Comparison of surrogate serum markers and transient elastography (Fibroscan) for assessing cirrhosis in patients with chronic viral hepatitis

Myoung Hee Lee, Jae Youn Cheong, Soon-Ho Um, Yeon Seok Seo, Dong Joon Kim, Seong Gyu Hwang, Jin Mo Yang, Kwang Hyub Han, Sung Won Cho

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Progressive hepatic fibrosis with development of cirrhosis is a feature of almost all chronic liver diseases. Aims: We assessed the performance of Fibroscan in patients with chronic viral hepatitis, and in comparison with and combined with several surrogate serum markers for predicting cirrhosis. Methods: In this prospective multicenter cohort study, a novel panel of serum markers was constructed and serum levels of surrogate markers of liver fibrosis and Fibroscan were compared with the stage of fibrosis in the liver biopsy specimens obtained from 121 subjects with chronic viral hepatitis. Another 159 patients were enrolled to validate the diagnostic accuracy of this novel panel. Results: Multivariate analysis identified platelet count and procollagen III N-terminal peptide (PIIINP) as independent predictors of liver cirrhosis. The PP score (combining of platelet count and PIIINP) showed significantly better diagnostic accuracy (areas under the receiver operating characteristic curves, AUROC: 0.885) than that of previously reported serologic tests, including APRI, Forns fibrosis index, FIB-4 index and ELF algorithm, in the validation group (AUROC: 0.792, 0.740, 0.800, and 0.775, respectively). The AUROC of Fibroscan was 0.743 and the best performance was obtained by combining Fibroscan, platelet count and PIIINP, with an AUROC of 0.826. However, there was no significant difference among the AUROCs of Fibroscan alone, PP score, the combination of Fibroscan and PP score, and previously reported serologic tests in the estimation group. Conclusions: Fibroscan and surrogate serum markers had similar accuracy for predicting cirrhosis, and combining Fibroscan and serum markers did not improve the accuracy.

Original languageEnglish
Pages (from-to)3552-3560
Number of pages9
JournalDigestive Diseases and Sciences
Volume55
Issue number12
DOIs
Publication statusPublished - 2010 Dec 1

Fingerprint

Elasticity Imaging Techniques
Chronic Hepatitis
Fibrosis
Biomarkers
Procollagen
Platelet Count
Liver Cirrhosis
Serologic Tests
Peptides
ROC Curve
Multicenter Studies
Liver Diseases
Chronic Disease
Cohort Studies
Multivariate Analysis
Biopsy
Liver
Serum

Keywords

  • Cirrhosis
  • Elastography
  • PIIINP
  • Platelet
  • Serum markers

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

Comparison of surrogate serum markers and transient elastography (Fibroscan) for assessing cirrhosis in patients with chronic viral hepatitis. / Lee, Myoung Hee; Cheong, Jae Youn; Um, Soon-Ho; Seo, Yeon Seok; Kim, Dong Joon; Hwang, Seong Gyu; Yang, Jin Mo; Han, Kwang Hyub; Cho, Sung Won.

In: Digestive Diseases and Sciences, Vol. 55, No. 12, 01.12.2010, p. 3552-3560.

Research output: Contribution to journalArticle

Lee, Myoung Hee ; Cheong, Jae Youn ; Um, Soon-Ho ; Seo, Yeon Seok ; Kim, Dong Joon ; Hwang, Seong Gyu ; Yang, Jin Mo ; Han, Kwang Hyub ; Cho, Sung Won. / Comparison of surrogate serum markers and transient elastography (Fibroscan) for assessing cirrhosis in patients with chronic viral hepatitis. In: Digestive Diseases and Sciences. 2010 ; Vol. 55, No. 12. pp. 3552-3560.
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abstract = "Background: Progressive hepatic fibrosis with development of cirrhosis is a feature of almost all chronic liver diseases. Aims: We assessed the performance of Fibroscan in patients with chronic viral hepatitis, and in comparison with and combined with several surrogate serum markers for predicting cirrhosis. Methods: In this prospective multicenter cohort study, a novel panel of serum markers was constructed and serum levels of surrogate markers of liver fibrosis and Fibroscan were compared with the stage of fibrosis in the liver biopsy specimens obtained from 121 subjects with chronic viral hepatitis. Another 159 patients were enrolled to validate the diagnostic accuracy of this novel panel. Results: Multivariate analysis identified platelet count and procollagen III N-terminal peptide (PIIINP) as independent predictors of liver cirrhosis. The PP score (combining of platelet count and PIIINP) showed significantly better diagnostic accuracy (areas under the receiver operating characteristic curves, AUROC: 0.885) than that of previously reported serologic tests, including APRI, Forns fibrosis index, FIB-4 index and ELF algorithm, in the validation group (AUROC: 0.792, 0.740, 0.800, and 0.775, respectively). The AUROC of Fibroscan was 0.743 and the best performance was obtained by combining Fibroscan, platelet count and PIIINP, with an AUROC of 0.826. However, there was no significant difference among the AUROCs of Fibroscan alone, PP score, the combination of Fibroscan and PP score, and previously reported serologic tests in the estimation group. Conclusions: Fibroscan and surrogate serum markers had similar accuracy for predicting cirrhosis, and combining Fibroscan and serum markers did not improve the accuracy.",
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AU - Lee, Myoung Hee

AU - Cheong, Jae Youn

AU - Um, Soon-Ho

AU - Seo, Yeon Seok

AU - Kim, Dong Joon

AU - Hwang, Seong Gyu

AU - Yang, Jin Mo

AU - Han, Kwang Hyub

AU - Cho, Sung Won

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N2 - Background: Progressive hepatic fibrosis with development of cirrhosis is a feature of almost all chronic liver diseases. Aims: We assessed the performance of Fibroscan in patients with chronic viral hepatitis, and in comparison with and combined with several surrogate serum markers for predicting cirrhosis. Methods: In this prospective multicenter cohort study, a novel panel of serum markers was constructed and serum levels of surrogate markers of liver fibrosis and Fibroscan were compared with the stage of fibrosis in the liver biopsy specimens obtained from 121 subjects with chronic viral hepatitis. Another 159 patients were enrolled to validate the diagnostic accuracy of this novel panel. Results: Multivariate analysis identified platelet count and procollagen III N-terminal peptide (PIIINP) as independent predictors of liver cirrhosis. The PP score (combining of platelet count and PIIINP) showed significantly better diagnostic accuracy (areas under the receiver operating characteristic curves, AUROC: 0.885) than that of previously reported serologic tests, including APRI, Forns fibrosis index, FIB-4 index and ELF algorithm, in the validation group (AUROC: 0.792, 0.740, 0.800, and 0.775, respectively). The AUROC of Fibroscan was 0.743 and the best performance was obtained by combining Fibroscan, platelet count and PIIINP, with an AUROC of 0.826. However, there was no significant difference among the AUROCs of Fibroscan alone, PP score, the combination of Fibroscan and PP score, and previously reported serologic tests in the estimation group. Conclusions: Fibroscan and surrogate serum markers had similar accuracy for predicting cirrhosis, and combining Fibroscan and serum markers did not improve the accuracy.

AB - Background: Progressive hepatic fibrosis with development of cirrhosis is a feature of almost all chronic liver diseases. Aims: We assessed the performance of Fibroscan in patients with chronic viral hepatitis, and in comparison with and combined with several surrogate serum markers for predicting cirrhosis. Methods: In this prospective multicenter cohort study, a novel panel of serum markers was constructed and serum levels of surrogate markers of liver fibrosis and Fibroscan were compared with the stage of fibrosis in the liver biopsy specimens obtained from 121 subjects with chronic viral hepatitis. Another 159 patients were enrolled to validate the diagnostic accuracy of this novel panel. Results: Multivariate analysis identified platelet count and procollagen III N-terminal peptide (PIIINP) as independent predictors of liver cirrhosis. The PP score (combining of platelet count and PIIINP) showed significantly better diagnostic accuracy (areas under the receiver operating characteristic curves, AUROC: 0.885) than that of previously reported serologic tests, including APRI, Forns fibrosis index, FIB-4 index and ELF algorithm, in the validation group (AUROC: 0.792, 0.740, 0.800, and 0.775, respectively). The AUROC of Fibroscan was 0.743 and the best performance was obtained by combining Fibroscan, platelet count and PIIINP, with an AUROC of 0.826. However, there was no significant difference among the AUROCs of Fibroscan alone, PP score, the combination of Fibroscan and PP score, and previously reported serologic tests in the estimation group. Conclusions: Fibroscan and surrogate serum markers had similar accuracy for predicting cirrhosis, and combining Fibroscan and serum markers did not improve the accuracy.

KW - Cirrhosis

KW - Elastography

KW - PIIINP

KW - Platelet

KW - Serum markers

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