Including osteoprotegerin and collagen IV in a score-based blood test for liver fibrosis increases diagnostic accuracy.
Clinica chimica acta; international journal of clinical chemistry
Bosselut N, Taibi L, Guéchot J, Zarski JP, Sturm N, Gelineau MC, Poggi B, Thoret S, Lasnier E, Baudin B, Housset C, Vaubourdolle M
2013 Clin. Chim. Acta Volume 415 Issue None
PubMed 23022619 DOI 10.1016/j.cca.2012.09.020
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.
CONCLUSION
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.
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