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Usefulness of Non-invasive Markers for Predicting Significant Fibrosis in Patients with Chronic Liver Disease
Authors:Han Hyo Lee   Yeon Seok Seo   Soon Ho Um   Nam Hee Won   Hanna Yoo   Eun Suk Jung   Yong Dae Kwon   Sanghoon Park   Bora Keum   Yong Sik Kim   Hyung Joon Yim   Yoon Tae Jeen   Hoon Jai Chun   Chang Duck Kim     Ho Sang Ryu
Affiliation:1Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.;2Department of Pathology, College of Medicine, Korea University, Seoul, Korea.;3Department of Statistics, Korea University, Seoul, Korea.
Abstract:The purpose of this prospective study was to verify and compare the strengths of various blood markers and fibrosis models in predicting significant liver fibrosis. One hundred fifty-eight patients with chronic liver disease who underwent liver biopsy were enrolled. The mean age was 41 yr and male patients accounted for 70.2%. The common causes of liver disease were hepatitis B (67.7%) and C (16.5%) and fatty liver (9.5%). Stages of liver fibrosis (F0-4) were assessed according to the Batts and Ludwig scoring system. Significant fibrosis was defined as ≥F2. Sixteen blood markers were measured along with liver biopsy, and estimates of hepatic fibrosis were calculated using various predictive models. Predictive accuracy was evaluated with a receiver-operating characteristics (ROC) curve. Liver biopsy revealed significant fibrosis in 106 cases (67.1%). On multivariate analysis, α2-macroglobulin, hyaluronic acid, and haptoglobin were found to be independently related to significant hepatic fibrosis. A new predictive model was constructed based on these variables, and its area under the ROC curve was 0.91 (95% confidence interval, 0.85-0.96). In conclusion, α2-macroglobulin, hyaluronic acid, and haptoglobin levels are independent predictors for significant hepatic fibrosis in chronic liver disease.
Keywords:Liver Cirrhosis   Biological Markers   Chronic Liver Disease
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