title: Non-invasive markers of liver fibrosis in chronic liver disease in a group of Mexican children. A multicenter study.
abstract: BACKGROUND
  Identifying liver fibrosis is important to evaluate the severity of liver damage and to establish a prognosis. Utility of non-invasive markers of liver fibrosis has been proved in adults but there are few reports in children. The aim of this study was to evaluate Fibrotest® score and APRI suitability to identify children with liver fibrosis.
  
  
  METHODS
  68 children with chronic liver disease requiring liver biopsy were prospectively included from three 3rd-level pediatric hospitals. The same pathologist evaluated all liver biopsies; fibrosis degree was determined by METAVIR score. Serum samples were obtained to determine Fibrotest® and APRI. AUROC were used to determine cut-off and differentiate between advanced fibrosis (METAVIR F3, F4) and no fibrosis (F0).
  
  
  RESULTS
  68 biopsies were evaluated; METAVIR > F3 was identified in 26 (38%). Non invasive liver fibrosis markers to differentiate between advanced and no fibrosis were: Fibrotest® AUROC = 0.90 (95% CI 0.77-1.00) (cut-off value 0.35) sensitivity 88.00% (95% CI 68-96) and specificity 80% (95% CI 29-98); and for APRI AUROC = 0.97 (95% CI 0.92-1.00) (cut-off value 0.82), sensitivity 88% (95% CI 68-96) and specificity = 100% (95% CI 46-100).
  
  
  CONCLUSIONS
  These results suggest the utility of Fibrotest® and APRI to identify advanced fibrosis; they can be recommended to select patients for liver biopsy and during patient follow-up.
authors.affiliation: Departamento de Gastroenterología y Anatomía Patológica, UMAE, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City, Mexico. judithflores1@hotmail.com
authors.forename: Judith
authors.initials: J
authors.lastname: Flores-Calderón
authors.forename: Segundo
authors.initials: S
authors.lastname: Morán-Villota
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ramón-García
authors.forename: Berenice
authors.initials: B
authors.lastname: González-Romano
authors.forename: María del Carmen
authors.initials: Mdel C
authors.lastname: Bojórquez-Ramos
authors.forename: Laura
authors.initials: L
authors.lastname: Cerdán-Silva
authors.forename: Pablo
authors.initials: P
authors.lastname: Hernández-Frías
mesh_terms: D000293:Adolescent; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003955:Diagnostic Tests, Routine; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology; D008107:Liver Diseases / Q000097:blood / Q000150:complications* / Q000208:ethnology; D008297:Male; D008800:Mexico; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases