title: A new scoring system for prediction of fibrosis in chronic hepatitis C.
abstract: BACKGROUND
  Liver biopsy (LB) is still considered to be the gold standard for assessment of liver fibrosis.
  
  
  OBJECTIVE
  To evaluate the effectiveness of various non-invasive methods for predicting liver fibrosis, including transient elastography (TE), APRI score, Lok score, Forns score, FIB-4 score, Fibrosis Index, King score, and Bonacini score, in comparison with the effectiveness of LB and to create a new scoring system for fibrosis prediction.
  
  
  METHODS
  This study included 212 patients with chronic HCV hepatitis. LB, TE, and various biological tests were performed during a single hospital visit. Using established formulae, data from these tests were used to create scores for assessment of liver fibrosis.
  
  
  RESULTS
  The results of all the tests showed significant correlation with histological fibrosis. TE results (r = 0.62), King score (r = 0.57), and APRI score (r = 0.56) showed the closest correlation with severity of fibrosis. The following formula was derived from our data by multiple regression: Predicted liver fibrosis score (PLF score) = 0.956 + 0.084 × TE - 0.004 × King score + 0.124 × Forns score + 0.202 × APRI score. A direct correlation (r = 0.68) was found between the PLF score and liver fibrosis. The cut-off values of the PLF score for various stages of fibrosis were: F ≥ 1, 1.77 (Area under ROC curve (AUROC) = 0.76); F ≥ 2, 2.18 (AUROC = 0.78); F ≥ 3, 2.47 (AUROC = 0.86); and F = 4, 2.98 (AUROC = 0.97).
  
  
  CONCLUSIONS
  We found that our newly developed PLF score, which is derived from the scores of multiple tests, is more strongly correlated with fibrosis than each component score used individually. The PLF score is more effective than TE for predicting severe fibrosis, but they have similar effectiveness in predicting liver cirrhosis.
authors.affiliation: Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Simona
authors.initials: S
authors.lastname: Bota
authors.forename: Roxana
authors.initials: R
authors.lastname: Sirli
authors.forename: Ioan
authors.initials: I
authors.lastname: Sporea
authors.forename: Mircea
authors.initials: M
authors.lastname: Focsa
authors.forename: Alina
authors.initials: A
authors.lastname: Popescu
authors.forename: Mirela
authors.initials: M
authors.lastname: Danila
authors.forename: Mihnea
authors.initials: M
authors.lastname: Strain
authors.forename: Madalina
authors.initials: M
authors.lastname: Sendroiu
authors.forename: Alexandra
authors.initials: A
authors.lastname: Deleanu
authors.forename: Isabel
authors.initials: I
authors.lastname: Dan
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