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| Diagnostic accuracy of enhanced liver fibrosis test to assess liver fibrosis in patients with chronic hepatitis C |
| Roberto Catanzaro, Michele Milazzo, Silvia Arona, Chiara Sapienza, Dario Vasta, Domenico Arcoria and Francesco Marotta |
Catania, Italy
Author Affiliations: Department of Medical and Pediatric Sciences, Institute of Internal Medicine "A. Francaviglia", Section of Gastro-enterology, University of Catania, "G. Rodolico" Hospital, Via S. Sofia, 78-95123-Catania, Italy (Catanzaro R, Milazzo M, Arona S and Sapienza C); Laboratory analysis "MedLab-Analisi Cliniche", Catania, Italy (Vasta D); Specialist in diabetes and metabolic diseases, Catania, Italy (Arcoria D); and ReGenera Research Group for Aging Intervention, Milano, Italy (Marotta F)
Corresponding Author: Professor Roberto Catanzaro, Department of Medical and Pediatric Sciences, Institute of Internal Medicine "A. Francaviglia", Section of Gastroenterology, University of Catania, "G. Rodolico" Hospital, Pad. 4, I Piano, Stanza 17, Via S. Sofia, 78-95123- Catania, Italy (Tel: 39-95-3782902; Fax: 39-95-3782376; Email: rcatanza@unict.it) |
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Abstract BACKGROUND: The prognosis and clinical management of patients with chronic liver diseases are closely related to the severity of liver fibrosis. Liver biopsy is considered the gold standard for the staging of liver fibrosis. However, it is an invasive test sometimes related to complications. This study aimed to assess the diagnostic value of enhanced liver fibrosis (ELF) test to predict liver fibrosis in patients with chronic hepatitis C.
METHODS: This study included 162 patients with liver disease and 67 healthy controls. Hyaluronic acid, tissue inhibitor of matrix metalloproteinase type 1, and amino-terminal propeptide type III procollagen were measured by enzyme-linked immunosorbent assay with the ELF test ADVIA Centaur® (Siemens Healthcare Diagnostics Inc.). Fibrosis stage was determined using the Metavir scoring system.
RESULTS: In our study, for the diagnosis of significant fibrosis (Metavir F≥2) a cut-off value >7.72 provides a sensitivity of 93.0% and a specificity of 83.0%. The areas under the receiver operator characteristic curve, sensitivity, specificity, and positive and negative predictive values were 0.94, 93.3%, 81.0%, 93.3%, and 81.0%, respectively (P<0.001). For the diagnosis of cirrhosis (Metavir F=4) a cut-off value >9.3 provides a sensitivity of 93.0% and a specificity of 86.0%. The areas under the receiver operator characteristic curve, sensitivity, specificity, and positive and negative predictive values were 0.94, 79.1%, 90.8%, 75.6%, and 92.3%, respectively (P<0.001).
CONCLUSIONS: The ELF test is a promising non-invasive method for assessing liver fibrosis in patients with chronic hepatitis C. It is effective in the diagnosis of both fibrosis and cirrhosis.
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2013, Vol. 12 
