title: Diagnostic value of fibronectin discriminant score for predicting liver fibrosis stages in chronic hepatitis C virus patients.
abstract: BACKGROUND
  Several noninvasive predictive models were developed to substitute liver biopsy for fibrosis assessment.
  
  
  OBJECTIVE
  To evaluate the diagnostic value of fibronectin which reflect extracellular matrix metabolism and standard liver functions tests which reflect alterations in hepatic functions.
  
  
  METHODS
  Chronic hepatitis C (CHC) patients (n = 145) were evaluated using ROC curves and stepwise multivariate discriminant analysis (MDA) and was validated in 180 additional patients. Liver biochemical profile including transaminases, bilirubin, alkaline phosphatase, albumin, complete blood count were estimated. Fibronectin concentration was determined using monoclonal antibody and ELISA.
  
  
  RESULTS
  A novel index named fibronectin discriminant score (FDS) based on fibronectin, APRI and albumin was developed. FDS produced areas under ROC curves (AUC) of 0.91 for significant fibrosis and 0.81 for advanced fibrosis. The FDS correctly classified 79% of the significant liver fibrosis patients (F2-F4) with 87% sensitivity and 75% specificity. The relative risk [odds ratio (OR)] of having significant liver fibrosis using the cut-off values determined by ROC curve analyses were 6.1 for fibronectin, 4.9 for APRI, and 4.2 for albumin. FDS predicted liver fibrosis with an OR of 16.8 for significant fibrosis and 8.6 for advanced fibrosis. The FDS had similar AUC and OR in the validation group to the estimation group without statistically significant difference.
  
  
  CONCLUSIONS
  FDS predicted liver fibrosis with high degree of accuracy, potentially decreasing the number of liver biopsy required.
authors.affiliation: Research Department, Biotechnology Research Center, New Damietta City, Egypt. amattallah@hotmail.com
authors.forename: Abdelfattah M
authors.initials: AM
authors.lastname: Attallah
authors.forename: Sanaa O
authors.initials: SO
authors.lastname: Abdallah
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Attallah
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Omran
authors.forename: Khaled
authors.initials: K
authors.lastname: Farid
authors.forename: Wesam A
authors.initials: WA
authors.lastname: Nasif
authors.forename: Gamal E
authors.initials: GE
authors.lastname: Shiha
authors.forename: Abdel-Aziz F
authors.initials: AA
authors.lastname: Abdel-Aziz
authors.forename: Nancy
authors.initials: N
authors.lastname: Rasafy
authors.forename: Yehia M
authors.initials: YM
authors.lastname: Shaker
mesh_terms: D000328:Adult; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers; D062005:Biopsy, Large-Core Needle; D016002:Discriminant Analysis; D005109:Extracellular Matrix / Q000378:metabolism / Q000473:pathology; D005260:Female; D005353:Fibronectins / Q000097:blood*; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D005353:Fibronectins; D012709:Serum Albumin; D001219:Aspartate Aminotransferases