood*; D010976:Platelet Count; D011347:Procollagen / Q000097:blood*; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide