Noninvasive diagnosis of liver fibrosis and cirrhosis in chronic hepatitis C patients

J Clin Lab Anal. 2013 Mar;27(2):121-9. doi: 10.1002/jcla.21572. Epub 2013 Mar 4.

Abstract

Background: We aimed to derive a simple noninvasive test for liver-fibrosis staging and then estimate its performance against four simple noninvasive tests in chronic hepatitis C (CHC) patients.

Methods: CHC patients were divided into two cohorts: an estimation set (n = 324) and a validation set (n = 524). Liver fibrosis was staged according to the METAVIR scoring system. Statistical analysis was done using stepwise linear discriminant analysis and area under receiver-operating characteristic curves (AUCs).

Results: Biotechnology Research Center (BRC) score was constructed combining several blood markers that proved useful to stage liver fibrosis. Aspartate aminotransferase /alanine aminotransferase ratio (AAR), aspartate to platelet ratio index (APRI), Fibro-α, King, and BRC scores correlated with the histological fibrosis stages with correlation coefficient 0.26, 0.36, 0.58, 0.45, and 0.73, respectively. BRC score produced AUCs 0.87, 0.83, and 0.89 for significant (F2-F4), advanced fibrosis (F3-F4), and cirrhosis (F4), respectively. These results were reproduced in the validation study with no significant difference yielding AUCs 0.85 for F2-F4, 0.82 for F3-F4, and 0.88 for F4.

Conclusion: BRC score, a novel noninvasive test, is a useful and easy tool to evaluate liver fibrosis in CHC patients and seems more efficient than AAR, APRI, Fibro-α score, and King's score in this group of Egyptian patients.

MeSH terms

  • Adult
  • Analysis of Variance
  • Area Under Curve
  • Biomarkers / blood
  • Cohort Studies
  • Female
  • Hepatitis C, Chronic / blood*
  • Hepatitis C, Chronic / pathology*
  • Humans
  • Linear Models
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / virology*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • ROC Curve
  • Reproducibility of Results

Substances

  • Biomarkers