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A new index for non-invasive assessment of liver fibrosis
Naohiro Ichino, Keisuke Osakabe, Toru Nishikawa, Hiroko Sugiyama, Miho Kato, Shiho Kitahara, Senju Hashimoto, Naoto Kawabe, Masao Harata, Yoshifumi Nitta, Michihito Murao, Takuji Nakano, Yuko Arima, Hiroaki Shimazaki, Koji Suzuki, Kentaro Yoshioka
Naohiro Ichino, Keisuke Osakabe, Koji Suzuki, Faculty of Medical Technology, School of Health Sciences, Fujita Health University, Toyoake, Aichi 470-1192, Japan
Toru Nishikawa, Hiroko Sugiyama, Miho Kato, Shiho Kitahara, Department of Clinical Laboratory, Fujita Health University Hospital, Toyoake, Aichi 470-1192, Japan
Senju Hashimoto, Naoto Kawabe, Masao Harata, Yoshifumi Nitta, Michihito Murao, Takuji Nakano, Yuko Arima, Hiroaki Shimazaki, Kentaro Yoshioka, Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University, Toyoake, Aichi 470-1192, Japan
Author contributions: Ichino N, Osakabe K and Yoshioka K designed the research; Nishikawa T, Sugiyama H, Kato M and Kitahara S performed the measurement of liver stiffness; Hashimoto S, Kawabe N, Harata M, Nitta Y, Murao M, Nakano T, Arima Y and Shimazaki H provided the collection of clinical data; Yoshioka K and Kawabe N performed the histological assessment; Ichino N analyzed the data; Suzuki K performed the statistical analysis; Ichino N and Yoshioka K wrote the manuscript.
Correspondence to: Kentaro Yoshioka, MD, Professor, Department of Liver, Biliary Tract and Pancreas Diseases, Fujita Health University, 1-98 Demgakugakubo, Kutsukake, Toyoake, Aichi 470-1192, Japan. kyoshiok@fujita-hu.ac.jp
Telephone: +81-562-932324 Fax: +81-562-938601
Received: June 14, 2010
Revised: July 19, 2010
Accepted: July 26, 2010
Published online: October 14, 2010
AIM: To construct and evaluate a new non-invasive fibrosis index for assessment of the stage of liver fibrosis.
METHODS: A new fibrosis index (Fibro-Stiffness index) was developed in 165 of 285 patients with chronic hepatitis C, and was validated in the other 120 patients where liver biopsy was performed. Its usefulness was compared with liver stiffness (LS) measured by FibroScan, the aminotransferase-to-platelet ratio index, the Forns index and the FibroIndex.
RESULTS: The Fibro-Stiffness index consists of LS, platelet count and prothrombin time. The values of the Fibro-Stiffness index differed significantly between neighboring fibrosis stages except F0-F1. The area under the receiver operating characteristics curves of the Fibro-Stiffness index for prediction of F ≥ 2 (0.90), F ≥ 3 (0.90) and F = 4 (0.92) in the estimation group and those for F ≥ 3 (0.93) and F = 4 (0.97) in the validation group were the highest among the 5 methods examined. The accuracy of the Fibro-Stiffness index had highest values for F ≥ 2, F ≥ 3 and F = 4 in both the estimation and validation groups. The diagnostic performance for F = 4 was improved by a combination of the Fibro-Stiffness index with serum hyaluronic acid level.
CONCLUSION: The Fibro-Stiffness index was constructed and validated. It showed superior diagnostic performance to other indices for F ≥ 2, 3 and 4.
