Poynard Thierry, Ngo Yen, Perazzo Hugo, Munteanu Mona, Lebray Pascal, Moussalli Joseph, Thabut Dominique, Benhamou Yves, Ratziu Vlad
Drs. Poynard, Perazzo, Lebray, Moussalli, Thabut, Benhamou, and Ratziu are affiliated with the Department of Hepato-Gastroenterology at the APHP UPMC Liver Center in Paris, France. Drs. Ngo and Munteanu are affiliated with Biopredictive in Paris, France.
Gastroenterol Hepatol (N Y). 2011 Jul;7(7):445-54.
Several serum biomarkers such as FibroTest, aspartate transaminase-platelet ratio index (APRI), FIB-4, and liver stiffness measurement by FibroScan have been validated as alternatives to biopsy for the diagnosis of fibrosis in patients with chronic liver disease. This paper aims to assess the 5-year prognostic values of these biomarkers. A meta-analysis combined all published prognostic studies. Baseline biopsy and APRI data were used as references.
Only 3 biomarkers had several prognostic validations: FibroTest (4 studies; 2,396 patients), APRI (5 studies; 2,422 patients), and FIB-4 (3 studies; 1,184 patients). For the prediction of survival without liver-related death, the areas under the receiver operating characteristic curves (AUROCs) were 0.86 for biopsy (95% confidence interval [CI], 0.77-0.95), 0.88 for FibroTest (95% CI, 0.79-0.98), 0.73 for FIB-4 (95% CI, 0.62-0.85), and 0.66 for APRI (95% CI, 0.57-0.75). APRI had a significantly lower prognostic value versus biopsy, with a mean difference between AUROCs of -0.21 (95% CI, -0.33 to -0.10; P<.001); FIB-4 had a significantly lower prognostic value versus biopsy, with a mean difference between AUROCs of -0.21 (95% CI, -0.20 to -0.02; P=.02). Only FibroTest did not show a significant difference in prognostic value versus biopsy, with a mean difference in AUROCs of +0.02 (95% CI, -0.05 to +0.09; P=.85).
FibroTest is a validated biomarker for the prognosis of patients with chronic liver disease.
几种血清生物标志物，如FibroTest、天冬氨酸转氨酶-血小板比率指数（APRI）、FIB-4以及通过FibroScan测量的肝脏硬度，已被证实可作为活检的替代方法，用于诊断慢性肝病患者的纤维化。本文旨在评估这些生物标志物的5年预后价值。进行了一项荟萃分析，纳入了所有已发表的预后研究。将基线活检和APRI数据用作参考。
只有3种生物标志物有多项预后验证：FibroTest（4项研究；2396例患者）、APRI（5项研究；2422例患者）和FIB-4（3项研究；1184例患者）。对于预测无肝相关死亡的生存率，活检的受试者工作特征曲线下面积（AUROC）为0.86（95%置信区间[CI]，0.77 - 0.95），FibroTest为0.88（95%CI，0.79 - 0.98），FIB-4为0.73（95%CI，0.62 - 0.85），APRI为0.66（95%CI，0.57 - 0.75）。与活检相比，APRI的预后价值显著较低，AUROC的平均差值为-0.21（95%CI，-0.33至-0.10；P <.001）；FIB-4与活检相比，预后价值显著较低，AUROC的平均差值为-0.21（95%CI，-0.20至-0.02；P = 0.02）。只有FibroTest与活检相比，预后价值未显示出显著差异，AUROC的平均差值为+0.02（95%CI，-0.05至+0.09；P = 0.85）。
FibroTest是一种经证实的用于慢性肝病患者预后评估的生物标志物。
