期刊
CLINICAL BIOCHEMISTRY
卷 43, 期 16-17, 页码 1315-1322出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.clinbiochem.2010.08.010
关键词
Liver fibrosis; Liver biopsy; Diagnostic accuracy; Blood test; Fibroscan; Hepatitis C; Diagnosis; Bootstrap
资金
- French Department of Health, ANRS (French national agency for research on AIDS and Viral Hepatitis) [SNIFF 14, SNIFF 17]
Objectives: To optimize the performance and feasibility of fibrosis blood tests and evaluate their robustness. Design and methods: The derivation population included 1056 HCV patients with liver biopsy and blood markers. Validation populations included 984 patients with various viral hepatitis causes, and Fibroscan and/or liver biopsy and/or blood markers. Results: The bootstrap method validated the markers of the original FibroMeter(2G), but not those of Fibrotest and Hepascore, and provided a hyaluronate-free FibroMeter(3G). AUROCs for significant fibrosis were: FibroMeter(2G): 0.853 vs. FibroMeter(3G): 0.851, p = 0.489. Compared to FibroMeter(2G), FibroMeter(3G) had a significantly higher patient rate with predictive values >= 90% for significant fibrosis. Accuracy for fibrosis stage classification was: Fibrotest: 37.9%, FibroMeter(2G): 74.9%, and FibroMeter(3G): 86.9% (p<10(-3)). Conclusion: The bootstrap method validated FibroMeter(2G) and provided a cheaper and more feasible hyaluronate-free FibroMeter(3G) with comparable performance. Compared to binary diagnosis, fibrosis stage classification increased discrimination, with an increased accuracy to 87% for FibroMeter(3G). (C) 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
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