Skip to Main content Skip to Navigation
Journal articles

Improved fibrosis staging by elastometry and blood test in chronic hepatitis C

Abstract : AIMS: Our main objective was to improve non-invasive fibrosis staging accuracy by resolving the limits of previous methods via new test combinations. Our secondary objectives were to improve staging precision, by developing a detailed fibrosis classification, and reliability (personalized accuracy) determination. METHODS: All patients (729) included in the derivation population had chronic hepatitis C, liver biopsy, 6 blood tests and Fibroscan. Validation populations included 1584 patients. RESULTS: The most accurate combination was provided by using most markers of FibroMeter and Fibroscan results targeted for significant fibrosis, i.e. 'E-FibroMeter'. Its classification accuracy (91.7%) and precision (assessed by F difference with Metavir: 0.62 ± 0.57) were better than those of FibroMeter (84.1%, P < 0.001; 0.72 ± 0.57, P < 0.001), Fibroscan (88.2%, P = 0.011; 0.68 ± 0.57, P = 0.020), and a previous CSF-SF classification of FibroMeter + Fibroscan (86.7%, P < 0.001; 0.65 ± 0.57, P = 0.044). The accuracy for fibrosis absence (F0) was increased, e.g. from 16.0% with Fibroscan to 75.0% with E-FibroMeter (P < 0.001). Cirrhosis sensitivity was improved, e.g. E-FibroMeter: 92.7% vs. Fibroscan: 83.3%, P = 0.004. The combination improved reliability by deleting unreliable results (accuracy <50%) observed with a single test (1.2% of patients) and increasing optimal reliability (accuracy ≥85%) from 80.4% of patients with Fibroscan (accuracy: 90.9%) to 94.2% of patients with E-FibroMeter (accuracy: 92.9%), P < 0.001. The patient rate with 100% predictive values for cirrhosis by the best combination was twice (36.2%) that of the best single test (FibroMeter: 16.2%, P < 0.001). CONCLUSION: The new test combination increased: accuracy, globally and especially in patients without fibrosis, staging precision, cirrhosis prediction, and even reliability, thus offering improved fibrosis staging.
Document type :
Journal articles
Complete list of metadata

https://hal.univ-lorraine.fr/hal-01689789
Contributor : Ngere Ul <>
Submitted on : Monday, January 22, 2018 - 2:36:06 PM
Last modification on : Friday, November 6, 2020 - 4:00:08 AM

Links full text

Identifiers

Citation

Paul Calès, Jérôme Boursier, Alexandra Ducancelle, Frédéric Oberti, Isabelle Hubert, et al.. Improved fibrosis staging by elastometry and blood test in chronic hepatitis C. Liver International, Wiley-Blackwell, 2014, 34 (6), pp.907 - 917. ⟨10.1111/liv.12327⟩. ⟨hal-01689789⟩

Share

Metrics

Record views

251