Fibrosis assessment using Fibro Meter combined to first generation tests in hepatitis C

作     者：Maria Chiara Chindamo Jerome Boursier Ronir Raggio Luiz Isabelle Fouchard-Hubert Vera Lúcia Nunes Pannain Joao Marcello de Araújo Neto Henrique Sérgio Moraes Coelho Renata de Mello Perez Paul Calès Cristiane Alves Villela-Nogueira 

作者机构：Departament of Internal MedicineFederal University of Rio de Janeiro Department of HepatologyUniversity Hospital HIFIH LaboratoryUPRES 3859SFR 4208Bretagne Loire University Institute of Public Health StudiesFederal University of Rio de Janeiro Departament of PathologyFederal University of Rio de Janeiro Gastroenterology DepartmentUniversity of the State of Rio de Janeiro D’Or Institute for Research and Education 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2017年第9卷第6期

页      面：310-317页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：Chronic hepatitis C Fibrosis Liver biopsy Non-invasive methods FibroMeter^Virus3G Combination algorithms 

摘      要：AIMTo evaluate the performance of FibroMeterVirus3G combined to the first generation tests aspartate aminotransferase-to-platelet ratio index (APRI) or Forns index to assess significant fibrosis in chronic hepatitis C (CHC). METHODSFirst generation tests APRI or Forns were initially applied in a derivation population from Rio de Janeiro in Brazil considering cut-offs previously reported in the literature to evaluate significant fibrosis. FibroMeterVirus3G was sequentially applied to unclassified cases from APRI or Forns. Accuracy of non-invasive combination of tests, APRI plus FibroMeterVirus3G and Forns plus FibroMeterVirus3G was evaluated in the Brazilian derivation population. APRI plus FibroMeterVirus3G combination was validated in a population of CHC patients from Angers in France. All patients were submitted to liver biopsy staged according to METAVIR score by experienced hepatopathologists. Significant fibrosis was considered as METAVIR F ≥ 2. The fibrosis stage classification was used as the reference for accuracy evaluation of non-invasive combination of tests. Blood samples for the calculation of serum tests were collected on the same day of biopsy procedure or within a maximum 3 mo interval and stored at -70 °C. RESULTSSeven hundred and sixty CHC patients were included (222 in the derivation population and 538 in the validation group). In the derivation population, the FibroMeterVirus3G AUROC was similar to APRI AUROC (0.855 vs 0.815, P = 0.06) but higher than Forns AUROC (0.769, P Virus3G cut-off to discriminate significant fibrosis was 0.61 (80% diagnostic accuracy; 75% in the validation population, P = 0.134). The sequential combination of APRI or Forns with FibroMeterVirus3G in derivation population presented similar performance compared to FibroMeterVirus3G used alone (79% vs 78% vs 80%, respectively, P = 0.791). Unclassified cases of significant fibrosis af