Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference
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Citações na Scopus
72
Tipo de produção
article
Data de publicação
2016
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY-BLACKWELL
Autores
MUNTEANU, M.
TINIAKOS, D.
ANSTEE, Q.
CHARLOTTE, F.
MARCHESINI, G.
BUGIANESI, E.
TRAUNER, M.
GOMEZ, M. Romero
DAY, C.
Citação
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, v.44, n.8, p.877-889, 2016
Resumo
Background Blood tests of liver injury are less well validated in non-alcoholic fatty liver disease (NAFLD) than in patients with chronic viral hepatitis. Aims To improve the validation of three blood tests used in NAFLD patients, FibroTest for fibrosis staging, SteatoTest for steatosis grading and ActiTest for inflammation activity grading. Methods We pre-included new NAFLD patients with biopsy and blood tests from a single-centre cohort (FibroFrance) and from the multicentre FLIP consortium. Contemporaneous biopsies were blindly assessed using the new steatosis, activity and fibrosis (SAF) score, which provides a reliable and reproducible diagnosis and grading/staging of the three elementary features of NAFLD (steatosis, inflammatory activity) and fibrosis with reduced interobserver variability. We used nonbinary-ROC (NonBinAUROC) as the main endpoint to prevent spectrum effect and multiple testing. Results A total of 600 patients with reliable tests and biopsies were included. The mean NonBinAUROCs (95% CI) of tests were all significant (P < 0.0001): 0.878 (0.864-0.892) for FibroTest and fibrosis stages, 0.846 (0.830-0.862) for ActiTest and activity grades, and 0.822 (0.804-0.840) for SteatoTest and steatosis grades. FibroTest had a higher NonBinAUROC than BARD (0.836; 0.820-0.852; P = 0.0001), FIB4 (0.845; 0.829-0.861; P = 0.007) but not significantly different than the NAFLD score (0.866; 0.850-0.882; P = 0.26). FibroTest had a significant difference in median values between adjacent stage F2 and stage F1 contrarily to BARD, FIB4 and NAFLD scores (Bonferroni test P < 0.05). Conclusions In patients with NAFLD, SteatoTest, ActiTest and FibroTest are non-invasive tests that offer an alternative to biopsy, and they correlate with the simple grading/staging of the SAF scoring system across the three elementary features of NAFLD: steatosis, inflammatory activity and fibrosis.
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Referências
- Adams LA, 2011, J GASTROEN HEPATOL, V26, P1536, DOI 10.1111/j.1440-1746.2011.06774.x
- Bedossa P, 1996, HEPATOLOGY, V24, P289, DOI 10.1002/hep.510240201
- Bedossa P, 2012, HEPATOLOGY, V56, P1751, DOI 10.1002/hep.25889
- Bedossa P, 2014, HEPATOLOGY, V60, P565, DOI 10.1002/hep.27173
- Boursier J, 2015, J HEPATOL, V62, P807, DOI 10.1016/j.jhep.2014.10.042
- Boursier J, 2016, J HEPATOL, V65, P570, DOI 10.1016/j.jhep.2016.04.023
- Chao DT, 2014, ALIMENT PHARM THER, V39, P349, DOI 10.1111/apt.12590
- Chou R, 2013, ANN INTERN MED, V158, P807, DOI 10.7326/0003-4819-158-11-201306040-00005
- Ding H, 2015, J GASTROEN HEPATOL, V30, P553, DOI 10.1111/jgh.12789
- European Association for Study of Liver, 2015, J HEPATOL, V63, P237, DOI 10.1016/J.JHEP.2015.04.006
- Friedman S, 2016, CONTEMP CLIN TRIALS, V47, P356, DOI 10.1016/j.cct.2016.02.012
- Friedrich-Rust M, 2016, NAT REV GASTRO HEPAT, V13, P402, DOI 10.1038/nrgastro.2016.86
- Houot M, 2016, ALIMENT PHARM THER, V43, P16, DOI 10.1111/apt.13446
- Imbert-Bismut F, 2004, CLIN CHEM LAB MED, V42, P323, DOI 10.1515/CCLM.2004.058
- Kalsch J, 2015, SCI REP-UK, V5, DOI 10.1038/srep13058
- Kleiner DE, 2005, HEPATOLOGY, V41, P1313, DOI 10.1002/hep.20701
- Lambert J, 2008, CLIN CHEM, V54, P1372, DOI 10.1373/clinchem.2007.097923
- Lassailly G, 2011, EUR J GASTROEN HEPAT, V23, P499, DOI 10.1097/MEG.0b013e3283464111
- Naveau S, 2009, HEPATOLOGY, V49, P97, DOI 10.1002/hep.22576
- Nguyen P, 2007, J STAT SOFTW, V21, P1
- Perazzo H, 2014, ALIMENT PHARM THER, V40, P1081, DOI 10.1111/apt.12946
- Poynard T, 2004, COMP HEPATOL, V23, P3
- Poynard T, 2003, J HEPATOL, V38, P257, DOI 10.1016/S0168-8278(02)00413-0
- Poynard T, 2015, BMJ OPEN, V23
- Poynard T, 2010, GASTROEN CLIN BIOL, V34, P388, DOI 10.1016/j.gcb.2010.05.001
- Poynard T, 2007, ALIMENT PHARM THERAP, V25, P733, DOI 10.1111/j.1365-2036.2007.03252.x
- Poynard T, 1997, LANCET, V349, P825, DOI 10.1016/S0140-6736(96)07642-8
- Poynard T, 2010, BMC GASTROENTEROL, V10, DOI 10.1186/1471-230X-10-40
- Poynard T, 2014, J HEPATOL, V60, P706, DOI 10.1016/j.jhep.2013.11.016
- Poynard T, 2007, BMC GASTROENTEROL, V7, DOI 10.1186/1471-230X-7-40
- Poynard T, 2011, BMC GASTROENTEROL, V11, DOI 10.1186/1471-230X-11-39
- Poynard T, 2006, BMC GASTROENTEROL, V6, DOI 10.1186/1471-230X-6-34
- Poynard T, 2011, CLIN RES HEPATOL GAS, V35, P720, DOI 10.1016/j.clinre.2011.07.003
- Poynard T, 2014, J HEPATOL, V61, P994, DOI 10.1016/j.jhep.2014.06.027
- Poynard Thierry, 2005, Comp Hepatol, V4, P10, DOI 10.1186/1476-5926-4-10
- Poynard T, 2012, J HEPATOL, V57, P541, DOI 10.1016/j.jhep.2012.04.025
- Poynard T, 2007, CLIN CHEM, V53, P1615, DOI 10.1373/clinchem.2007.085795
- Poynard T, 2012, CLIN GASTROENTEROL H, V10, P657, DOI 10.1016/j.cgh.2012.01.023
- Poynard T, 2012, PLOS ONE, V7, DOI 10.1371/journal.pone.0030325
- Ratziu V, 2007, ALIMENT PHARM THERAP, V25, P207, DOI 10.1111/j.1365-2036.2006.03182.x
- Ratziu V, 2005, GASTROENTEROLOGY, V128, P1898, DOI 10.1053/j.gastro.2005.03.084
- Ratziu V, 2006, BMC GASTROENTEROL, V6, DOI 10.1186/1471-230X-6-6
- Ratziu V, 2011, J HEPATOL, V54, P1011, DOI 10.1016/j.jhep.2010.08.030
- Ratziu V, 2016, GASTROENTEROLOGY, V150, P1147, DOI 10.1053/j.gastro.2016.01.038
- Rousselet MC, 2005, HEPATOLOGY, V41, P257, DOI 10.1002/hep.20535
- Sebastiani G, 2011, ALIMENT PHARM THER, V34, P1202, DOI 10.1111/j.1365-2036.2011.04861.x