Diagnostic accuracy of enhanced liver fibrosis test to assess liver fibrosis in patients with chronic hepatitis C

摘要

BACKGROUND: The  prognosis  and  clinical  management  of patients  with  chronic  liver  diseases  are  closely  related  to  the severity  of  liver  fibrosis.  Liver  biopsy  is  considered  the  gold standard  for  the  staging  of  liver  fibrosis.  However,  it  is  an invasive  test  sometimes  related  to  complications.  This  study aimed to assess the diagnostic value of enhanced liver fibrosis (ELF)  test  to  predict  liver  fibrosis  in  patients  with  chronic hepatitis C. METHODS: This study included 162 patients with liver disease and  67  healthy  controls.  Hyaluronic  acid,  tissue  inhibitor of  matrix  metalloproteinase  type  1,  and  amino-terminal propeptide  type  III  procollagen  were  measured  by  enzyme-linked immunosorbent assay with the ELF test ADVIA Centaur ® (Siemens  Healthcare  Diagnostics  Inc.).  Fibrosis  stage  was determined using the Metavir scoring system. RESULTS: In our study, for the diagnosis of significant fibrosis (Metavir  F≥2)  a  cut-off  value  >7.72  provides  a  sensitivity  of 93.0% and a specificity of 83.0%. The areas under the receiver operator  characteristic  curve,  sensitivity,  specificity,  and positive and negative predictive values were 0.94, 93.3%, 81.0%, 93.3%,  and  81.0%,  respectively  (P<0.001).  For  the  diagnosis of  cirrhosis  (Metavir  F=4)  a  cut-off  value  >9.3  provides  a sensitivity of 93.0% and a specificity of 86.0%. The areas under the receiver operator characteristic curve, sensitivity, specificity, and  positive  and  negative  predictive  values  were  0.94,  79.1%, 90.8%, 75.6%, and 92.3%, respectively (P<0.001). CONCLUSIONS: The  ELF  test  is  a  promising  non-invasive method  for  assessing  liver  fibrosis  in  patients  with  chronic hepatitis C. It is effective in the diagnosis of both fibrosis and cirrhosis.