title: Egy-score predicts severe hepatic fibrosis and cirrhosis in Egyptians with chronic liver diseases: a pilot study.
abstract: BACKGROUND
  Non-invasive methods for assessment of hepatic fibrosis are increasingly needed. Recent studies showed that combined elevation of tumor markers CA 19-9 and CA 125 is predictive of severe hepatic fibrosis or cirrhosis with high specificity.
  
  
  OBJECTIVE
  We aimed at developing a new panel of surrogate biomarkers for prediction of the stage of hepatic fibrosis by combining tumor markers with other known biomarkers of hepatic fibrosis.
  
  
  METHODS
  A total of 92 patients with different types of chronic liver diseases (chronic hepatitis B, chronic hepatitis C and autoimmune hepatitis), were prospectively enrolled in our cohort. They were subjected to: ALT, AST, GGT, ALP, total bilirubin, INR, total cholesterol, albumin, platelet count, cancer antigen 19-9 (CA 19-9), cancer antigen 125 (CA 125), cancer antigen 15-3 (CA 15-3), haptoglobin, alpha-2-macroglobulin, apolipoprotein A1, abdominal ultrasound, liver biopsy and histological staging of hepatic fibrosis using the METAVIR system.
  
  
  RESULTS
  Combined elevation of CA 19-9 and CA 125 with a summated value > 37 U/mL is predictive of severe hepatic fibrosis or cirrhosis (stage F3-F4 METAVIR) with a probability of 77.6%. Multivariate analysis showed that the most relevant collection of biomarkers for prediction of stage of hepatic fibrosis is: CA 19-9, age, alpha-2- macroglobulin, total bilirubin, platelet count & albumin. We developed a new score, named the "Egy-Score", using a regression equation composed of this panel of biomarkers. Egy-Score could differentiate no or early fibrosis (stage F0-F2 METAVIR) from severe fibrosis or cirrhosis (stage F3-F4 METAVIR) with 83.7% accuracy.
  
  
  CONCLUSIONS
  Non-invasive assessment of hepatic fibrosis could be done using the Egy-Score. Egy-Score could differentiate no or early fibrosis (stage F0-F2 METAVIR) from severe fibrosis or cirrhosis (stage F3 - F4 METAVIR) with 83.7% accuracy.
authors.affiliation: Department of Internal Medicine, Al-Azhar University, Cairo, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Alboraie
authors.forename: Mahmoud E
authors.initials: ME
authors.lastname: Afifi
authors.forename: Fathy G
authors.initials: FG
authors.lastname: Elghamry
authors.forename: Helmy A
authors.initials: HA
authors.lastname: Shalaby
authors.forename: Gamal E
authors.initials: GE
authors.lastname: Elshennawy
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Abdelaziz
authors.forename: Mohamed U
authors.initials: MU
authors.lastname: Shaheen
authors.forename: Amany R
authors.initials: AR
authors.lastname: Abo El-Seoud
keywords: Alpha-Macroglobulins; Biological Markers; CA-19-9 Antigen; Fibrosis; Liver Cirrhosis
references.citation: Lancet. 2008 Mar 8;371(9615):838-51
references.pmid: 18328931
references.citation: Virol J. 2011 Feb 08;8:53
references.pmid: 21299910
references.citation: Lancet. 1997 Mar 22;349(9055):825-32
references.pmid: 9121257
references.citation: Am J Gastroenterol. 2011 Dec;106(12):2121-2
references.pmid: 22138940
references.citation: Fibrogenesis Tissue Repair. 2012 Jan 03;5(1):1
references.pmid: 22214245
references.citation: Hepatology. 1993 Nov;18(5):1224-31
references.pmid: 8225229
references.citation: Hepatol Int. 2011 Jun;5(2):625-34
references.pmid: 21484142
references.citation: J Clin Gastroenterol. 2010 Sep;44(8):575-82
references.pmid: 20104185
references.citation: Hepatology. 2003 Aug;38(2):518-26
references.pmid: 12883497
references.citation: Dig Liver Dis. 2011 Jun;43(6):491-7
references.pmid: 21439919
references.citation: J Hepatol. 2010 Dec;53(6):1013-21
references.pmid: 20850886
references.citation: Hepatology. 2004 Apr;39(4):1147-71
references.pmid: 15057920
references.citation: Clin Chem. 1991 Aug;37(8):1379-83
references.pmid: 1868598
references.citation: Dig Dis Sci. 2006 Feb;51(2):338-45
references.pmid: 16534678
references.citation: Gastroenterol Hepatol. 2012 Aug-Sep;35(7):488-95
references.pmid: 22560536
references.citation: Gastroenterology. 2004 Dec;127(6):1704-13
references.pmid: 15578508
references.citation: J Viral Hepat. 2011 Jan;18(1):23-31
references.pmid: 20196799
references.citation: J Hepatol. 1995 Jun;22(6):696-9
references.pmid: 7560864
references.citation: Clin Mol Hepatol. 2012 Jun;18(2):163-73
references.pmid: 22893866
references.citation: J Viral Hepat. 2009 May;16(5):300-14
references.pmid: 19254351
references.citation: Dig Dis Sci. 1994 Nov;39(11):2426-32
references.pmid: 7525168
references.citation: Gastroenterology. 2008 May;134(6):1670-81
references.pmid: 18471546
references.citation: Dig Dis Sci. 2013 Jan;58(1):265-74
references.pmid: 22790906
references.citation: J Hepatol. 2013 Jul;59(1):180-2
references.pmid: 23333447
references.citation: Eur J Surg Oncol. 2000 Aug;26(5):474-9
references.pmid: 11016469
references.citation: Int J Biol Markers. 2000 Jul-Sep;15(3):226-30
references.pmid: 11012098
references.citation: Gastroenterol Clin Biol. 2008 Sep;32(6 Suppl 1):40-51
references.pmid: 18973845
references.citation: BMC Gastroenterol. 2011 Aug 17;11:91
references.pmid: 21849046
references.citation: Hepatology. 2002 Oct;36(4 Pt 1):986-92
references.pmid: 12297848
references.citation: Hepatology. 2006 Oct;44(4):925-35
references.pmid: 17006909
references.citation: Liver Int. 2013 Aug;33(7):982-90
references.pmid: 23509874
references.citation: Gastroenterol Hepatol (N Y). 2008 Aug;4(8):539-41
references.pmid: 21960933
references.citation: Expert Rev Mol Diagn. 2004 Sep;4(5):593-7
references.pmid: 15347253
references.citation: Arab J Gastroenterol. 2011 Jun;12(2):74-9
references.pmid: 21684477
references.citation: Gastroenterology. 2008 Jul;135(1):32-40
references.pmid: 18471441
references.citation: Liver Int. 2013 May;33(5):698-705
references.pmid: 23432782
references.citation: Clin Chem. 2005 Oct;51(10):1867-73
references.pmid: 16055434