title: Including osteoprotegerin and collagen IV in a score-based blood test for liver fibrosis increases diagnostic accuracy.
abstract: BACKGROUND
  Noninvasive methods for liver fibrosis evaluation in chronic liver diseases have been recently developed, i.e. transient elastography (Fibroscan™) and blood tests (Fibrometer®, Fibrotest®, and Hepascore®). In this study, we aimed to design a new score in chronic hepatitis C (CHC) by selecting blood markers in a large panel and we compared its diagnostic performance with those of other noninvasive methods.
  
  
  METHODS
  Sixteen blood tests were performed in 306 untreated CHC patients included in a multicenter prospective study (ANRS HC EP 23 Fibrostar) using METAVIR histological fibrosis stage as reference. The new score was constructed by non linear regression using the most accurate biomarkers.
  
  
  RESULTS
  Five markers (alpha-2-macroglobulin, apolipoprotein-A1, AST, collagen IV and osteoprotegerin) were included in the new function called Coopscore©. Using the Obuchowski Index, Coopscore© shows higher diagnostic performances than for Fibrometer®, Fibrotest®, Hepascore® and Fibroscan™ in CHC. Association between Fibroscan™ and Coopscore© might avoid 68% of liver biopsies for the diagnosis of significant fibrosis.
  
  
  CONCLUSIONS
  Coopscore© provides higher accuracy than other noninvasive methods for the diagnosis of liver fibrosis in CHC. The association of Coopscore© with Fibroscan™ increases its predictive value.
authors.affiliation: Laboratoire de Biochimie A, Hôpitaux Universitaires Paris-Est, site Saint-Antoine, AP-HP, F-75012, Paris, France. nelly.bosselut@pbr.aphp.fr
authors.forename: Nelly
authors.initials: N
authors.lastname: Bosselut
authors.forename: Ludmia
authors.initials: L
authors.lastname: Taibi
authors.forename: Jérôme
authors.initials: J
authors.lastname: Guéchot
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Zarski
authors.forename: Nathalie
authors.initials: N
authors.lastname: Sturm
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Gelineau
authors.forename: Bernard
authors.initials: B
authors.lastname: Poggi
authors.forename: Sophie
authors.initials: S
authors.lastname: Thoret
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Lasnier
authors.forename: Bruno
authors.initials: B
authors.lastname: Baudin
authors.forename: Chantal
authors.initials: C
authors.lastname: Housset
authors.forename: Michel
authors.initials: M
authors.lastname: Vaubourdolle
mesh_terms: D000328:Adult; D016632:Apolipoprotein A-I / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood; D024141:Collagen Type IV / Q000097:blood*; D005260:Female; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood*; D011446:Prospective Studies; D012107:Research Design; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D000511:alpha-Macroglobulins / Q000032:analysis
chemical_list: C578813:A2M protein, human; D016632:Apolipoprotein A-I; D015415:Biomarkers; D024141:Collagen Type IV; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human; D000511:alpha-Macroglobulins; D001219:Aspartate Aminotransferases