Diagnostic and prognostic values of noninvasive biomarkers of fibrosis in patients with alcoholic liver disease

Authors

  • Sylvie Naveau,

    1. Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Antoine Béclère, Service d'Hépato-gastroenterologie, Clamart, France
    2. University Paris-Sud, Faculté de médecine Paris-Sud, Institut Fédératif de Recherche 13, Clamart, France
    3. INSERM, Unite 764, Clamart, France
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  • Guillaume Gaudé,

    1. Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Antoine Béclère, Service d'Hépato-gastroenterologie, Clamart, France
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  • Amani Asnacios,

    1. Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Antoine Béclère, Service d'Hépato-gastroenterologie, Clamart, France
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  • Hélène Agostini,

    1. AP-HP, Unité de recherche clinique Paris-Sud, Clamart, France
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  • Annie Abella,

    1. AP-HP, Hôpital Antoine Béclère, Service de biochimie, Clamart, France
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  • Nadège Barri-Ova,

    1. Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Antoine Béclère, Service d'Hépato-gastroenterologie, Clamart, France
    2. University Paris-Sud, Faculté de médecine Paris-Sud, Institut Fédératif de Recherche 13, Clamart, France
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  • Barbara Dauvois,

    1. Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Antoine Béclère, Service d'Hépato-gastroenterologie, Clamart, France
    2. University Paris-Sud, Faculté de médecine Paris-Sud, Institut Fédératif de Recherche 13, Clamart, France
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  • Sophie Prévot,

    1. AP-HP, Hôpital Antoine Béclère, Service d'Anatomie Pathologique, Clamart, France
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  • Yen Ngo,

    1. AP-HP Groupe Hospitalier Pitié-Salpêtrière, Service of Hepato-Gastroenterology, Paris, France
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  • Mona Munteanu,

    1. Biopredictive, Paris, France
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    • Mona Munteanu is a full-time employee of Biopredictive.

  • Axel Balian,

    1. Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Antoine Béclère, Service d'Hépato-gastroenterologie, Clamart, France
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  • Micheline Njiké-Nakseu,

    1. Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Antoine Béclère, Service d'Hépato-gastroenterologie, Clamart, France
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  • Gabriel Perlemuter,

    1. Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Antoine Béclère, Service d'Hépato-gastroenterologie, Clamart, France
    2. University Paris-Sud, Faculté de médecine Paris-Sud, Institut Fédératif de Recherche 13, Clamart, France
    3. INSERM, Unite 764, Clamart, France
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  • Thierry Poynard

    Corresponding author
    1. AP-HP Groupe Hospitalier Pitié-Salpêtrière, Service of Hepato-Gastroenterology, Paris, France
    • APHP Groupe Hospitalier Pitié-Salpêtrière, Service of Hepato-Gastroenterology, Groupe Hospitalier Pitie-Salpetriere, 47-83 Boulevard de l'Hopital, 75651 Paris Cedex 13, France
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    • fax: (33)14-2161427


  • Potential conflict of interest: Thierry Poynard is the inventor of the FibroTest with a capital interest in Biopredictive the company marketing FibroTest, the royalties belonging to the French public organization Assistance Publique Hôpitaux de Paris.

Abstract

FibroTest has been validated as a biomarker of fibrosis in patients with chronic viral hepatitis, with a similar prognostic value as biopsy. The aim of the study was to compare the diagnostic and prognostic values of FibroTest versus the recently patented biomarkers, FibrometerA, and Hepascore. A total of 218 consecutive patients with ALD and available liver biopsy examination were included. Biomarkers were compared using univariate area under the ROC curves (AUROC) and multivariate analysis (logistic regression and Cox). The median follow-up was 8.2 years. Eighty-five patients died, including 42 deaths related to liver complications. The diagnostic values of FibrometerA and Hepascore did not differ from that of FibroTest for advanced fibrosis (all AUROC = 0.83 ± 0.03) and cirrhosis (FibroTest and FibrometerA = 0.94 ± 0.02, Hepascore = 0.92 ± 0.02), and were significantly greater than those of nonpatented biomarkers (APRI, Forns, FIB4; P < 0.01). In multivariate analysis the most significant was FibroTest (P = 0.001), without independent diagnostic value for FibrometerA (P = 0.19), and Hepascore (P = 0.40). The prognostic values of FibroTest (AUROC for survival or non liver disease-related death = 0.79 ± 0.04), FibrometerA (0.80 ± 0.04), Hepascore (0.78 ± 0.04), did not differ from that of biopsy fibrosis staging (0.77 ± 0.04). In multivariate analysis the most significant were FibroTest (P = 0.004) and biopsy (P = 0.03), without independent prognostic values for FibrometerA (P = 0.41) and Hepascore (P = 0.28). In patients with alcoholic liver disease, FibrometerA and Hepascore did not improve the diagnostic and prognostic values of FibroTest. (HEPATOLOGY 2009;49:97-105.)

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