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Prospective validation of FibroTest in comparison with liver stiffness for predicting liver fibrosis in Asian subjects with chronic hepatitis B

Authors
 Beom Kyung Kim  ;  Seung Up Kim  ;  Hyon Suk Kim  ;  Jun Yong Park  ;  Sang Hoon Ahn  ;  Chae Yoon Chon  ;  In Rae Cho  ;  Dong-Hoo Joh  ;  Young Nyun Park  ;  Kwang-Hyub Han  ;  Do Young Kim 
Citation
 PLoS One, Vol.7(4) : e35825, 2012 
Journal Title
 PLoS One 
ISSN
 1932-6203 
Issue Date
2012
Abstract
BACKGROUND AND AIMS: Diagnostic values of FibroTest (FT) for hepatic fibrosis have rarely been assessed in Asian chronic hepatitis B (CHB) patients. We aimed to validate its diagnostic performances in comparison with liver stiffness (LS). METHODS: From 2008 to 2010, 194 CHB patients who underwent liver biopsies along with FT and transient elastography were prospectively enrolled. Fibrosis stage was assessed according to the Batts and Ludwig system. RESULTS: To predict significant fibrosis (F≥2), advanced fibrosis (F≥3), and cirrhosis (F = 4), areas under receiver operating characteristic curves (AUROCs) of FT were 0.903, 0.907, and 0.866, comparable to those of LS (0.873, 0.897, and 0.910, respectively). Optimized cutoffs of FT to maximize sum of sensitivity and specificity were 0.32, 0.52, and 0.68 for F≥2, F≥3, and F = 4, while those of LS were 8.8, 10.2, and 14.1 kPa, respectively. According to FT and LS cutoffs, 123 (63.4%) and 124 (63.9%) patients were correctly classified consistent with histological fibrosis (F1, F2, F3, and F4), respectively. Overall concordance between each fibrosis stage estimated by FT and LS was observed in 111 patients, where 88 were correctly classified with histological results. A combination formula adding LS to FT (LS+FT) showed similar AUROC levels (0.885, 0.905, and 0.915), while another multiplying LS by FT (LS×FT) showed the best AUROCs (0.941, 0.931, and 0.929 for F≥2, F≥3, and F4, respectively). CONCLUSIONS: FT provides good fibrosis prediction, with comparable outcomes to LS in Asian CHB patients. FT substantially reduces need for liver biopsy, especially when used in combination with LS.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91687
DOI
10.1371/journal.pone.0035825
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
Yonsei Authors
김도영(Kim, Do Young) ; 김범경(Kim, Beom Kyung) ; 김승업(Kim, Seung Up) ; 김현숙(Kim, Hyon Suk) ; 박영년(Park, Young Nyun) ; 박준용(Park, Jun Yong) ; 안상훈(Ahn, Sang Hoon) ; 전재윤(Chon, Chae Yoon) ; 조동후(Joh, Dong Hoo) ; 조인래(Cho, In Rae) ; 한광협(Han, Kwang Hyup)
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