BACKGROUND & AIMS: There is increasing need to identify individuals with advanced liver fibrosis, who are at risk of complications such as hepatocellular carcinoma. The commercially available enhanced liver fibrosis (ELF) test provides a non-invasive assessment of fibrosis severity. This study was designed to determine the diagnostic accuracy of the manufacturer's cut-off value (≥9.8) in identifying advanced fibrosis. METHODS: The relationship between ELF score and fibrosis was examined using serum collected at time of liver biopsy for investigation of liver disease, particularly viral hepatitis. Fibrosis was staged using a modified METAVIR score. If available, liver tissue was recut and stained with Sirius red to determine collagen proportional area (CPA) and subsinusoidal fibrosis (SSF). RESULTS: Enhanced liver fibrosis score ≥9.8 had a sensitivity of 74.4% and specificity 92.4% for detecting advanced fibrosis. In the whole cohort (n = 329), ELF score was more likely to incorrectly classify individuals if age was ≥45 years and METAVIR inflammatory grade was 2 or 3 (adjusted OR, odds ratio 3.71 and 2.62 respectively). In contrast, ELF score was less likely to misclassify individuals in the presence of steatosis (OR 0.37). Neither SSF nor CPA explained the discordance in ELF score for patients with or without advanced fibrosis. CONCLUSION: Although ELF score ≥9.8 reliably identifies advanced fibrosis in patients with chronic liver disease, both age and inflammatory activity need to be considered when interpreting the result. Importantly, ELF score performed well in the presence of steatosis and could thus be helpful in the assessment of fatty liver disease.
BACKGROUND & AIMS: There is increasing need to identify individuals with advanced liver fibrosis, who are at risk of complications such as hepatocellular carcinoma. The commercially available enhanced liver fibrosis (ELF) test provides a non-invasive assessment of fibrosis severity. This study was designed to determine the diagnostic accuracy of the manufacturer's cut-off value (≥9.8) in identifying advanced fibrosis. METHODS: The relationship between ELF score and fibrosis was examined using serum collected at time of liver biopsy for investigation of liver disease, particularly viral hepatitis. Fibrosis was staged using a modified METAVIR score. If available, liver tissue was recut and stained with Sirius red to determine collagen proportional area (CPA) and subsinusoidal fibrosis (SSF). RESULTS: Enhanced liver fibrosis score ≥9.8 had a sensitivity of 74.4% and specificity 92.4% for detecting advanced fibrosis. In the whole cohort (n = 329), ELF score was more likely to incorrectly classify individuals if age was ≥45 years and METAVIR inflammatory grade was 2 or 3 (adjusted OR, odds ratio 3.71 and 2.62 respectively). In contrast, ELF score was less likely to misclassify individuals in the presence of steatosis (OR 0.37). Neither SSF nor CPA explained the discordance in ELF score for patients with or without advanced fibrosis. CONCLUSION: Although ELF score ≥9.8 reliably identifies advanced fibrosis in patients with chronic liver disease, both age and inflammatory activity need to be considered when interpreting the result. Importantly, ELF score performed well in the presence of steatosis and could thus be helpful in the assessment of fatty liver disease.
Authors: Thomas Ebert; Nicolas Linder; Alexander Schaudinn; Harald Busse; Joachim Berger; Ralf Lichtinghagen; Volker Keim; Johannes Wiegand; Thomas Karlas Journal: Endocrine Date: 2017-09-15 Impact factor: 3.633
Authors: Iria Cebreiros López; Florentina Guzmán Aroca; Maria Dolores Frutos Bernal; Juan Antonio Luján Mompeán; Águeda Bas Bernal; Antonio Miguel Hernández Martínez; Enrique Martínez Barba; Jose Antonio Noguera Velasco; Pascual Parilla Paricio Journal: Obes Surg Date: 2017-09 Impact factor: 4.129
Authors: Divya Ramnath; Katharine M Irvine; Samuel W Lukowski; Leigh U Horsfall; Zhixuan Loh; Andrew D Clouston; Preya J Patel; Kevin J Fagan; Abishek Iyer; Guy Lampe; Jennifer L Stow; Kate Schroder; David P Fairlie; Joseph E Powell; Elizabeth E Powell; Matthew J Sweet Journal: JCI Insight Date: 2018-07-26
Authors: Katharina Staufer; Emina Halilbasic; Walter Spindelboeck; Magdalena Eilenberg; Gerhard Prager; Vanessa Stadlbauer; Andreas Posch; Petra Munda; Rodrig Marculescu; Barbara Obermayer-Pietsch; Judith Stift; Carolin Lackner; Michael Trauner; Rudolf E Stauber Journal: United European Gastroenterol J Date: 2019-07-12 Impact factor: 4.623
Authors: Antje Blumenthal; Elizabeth E Powell; Katharine M Irvine; Andrew D Clouston; Victoria L Gadd; Gregory C Miller; Weng-Yew Wong; Michelle Melino; Muralidhara Rao Maradana; Kelli MacDonald; Richard A Lang; Matthew J Sweet Journal: Fibrogenesis Tissue Repair Date: 2015-10-15
Authors: Katharine M Irvine; Leesa F Wockner; Isabell Hoffmann; Leigh U Horsfall; Kevin J Fagan; Veonice Bijin; Bernett Lee; Andrew D Clouston; Guy Lampe; John E Connolly; Elizabeth E Powell Journal: PLoS One Date: 2016-11-18 Impact factor: 3.240
Authors: Thomas Karlas; Arne Dietrich; Veronica Peter; Christian Wittekind; Ralf Lichtinghagen; Nikita Garnov; Nicolas Linder; Alexander Schaudinn; Harald Busse; Christiane Prettin; Volker Keim; Michael Tröltzsch; Tatjana Schütz; Johannes Wiegand Journal: PLoS One Date: 2015-11-03 Impact factor: 3.240