Prospective validation of ELF test in comparison with fibroscan and fibrotest to predict liver fibrosis in Asian subjects with chronic hepatitis B

Beom Kyung Kim, Hyon Suk Kim, Junyong Park, doyoung kim, SangHoon Ahn, Chae Yoon Chon, Young Nyun Park, KwangHyub Han, Seungup Kim

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Background and Aims: Liver stiffness measurement (LSM) and FibroTest (FT) are frequently used as non-invasive alternatives for fibrosis staging to liver biopsy. However, to date, diagnostic performances of Enhanced Liver Fibrosis (ELF) test, which consists of hyaluronic acid, aminoterminal propeptide of procollagen type-III, and tissue inhibitor of matrix metalloproteinases-1, have not been compared to those of LSM and FT in Asian chronic hepatitis B (CHB) patients. Methods: Between June 2010 and November 2011, we prospectively enrolled 170 CHB patients who underwent liver biopsies along with LSM, FT, and ELF. The Batts system was used to assess fibrosis stages. Results: Areas under receiver operating characteristic curves (AUROCs) to predict significant fibrosis (F≥2), advanced fibrosis (F≥3), and cirrhosis (F = 4) were 0.901, 0.860, and 0.862 for ELF, respectively; 0.937, 0.956, and 0.963 for LSM; and 0.896, 0.921, and 0.881 for FT. AUROCs to predict F≥2 were similar between each other, whereas LSM and FT had better AUROCs than ELF for predicting F≥3 (both p<0.05), and LSM predicted F4 more accurately than ELF (p<0.05). Optimized cutoffs of ELF to maximize sum of sensitivity and specificity were 8.5, 9.4, and 10.1 for F≥2, F≥3, and F = 4, respectively. Using suggested ELF, LSM and FT cutoffs to diagnose F1, F2, F3, and F4, 91 (53.5%), 117 (68.8%), and 110 (64.7%) patients, respectively, were correctly classified according to histological results. Conclusions: ELF demonstrated considerable diagnostic value in fibrosis staging in Asian CHB patients, especially in predicting F≥2. However, LSM consistently provided better performance for predicting F≥3 and F4.

Original languageEnglish
Article numbere41964
JournalPLoS One
Volume7
Issue number7
DOIs
Publication statusPublished - 2012 Jul 27

Fingerprint

chronic hepatitis B
liver cirrhosis
Chronic Hepatitis B
Liver Cirrhosis
Liver
liver
fibrosis
Fibrosis
testing
Stiffness
ROC Curve
biopsy
interstitial collagenase
Biopsy
hyaluronic acid
Matrix Metalloproteinase 1
Tissue Inhibitor of Metalloproteinase-1
Collagen Type III
disease diagnosis
Hyaluronic Acid

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

@article{3aaab0494661412f97b5d4e394dbac43,
title = "Prospective validation of ELF test in comparison with fibroscan and fibrotest to predict liver fibrosis in Asian subjects with chronic hepatitis B",
abstract = "Background and Aims: Liver stiffness measurement (LSM) and FibroTest (FT) are frequently used as non-invasive alternatives for fibrosis staging to liver biopsy. However, to date, diagnostic performances of Enhanced Liver Fibrosis (ELF) test, which consists of hyaluronic acid, aminoterminal propeptide of procollagen type-III, and tissue inhibitor of matrix metalloproteinases-1, have not been compared to those of LSM and FT in Asian chronic hepatitis B (CHB) patients. Methods: Between June 2010 and November 2011, we prospectively enrolled 170 CHB patients who underwent liver biopsies along with LSM, FT, and ELF. The Batts system was used to assess fibrosis stages. Results: Areas under receiver operating characteristic curves (AUROCs) to predict significant fibrosis (F≥2), advanced fibrosis (F≥3), and cirrhosis (F = 4) were 0.901, 0.860, and 0.862 for ELF, respectively; 0.937, 0.956, and 0.963 for LSM; and 0.896, 0.921, and 0.881 for FT. AUROCs to predict F≥2 were similar between each other, whereas LSM and FT had better AUROCs than ELF for predicting F≥3 (both p<0.05), and LSM predicted F4 more accurately than ELF (p<0.05). Optimized cutoffs of ELF to maximize sum of sensitivity and specificity were 8.5, 9.4, and 10.1 for F≥2, F≥3, and F = 4, respectively. Using suggested ELF, LSM and FT cutoffs to diagnose F1, F2, F3, and F4, 91 (53.5{\%}), 117 (68.8{\%}), and 110 (64.7{\%}) patients, respectively, were correctly classified according to histological results. Conclusions: ELF demonstrated considerable diagnostic value in fibrosis staging in Asian CHB patients, especially in predicting F≥2. However, LSM consistently provided better performance for predicting F≥3 and F4.",
author = "Kim, {Beom Kyung} and Kim, {Hyon Suk} and Junyong Park and doyoung kim and SangHoon Ahn and Chon, {Chae Yoon} and Park, {Young Nyun} and KwangHyub Han and Seungup Kim",
year = "2012",
month = "7",
day = "27",
doi = "10.1371/journal.pone.0041964",
language = "English",
volume = "7",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "7",

}

Prospective validation of ELF test in comparison with fibroscan and fibrotest to predict liver fibrosis in Asian subjects with chronic hepatitis B. / Kim, Beom Kyung; Kim, Hyon Suk; Park, Junyong; kim, doyoung; Ahn, SangHoon; Chon, Chae Yoon; Park, Young Nyun; Han, KwangHyub; Kim, Seungup.

In: PLoS One, Vol. 7, No. 7, e41964, 27.07.2012.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prospective validation of ELF test in comparison with fibroscan and fibrotest to predict liver fibrosis in Asian subjects with chronic hepatitis B

AU - Kim, Beom Kyung

AU - Kim, Hyon Suk

AU - Park, Junyong

AU - kim, doyoung

AU - Ahn, SangHoon

AU - Chon, Chae Yoon

AU - Park, Young Nyun

AU - Han, KwangHyub

AU - Kim, Seungup

PY - 2012/7/27

Y1 - 2012/7/27

N2 - Background and Aims: Liver stiffness measurement (LSM) and FibroTest (FT) are frequently used as non-invasive alternatives for fibrosis staging to liver biopsy. However, to date, diagnostic performances of Enhanced Liver Fibrosis (ELF) test, which consists of hyaluronic acid, aminoterminal propeptide of procollagen type-III, and tissue inhibitor of matrix metalloproteinases-1, have not been compared to those of LSM and FT in Asian chronic hepatitis B (CHB) patients. Methods: Between June 2010 and November 2011, we prospectively enrolled 170 CHB patients who underwent liver biopsies along with LSM, FT, and ELF. The Batts system was used to assess fibrosis stages. Results: Areas under receiver operating characteristic curves (AUROCs) to predict significant fibrosis (F≥2), advanced fibrosis (F≥3), and cirrhosis (F = 4) were 0.901, 0.860, and 0.862 for ELF, respectively; 0.937, 0.956, and 0.963 for LSM; and 0.896, 0.921, and 0.881 for FT. AUROCs to predict F≥2 were similar between each other, whereas LSM and FT had better AUROCs than ELF for predicting F≥3 (both p<0.05), and LSM predicted F4 more accurately than ELF (p<0.05). Optimized cutoffs of ELF to maximize sum of sensitivity and specificity were 8.5, 9.4, and 10.1 for F≥2, F≥3, and F = 4, respectively. Using suggested ELF, LSM and FT cutoffs to diagnose F1, F2, F3, and F4, 91 (53.5%), 117 (68.8%), and 110 (64.7%) patients, respectively, were correctly classified according to histological results. Conclusions: ELF demonstrated considerable diagnostic value in fibrosis staging in Asian CHB patients, especially in predicting F≥2. However, LSM consistently provided better performance for predicting F≥3 and F4.

AB - Background and Aims: Liver stiffness measurement (LSM) and FibroTest (FT) are frequently used as non-invasive alternatives for fibrosis staging to liver biopsy. However, to date, diagnostic performances of Enhanced Liver Fibrosis (ELF) test, which consists of hyaluronic acid, aminoterminal propeptide of procollagen type-III, and tissue inhibitor of matrix metalloproteinases-1, have not been compared to those of LSM and FT in Asian chronic hepatitis B (CHB) patients. Methods: Between June 2010 and November 2011, we prospectively enrolled 170 CHB patients who underwent liver biopsies along with LSM, FT, and ELF. The Batts system was used to assess fibrosis stages. Results: Areas under receiver operating characteristic curves (AUROCs) to predict significant fibrosis (F≥2), advanced fibrosis (F≥3), and cirrhosis (F = 4) were 0.901, 0.860, and 0.862 for ELF, respectively; 0.937, 0.956, and 0.963 for LSM; and 0.896, 0.921, and 0.881 for FT. AUROCs to predict F≥2 were similar between each other, whereas LSM and FT had better AUROCs than ELF for predicting F≥3 (both p<0.05), and LSM predicted F4 more accurately than ELF (p<0.05). Optimized cutoffs of ELF to maximize sum of sensitivity and specificity were 8.5, 9.4, and 10.1 for F≥2, F≥3, and F = 4, respectively. Using suggested ELF, LSM and FT cutoffs to diagnose F1, F2, F3, and F4, 91 (53.5%), 117 (68.8%), and 110 (64.7%) patients, respectively, were correctly classified according to histological results. Conclusions: ELF demonstrated considerable diagnostic value in fibrosis staging in Asian CHB patients, especially in predicting F≥2. However, LSM consistently provided better performance for predicting F≥3 and F4.

UR - http://www.scopus.com/inward/record.url?scp=84864616413&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84864616413&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0041964

DO - 10.1371/journal.pone.0041964

M3 - Article

VL - 7

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 7

M1 - e41964

ER -