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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The combination of a blood test and Fibroscan improves the non-invasive diagnosis of liver fibrosis
Liver International, Volume 29, No. 10, Year 2009
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Description
Background and aims: Blood tests and liver stiffness evaluation (LSE) by ultrasonographic elastometry are accurate tools for diagnosing liver fibrosis. We evaluated whether their synchronous combination in new scores could improve the diagnostic accuracy and reduce liver biopsy requirement in algorithm. Methods: Three hundred and ninety patients with chronic liver disease of miscellaneous causes were included. Five blood fibrosis tests were evaluated: APRI, FIB-4, Hepascore, Fibrotest and FibroMeter. The reference was fibrosis Metavir staging. Results: Diagnosis of significant fibrosis (Metavir F≥2). The most accurate synchronous combination was FibroMeter1LSE, which provided a significantly higher area under the receiver operating characteristic curve (0.892) than LSE alone (0.867, P = 0.011) or Fibrometer (0.834, P<10-3). An algorithm using the FibroMeter1LSE combination and then a liver biopsy in indeterminate cases had 91.9% diagnostic accuracy and required significantly fewer biopsies (20.2%) than previously published Bordeaux algorithm (28.6%, P = 0.02) or sequential algorithm for fibrosis evaluation (SAFE) (55.7%, P<10-3). The Angers algorithm performance was not significantly different between viral hepatitis and other causes. Diagnosis of cirrhosis. The most accurate synchronous combination was LSE1FibroMeter, which provided Z90% predictive values for cirrhosis in 90.6% of patients vs 87.4% for LSE (P = 0.02) and 57.9% for FibroMeter (P<10-3). An algorithm including the LSE1FibroMeter combination, and then a liver biopsy in indeterminate cases, had a significantly higher diagnostic accuracy than the SAFE algorithm (91.0 vs 79.8%, P<10-3), and required significantly fewer biopsies than the Bordeaux algorithm (9.3 vs 25.3%, P<10-3). Conclusion: The synchronous combination of a blood test plus LSE improves the accuracy of the non-invasive diagnosis of liver fibrosis and, consequently, markedly decreases the biopsy requirement in the diagnostic algorithm, notably to <10% in cirrhosis diagnosis. © 2009 John Wiley & Sons A/S.
Authors & Co-Authors
Boursier, Jérôme
France, Angers
Université D’angers
France, Angers
Chu Angers
Vergniol, Julien
France, Pessac
Hopital Haut-lévêque C.h.u de Bordeaux
France, Paris
Inserm
Sawadogo, Apollinaire
France, Angers
Université D’angers
France, Angers
Chu Angers
Dakka, Taoufiq
Morocco, Agdal Rabat
Ibn Sina Hospital, Agdal Rabat
Michalak, Sophie
France, Angers
Université D’angers
France, Angers
Chu Angers
Gallois, Yves
France, Angers
Université D’angers
France, Angers
Chu Angers
Le Tallec, Véronique
France, Angers
Chu Angers
Oberti, Frédèric
France, Angers
Université D’angers
France, Angers
Chu Angers
Fouchard-Hubert, Isabelle
France, Angers
Université D’angers
France, Angers
Chu Angers
Dib, Nina
France, Angers
Université D’angers
France, Angers
Chu Angers
Rousselet, Marie Christine
France, Angers
Université D’angers
France, Angers
Chu Angers
Konaté, Anselme
France, Angers
Université D’angers
France, Angers
Chu Angers
Amrani, Naïma
Morocco, Agdal Rabat
Ibn Sina Hospital, Agdal Rabat
de Ĺedinghen, Victor
France, Pessac
Hopital Haut-lévêque C.h.u de Bordeaux
France, Paris
Inserm
Calès, Paul
France, Angers
Université D’angers
France, Angers
Chu Angers
Statistics
Citations: 120
Authors: 15
Affiliations: 5
Identifiers
Doi:
10.1111/j.1478-3231.2009.02101.x
ISSN:
14783223
e-ISSN:
14783231
Research Areas
Infectious Diseases