| Journal: | Annals of hepatology |
| Database: | PERIÓDICA |
| System number: | 000417638 |
| ISSN: | 1665-2681 |
| Authors: | Amorim, Thabata Glenda Fenili1 Staub, Guilherme Jonck1 Lazzarotto, Cesar1 Silva, Andre Pacheco1 Manes, Joice Manes1 Ferronato, Maria da Graca1 Shiozawa, Maria Beatriz Cacese2 Narciso-Schiavon, Janaína Luz1 Dantas-Correa, Esther Buzaglo1 Schiavon, Leonardo de Luca1 |
| Institutions: | 1Universidade Federal de Santa Catarina, Divisao de Gastroenterologia, Florianopolis, Santa Catarina. Brasil 2Universidade Federal de Santa Catarina, Departamento de Patologia, Florianopolis, Santa Catarina. Brasil |
| Year: | 2012 |
| Season: | Nov-Dic |
| Volumen: | 11 |
| Number: | 6 |
| Pages: | 855-861 |
| Country: | México |
| Language: | Inglés |
| Document type: | Estadística o encuesta |
| Approach: | Analítico |
| English abstract | Although it is standard procedure in the evaluation of liver diseases, biopsy is an invasive method subject to sampling error and intra or inter-observer variability. Thus, surrogate markers of liver fibrosis have been proposed, with variable availability and accuracy. Aim. Validate and compare the performance of APRI and FIB-4 as predictors of liver fibrosis in HCV patients. Material and methods. Crosssectional study including patients with HCV-RNA (+) who underwent liver biopsy. Significant fibrosis was defined as METAVIR stage ≥ 2. The diagnostic performance of the models in predicting significant fibrosis were evaluated and compared by ROC curves. Results. The study included 119 patients, mean age 43.7 ± 10.6 years and 62% males. Significant fibrosis was identified in 41 patients. The AUROCs observed were: APRI = 0.793 ± 0.047, FIB-4 = 0.811 ± 0.045 and AST/ALT = 0.661 ± 0.055 (P = 0.054 for APRI vs. AST/ALT, and P = 0.014 for FIB-4 vs. AST/ALT). Considering classic cutoffs, the PPV and NPV for APRI and FIB-4 were, respectively, 77% and 92% and 83% and 81%. Thirteen (19%) patients were misdiagnosed by APRI and 16 (18%) by FIB-4. By restricting the indication of liver biopsy to patients with intermediate values, it could have been correctly avoided in 47% and 63% of the patients with APRI and FIB-4, respectively. Conclusion. The models APRI and FIB-4 were superior to AST/ALT ratio in the diagnosis of significant fibrosis in chronic HCV infection. Even though the overall performance of APRI and FIB-4 was similar, a higher proportion of patients may be correctly classified by FIB-4 |
| Disciplines: | Medicina |
| Keyword: | Gastroenterología, Diagnóstico, Cirrosis hepática, Biomarcadores, Hepatitis C, Hepatitis crónica, Modelos predictivos, Variables, Laboratorio |
| Keyword: | Gastroenterology, Diagnosis, Liver cirrhosis, Biomarkers, Hepatitis C, Chronic hepatitis, Predictive models, Variables, Laboratory |
| Full text: | Texto completo (Ver HTML) |
