G Shiha1,2, S Seif3, A Eldesoky3, M Elbasiony3, R Soliman4, A Metwally5, K Zalata6, N Mikhail4. 1. Gastrohepatology Unit, Internal Medicine Department, Faculty of Medicine, Specialized Medical Hospital, Mansoura University, Mansoura, Egypt. g_shiha@hotmail.com. 2. Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt. g_shiha@hotmail.com. 3. Gastrohepatology Unit, Internal Medicine Department, Faculty of Medicine, Specialized Medical Hospital, Mansoura University, Mansoura, Egypt. 4. Egyptian Liver Research Institute and Hospital (ELRIAH), Mansoura, Egypt. 5. Community Medicine Department, National Research Center, Cairo, Egypt. 6. Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Abstract
INTRODUCTION: A simple non-invasive score (Fibrofast, FIB-5) was developed using five routine laboratory tests (ALT, AST, alkaline phosphatase, albumin and platelets count) for the detection of significant hepatic fibrosis in patients with chronic hepatitis C. The FIB-4 index is a non-invasive test for the assessment of liver fibrosis, and a score of ≤1.45 enables the correct identification of patients who have non-significant (F0-1) from significant fibrosis (F2-4), and could avoid liver biopsy. The aim of this study was to compare the performance characteristics of FIB-5 and FIB-4 to differentiate between non-significant and significant fibrosis. METHOD: A cross-sectional study included 604 chronic HCV patients. All liver biopsies were scored using the METAVIR system. Both FIB-5 and FIB-4 scores were measured and the performance characteristics were calculated using the ROC curve. RESULTS: The performance characteristics of FIB-5 at ≥7.5 and FIB-4 at ≤1.45 for the differentiation between non-significant fibrosis and significant fibrosis were: specificity 94.4%, PPV 85.7%, and specificity 54.9%, PPV 55.7% respectively. CONCLUSION: FIB-5 score at the new cutoff is superior to FIB-4 index for the differentiation between non-significant and significant fibrosis.
INTRODUCTION: A simple non-invasive score (Fibrofast, FIB-5) was developed using five routine laboratory tests (ALT, AST, alkaline phosphatase, albumin and platelets count) for the detection of significant hepatic fibrosis in patients with chronic hepatitis C. The FIB-4 index is a non-invasive test for the assessment of liver fibrosis, and a score of ≤1.45 enables the correct identification of patients who have non-significant (F0-1) from significant fibrosis (F2-4), and could avoid liver biopsy. The aim of this study was to compare the performance characteristics of FIB-5 and FIB-4 to differentiate between non-significant and significant fibrosis. METHOD: A cross-sectional study included 604 chronic HCVpatients. All liver biopsies were scored using the METAVIR system. Both FIB-5 and FIB-4 scores were measured and the performance characteristics were calculated using the ROC curve. RESULTS: The performance characteristics of FIB-5 at ≥7.5 and FIB-4 at ≤1.45 for the differentiation between non-significant fibrosis and significant fibrosis were: specificity 94.4%, PPV 85.7%, and specificity 54.9%, PPV 55.7% respectively. CONCLUSION: FIB-5 score at the new cutoff is superior to FIB-4 index for the differentiation between non-significant and significant fibrosis.
Authors: Evangelos Cholongitas; Marco Senzolo; Richard Standish; Laura Marelli; Alberto Quaglia; David Patch; Amar P Dhillon; Andrew Kenneth Burroughs Journal: Am J Clin Pathol Date: 2006-05 Impact factor: 2.493