title: Multiple approaches to assess fourteen non-invasive serum indexes for the diagnosis of liver fibrosis in chronic hepatitis C patients.
abstract: BACKGROUND
  The aim of this study was to compare fourteen non-invasive indexes/scores: AAR, APRI, Fibroindex, MODEL3, Forns index, FIB4, GUCI, FI, FCI, Pohl score, AP index, CDS, HGM-1 and HGM-2, in order to diagnose the hepatic fibrosis stage in a survey of patients with chronic hepatitis C.
  
  
  METHODS
  84 patients with chronic hepatitis C were studied. Liver fibrosis was staged according to the Scheuer scoring system. The diagnostic accuracy of these indexes/scores was evaluated by AUROC, contingency tables and logistic regression analysis.
  
  
  RESULTS
  The best AUROCs (>0.9) to discriminate cirrhosis (F=4), were observed for CDS, FI, AAR, MODEL3, FIB4, HGM-2 and FCI. To discriminate at least advance fibrosis (F≥3), the best AUROCs (>0.89) were for CDS, FI, FIB4, HGM2-2, MODEL3 and FCI. To discriminate at least significant fibrosis (F≥2), the best AUROCs (>0.8) were for FIB4, GUCI, APRI, FI, Forns index, HGM-2 and FCI. Contingency tables and logistic regression analysis supported the results obtained by AUROC.
  
  
  CONCLUSIONS
  This study compares the diagnostic performance of fourteen indexes for the diagnosis of liver fibrosis stage in the same group of CHC patients. These results allow the selection of the best indexes for further studies in larger populations, in order to build diagnostic algorithms as an alternative to liver biopsy for fibrosis staging in patients with chronic HCV infection. These algorithms would allow to take therapeutical decisions and the continuous follow-up of hepatic fibrosis in these patients.
authors.affiliation: Servicio de Bioquímica Clínica, HCU Lozano Blesa, Zaragoza, Spain.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Andrés-Otero
authors.affiliation: Dpto. Patología Animal, Universidad de Zaragoza, Zaragoza, Spain; Instituto Agroalimentario de Aragón, Zaragoza, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: De-Blas-Giral
authors.affiliation: Servicio de Bioquímica Clínica, HCU Lozano Blesa, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Puente-Lanzarote
authors.affiliation: Servicio de Digestivo, HCU Lozano Blesa, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
authors.forename: Trinidad
authors.initials: T
authors.lastname: Serrano-Aulló
authors.affiliation: Servicio Anatomía patológica, HCU Lozano Blesa, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Morandeira
authors.affiliation: Servicio de Digestivo, HCU Lozano Blesa, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Lorente
authors.affiliation: Dpto. Farmacología y Fisiología, Universidad de Zaragoza, Zaragoza, Spain; CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Spain; Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain; Instituto Agroalimentario de Aragón, Zaragoza, Spain. Electronic address: mlou@unizar.es.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Lou-Bonafonte
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers
keywords: Chronic hepatitis C; Fibrosis indexes; Fibrosis scores; Liver fibrosis