Challenges of liver cancer: Future emerging tools in imaging and urinary biomarkers

Table 1 Examples of serum markers for the assessment of fibrosis

Name	Constituents	Accuracy (%)
		Se	Sp	PPV	NPV
Indirect markers
APRI	AST, platelets	41	95	88	64
FibroTest	α2 macroglobulin, α2 and γ globulin, total bilirubin, apolipoprotein A1, γGT	87	59	63	85
Direct markers
ELF	PIIINP, HA, TIMP-1, (age)	90.5	41	99	92
FibroSpect	HA, TIMP-1, γ2 macroglobulin	77	73	74	76

APRI: Aspartate aminotransferase (AST) to platelet ratio index; γGT: γ-glutamyl transpeptidase; HA: Hyaluronic acid; PIIINP: Amino terminal of procollagenase III; TIMP-1: Tissue inhibitor of matrix metalloproteinase 1; ELF: Enhanced Liver Fibrosis test; Se: Sensitivity; Sp: Specificity; PPV: Positive predictive value; NPV: Negative predictive value.