| A non-invasive algorithm accurately predicts advanced fibrosis in hepatitis C: a comparison using histology with internal-external validation. | |
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MedLine Citation:
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PMID: 18706734 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/AIMS: Biochemical tests and ultrasonography (US) are useful in the non-invasive assessment of liver fibrosis in patients with chronic hepatitis C (CH-C); however histology remains the reference standard. This multicenter, cross-sectional cohort study evaluated the accuracy of APRI (AST-to-platelet-ratio-index) and liver surface ultrasound nodularity (LSN), singularly and sequentially combined in an algorithm, in diagnosing advanced fibrosis (i.e. METAVIR F3,F4), to derive a prediction rule to confirm or exclude F3,F4. METHODS: Four hundred and thirty consecutive CH-C patients with elevated ALT, grouped into a first cohort (training set), and an internal and an external validation cohort, were studied. APRI and LSN were compared to liver biopsy and sequentially combined in order to obtain a predictive rule for advanced fibrosis METAVIR F3,F4. RESULTS: LSN was negative and APRI < or = 1 in 185/430 patients, whereas LSN was positive and APRI>2 in 46/430 cases, with a 94% diagnostic accuracy for presence/absence of F3, F4, respectively. In a further 60/430 patients, F3,F4 was detected with an accuracy of 83%. In the remaining cases no classification was possible. CONCLUSIONS: An algorithm based on APRI and LSN confirms or excludes F3,F4 in 54% of CH-C patients with elevated ALT and suggests a highly probable diagnosis in a further one-sixth of patients, thus rendering liver biopsy unnecessary in these patients. |
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Authors:
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Silvia Paggi; Agostino Colli; Mirella Fraquelli; Mauro Viganò; Paolo Del Poggio; Corinna Facciotto; Massimo Colombo; Guido Ronchi; Dario Conte |
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Publication Detail:
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Type: Comparative Study; Journal Article; Validation Studies Date: 2008-07-24 |
Journal Detail:
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Title: Journal of hepatology Volume: 49 ISSN: 0168-8278 ISO Abbreviation: J. Hepatol. Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-09-08 Completed Date: 2009-01-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8503886 Medline TA: J Hepatol Country: England |
Other Details:
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Languages: eng Pagination: 564-71 Citation Subset: IM |
Affiliation:
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Second Division of Gastroenterology, Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, University of Milan, Milan, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Algorithms* Aspartate Aminotransferases / blood Blood Platelets / pathology Cohort Studies Cross-Sectional Studies Disease Progression Female Hepatitis C / blood*, complications, ultrasonography* Humans Liver / pathology, ultrasonography Liver Cirrhosis / blood*, complications, ultrasonography* Male Middle Aged Predictive Value of Tests Sensitivity and Specificity Severity of Illness Index |
| Chemical | |
Reg. No./Substance:
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EC 2.6.1.1/Aspartate Aminotransferases |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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