Independent validation of the Enhanced Liver Fibrosis (ELF) score in the ANRS HC EP 23 Fibrostar cohort of patients with chronic hepatitis C
-
Jérôme Guéchot
,
Candice Trocmé
Abstract
Background : The Enhanced Liver Fibrosis (ELF) score combining serum hyaluronan, N-terminal peptide of type III procollagen and tissue inhibitor of metalloproteinase-1, was reported as relevant in predicting liver fibrosis in chronic liver disease and proposed as an alternative to liver biopsy.
Methods : We evaluated the ELF score in a cohort of chronic hepatitis C (CHC) patients included in a multicenter prospective study (ANRS HC EP 23 Fibrostar) using commercial reagents, different from those developed by the manufacturer of the Siemens ELF™ test.
Results : In 512 CHC, the ELF score, using ROC curves, showed good predictive performances for severe fibrosis [AUROC=0.82; 95% confidence interval (CI) 0.78–0.86]and for cirrhosis (AUROC=0.85; 95% CI 0.81–0.90), but slightly lower for significant fibrosis (AUROC=0.78; 95% CI 0.74–0.82). The Obuchowski measure (0.81) showed that the ELF score globally performed as a marker of liver fibrosis. The ELF score predicted significant fibrosis (cut-off=9.0) with a sensitivity of 0.86, a specificity of 0.62, a positive predictive value (PPV) of 0.80 and a negative predictive value (NPV) of 0.70. For extensive fibrosis (cut-off=9.33), sensitivity was 0.90, specificity was 0.63, PPV was 0.73 and NPV was 0.85. For cirrhosis (cut-off=9.35), sensitivity was 0.83, specificity was 0.75, PPV was 0.44 and NPV was 0.95.
Conclusions : This study confirms the ELF score performance as an index to predict liver fibrosis or cirrhosis in CHC. The ELF test, using validated reagents, could be added to the health authorities approved non-invasive tests in assessing fibrosis as surrogate to liver biopsy.
- a
The ANRS HC EP 23 Fibrostar Study Group
Sponsor:
French National Agency for Research on aids and viral hepatitis (ANRS), Paris.
Scientific Committee:
Coordinators: J.-P. Zarski, Grenoble; M. Vaubourdolle, Paris;
Hepatologists: J.-P. Bronowicki, Lille; P. Calès, Angers; A. Mallat, Créteil; P. Mathurin, Lille;
Pathologists: N. Sturm, Grenoble; E.S. Zafrani, Créteil;
Biologists: B. Poggi, Lyon; J. Guéchot, Paris; Methodologists and administrators: J.L. Bosson; A. Paris; ANRS: L. Allain, Paris.
Methodologists and administrators:
A. Bechet, J.-L. Bosson, A. Paris, A. Plages, S. Royannais, Centre Hospitalier Universitaire de Grenoble
Biologists:
R.-C. Boisson, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon
M.-C. Gelineau, B. Poggi, Hôtel Dieu, Hospices Civils de Lyon
J.-C. Renversez, C. Trocmé, Centre Hospitalier Universitaire de Grenoble
J. Guéchot, E. Lasnier, M. Vaubourdolle, Hôpital Saint-Antoine, AP-HP, Paris
H. Voitot, Hôpital Beaujon, AP-HP, Paris
A. Vassault, Hôpital Necker, AP-HP, Paris
A. Rosenthal-Allieri, Centre Hospitalier Universitaire de Nice
A. Lavoinne, F. Ziegler, Centre Hospitalier Universitaire de Rouen
M. Bartoli, C. Dorche, C. Lebrun, Centre Hospitalier de Chambéry
A. Myara, Growwupe Hospitalier Paris Saint-Joseph, Paris
F. Guerber, A. Pottier, Laboratoire Elibio-Groupe Oriade, Vizille, La Mure
Hepatologists:
V. Leroy, J.-P. Zarski, Centre Hospitalier Universitaire de Grenoble A. Poujol-Robert, R. Poupon, Hôpital Saint-Antoine, AP-HP, Paris A. Abergel, Centre Hospitalier Universitaire de Clermont-Ferrand J.P. Bronowicki, H ô pital de Brabois, Centre Hospitalier Universitaire de Nancy
S. Metivier, J.P. Vinel, Hôpital Purpan, Centre Hospitalier Universitaire de Toulouse
V. De Ledinghen, Hôpital Haut Levêque, Centre Hospitalier Universitaire de Bordeaux
O. Goria, Centre Hospitalier Universitaire de Rouen
M. Maynard-Muet, C. Trepo, Hôtel Dieu, Hospices Civils de Lyon Ph. Mathurin, Centre Hospitalier Universitaire de Lille
H. Danielou, D. Guyader, Hôpital Pontchaillou, Centre Hospitalier Universitaire de Rennes
O. Rogeaux, Centre Hospitalier de Chambéry
S. Pol, Ph. Sogni, Hôpital Cochin, AP-HP, Paris
A. Tran, Hôpital De l’Archet, Centre Hospitalier Universitaire de Nice
P. Calès, Centre Hospitalier Universitaire d’Angers
T. Asselah, P. Marcellin, Hôpital Beaujon, AP-HP, Clichy
M. Bourlière, V. Oulès, Hôpital Saint Joseph, Assistance Publique- Hôpitaux de Marseille
D. Larrey, Centre Hospitalier Universitaire de Montpellier
F. Habersetzer, Centre Hospitalier Universitaire de Strasbourg
M. Beaugrand, Hôpital Jean Verdier, AP-HP, Bondy
Pathologists:
N. Sturm, Centre Hospitalier Universitaire de Grenoble E.-S. Zafrani, Hôpital Henri Mondor, AP-HP, Créteil
©2012 by Walter de Gruyter Berlin Boston
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Articles in the same Issue
- A sensitive quantitative test strip based point-of-care albuminuria screening assay
- Editorials
- Serum biomarkers for the non-invasive diagnosis of liver fibrosis: the importance of being validated
- Primary blood tubes mixing: time for updated recommendations
- Reviews
- 10.1515/cclm-2011-0847
- The hCG assay or pregnancy test
- Mini Reviews
- The role of mean platelet volume in predicting thrombotic events
- The role of red blood cell distribution width in cardiovascular and thrombotic disorders
- Genetics and Molecular Diagnostics
- Comparison of different collection procedures and two methods for DNA isolation from saliva
- Detection of α-globin gene deletion and duplication using quantitative multiplex PCR of short fluorescent fragments
- High-throughput detection, genotyping and quantification of the human papillomavirus using real-time PCR
- General Clinical Chemistry and Laboratory Medicine
- Quantification of human serum insulin concentrations in clinical pharmacokinetic or bioequivalence studies: what defines the “best method”?
- Serum cystatin C is an early biomarker for assessment of renal function in burn patients
- 10.1515/cclm.2011.0849
- Mid-stream vs. first-voided urine collection by using automated analyzers for particle examination in healthy subjects: an Italian multicenter study
- Percentage of hypochromic erythrocytes as a potential marker of iron availability
- Laboratory evaluation of a flow cytometric BCR-ABL immunobead assay
- Validation and Outcome Studies
- Independent validation of the Enhanced Liver Fibrosis (ELF) score in the ANRS HC EP 23 Fibrostar cohort of patients with chronic hepatitis C
- Cancer Diagnostics
- Demasking of epithelial cell adhesion molecule (EpCAM) on circulating epithelial tumor cells by Tween®20 treatment in breast cancer patients
- Anti-thyroid peroxidase antibodies are associated with the absence of distant metastases in patients with newly diagnosed breast cancer
- Blood presence of circulating oncofetal fibronectin mRNA, by RT-PCR, does not represent a useful specific marker for the management and follow-up of thyroid cancer patients
- Serum mesothelin and megakaryocyte potentiating factor in pancreatic and biliary cancers
- Cardiovascular Diseases
- The performance of high sensitivity troponin for the diagnosis of acute myocardial infarction is underestimated
- The prognostic value of N-terminal pro-brain natriuretic peptide in non-ST elevation acute coronary syndromes: a meta-analysis
- Measurement of high-molecular-weight adiponectin is not useful in assessing coronary stenosis
- Letters to the Editor
- Serum concentration of neopterin on admission does not improve the diagnostic performance of highly-sensitive troponin I
- Evaluation of the interference by homogentisic acid and other organic acids on the enzymatic and Jaffé method creatinine assay
- A comparative analysis of the Iris iQ200 with manual microscopy as a diagnostic tool for dysmorphic erythrocytes in urine
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- Congress Abstracts
- ISMD2012: Ninth International Symposium on Molecular Diagnostics
- ArabMedLab Marrakech 2012
- Masthead
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