Diagnostic value of fibronectin discriminant score for predicting liver fibrosis stages in chronic hepatitis C virus patients

• Published in: Annals of hepatology Vol. 12; no. 1; pp. 44 - 53
• Main Authors: Attallah, Abdelfattah M, Abdallah, Sanaa O, Attallah, Ahmed A, Omran, Mohamed M, Farid, Khaled, Nasif, Wesam A, Shiha, Gamal E, Abdel-Aziz, Abdel-Aziz F, Rasafy, Nancy, Shaker, Yehia M
• Format: Journal Article
• Language: English
• Published: Mexico Elsevier 01.01.2013
• Subjects: Adult; Advanced liver fibrosis; Aspartate Aminotransferases - blood; Biomarkers; Biopsy, Large-Core Needle; Blood markers; Discriminant Analysis; Extracellular Matrix - metabolism; Extracellular Matrix - pathology; Female; Fibronectins - blood; Hepatitis C, Chronic - blood; Hepatitis C, Chronic - diagnostic imaging; Hepatitis C, Chronic - pathology; Humans; Liver - diagnostic imaging; Liver - pathology; Liver Cirrhosis - blood; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - pathology; Logistic Models; Male; Middle Aged; Noninvasive; Platelet Count; Predictive Value of Tests; Prospective Studies; Reproducibility of Results; ROC Curve; Serum Albumin - analysis; Severity of Illness Index; Significant liver fibrosis; Ultrasonography
• ISSN: 1665-2681
• DOI: 10.1016/s1665-2681(19)31384-5

Several noninvasive predictive models were developed to substitute liver biopsy for fibrosis assessment. To evaluate the diagnostic value of fibronectin which reflect extracellular matrix metabolism and standard liver functions tests which reflect alterations in hepatic functions. Chronic hepatitis C (CHC) patients (n = 145) were evaluated using ROC curves and stepwise multivariate discriminant analysis (MDA) and was validated in 180 additional patients. Liver biochemical profile including transaminases, bilirubin, alkaline phosphatase, albumin, complete blood count were estimated. Fibronectin concentration was determined using monoclonal antibody and ELISA. A novel index named fibronectin discriminant score (FDS) based on fibronectin, APRI and albumin was developed. FDS produced areas under ROC curves (AUC) of 0.91 for significant fibrosis and 0.81 for advanced fibrosis. The FDS correctly classified 79% of the significant liver fibrosis patients (F2-F4) with 87% sensitivity and 75% specificity. The relative risk [odds ratio (OR)] of having significant liver fibrosis using the cut-off values determined by ROC curve analyses were 6.1 for fibronectin, 4.9 for APRI, and 4.2 for albumin. FDS predicted liver fibrosis with an OR of 16.8 for significant fibrosis and 8.6 for advanced fibrosis. The FDS had similar AUC and OR in the validation group to the estimation group without statistically significant difference. FDS predicted liver fibrosis with high degree of accuracy, potentially decreasing the number of liver biopsy required.