当前位置： SCI文献检索 > EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY期刊下所有文献 > Improved diagnostic accuracy of blood tests for severe fibrosis and cirrhosis in chronic hepatitis C.

Improved diagnostic accuracy of blood tests for severe fibrosis and cirrhosis in chronic hepatitis C.

Abstract：

OBJECTIVE:Blood tests are usually designed to identify significant fibrosis. We evaluated their diagnostic accuracy, and how to increase it, for the clinically important targets of severe fibrosis and cirrhosis. METHODS:The accuracy for severe fibrosis or cirrhosis of four blood tests was evaluated based on Metavir staging in 1056 patients with chronic hepatitis C recruited in five independent hospitals. RESULTS:Using original scores, an original diagnostic target (significant fibrosis) and best diagnostic cutoff, the correct classification rates in severe fibrosis and cirrhosis stages were, respectively: FibroMeter: 90.1, 100%, Fibrotest: 78.2, 95.1%, Hepascore: 73.8, 94.9%, aspartate aminotransferase to platelet ratio index (APRI): 71.4, 88.0% (P<0.003, P=0.004, respectively, between tests). The corresponding area under the receiver operating characteristics were FibroMeter: 0.885, 0.907, Fibrotest: 0.837, 0.882, Hepascore: 0.834, 0.896, APRI: 0.822, 0.841 (P<0.003, respectively). Observed 100% negative predictive values for severe fibrosis and cirrhosis were, respectively, FibroMeter: 15.4, 47.5%, Fibrotest: 3.6, 31.9%, Hepascore: 0.3, 24.6%, APRI: 1.4, 5.3% of patients (P<0.003, respectively, between tests). By calculating a specific test for cirrhosis, including the FibroMeter markers, the correct classification (93.0%) was significantly higher for the cirrhosis diagnosis compared with the original FibroMeter (90.9%, P=0.005). This specific test provided a 100% positive predictive value for cirrhosis diagnosis versus 88% for original FibroMeter. CONCLUSION:Using the most accurate original test, cirrhosis can be excluded in 47.5% of patients and is correctly diagnosed, as significant fibrosis, in 100% of patients. A specific test for cirrhosis provides a significant gain in diagnostic accuracy to 93% and in positive predictive value to 100% compared with the original test.

journal_name

Eur J Gastroenterol Hepatol

journal_title

European journal of gastroenterology & hepatology

authors

Boursier J,Bacq Y,Halfon P,Leroy V,de Ledinghen V,de Muret A,Bourlière M,Sturm N,Foucher J,Oberti F,Rousselet MC,Calès P

doi

10.1097/MEG.0b013e32830cebd7

subject

Has Abstract

pub_date

2009-01-01 00:00:00

pages

28-38

issue

eissn

0954-691X

issn

1473-5687

pii

00042737-200901000-00004

journal_volume

pub_type

杂志文章,多中心研究,评审

在线工具

Improved diagnostic accuracy of blood tests for severe fibrosis and cirrhosis in chronic hepatitis C.