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Cited by 400Liver Disease Diagnosis and TreatmentLiver Disease and TransplantationLiver Diseases and Immunity

The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index.

Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in non-alcoholic fatty liver disease

Boursier, Jérôme, Vergniol, Julien, Guillet, Anne, Hiriart, Jean-Baptiste, Lannes, Adrien, Le Bail, Brigitte, Michalak, Sophie, Chermak, Faiza, Bertrais, Sandrine, Foucher, Juliette, Oberti, Frédéric, Charbonnier, Maude, Fouchard-Hubert, Isabelle, Rousselet, Marie-Christine, Calès, Paul, de Lédinghen, Victor·2016·Journal of Hepatology
DOI 10.1016/j.jhep.2016.04.023
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Abstract

Background & aims NAFLD is highly prevalent but only a small subset of patients develop advanced liver fibrosis with impaired liver-related prognosis. We aimed to compare blood fibrosis tests and liver stiffness measurement (LSM) by FibroScan for the diagnosis of liver fibrosis and the evaluation of prognosis in NAFLD.Methods Diagnostic accuracy was evaluated in a cross-sectional study including 452 NAFLD patients with liver biopsy (NASH-CRN fibrosis stage), LSM, and eight blood fibrosis tests (BARD, NAFLD fibrosis score, FibroMeter(NAFLD), aspartate aminotransferase to platelet ratio index (APRI), FIB4, FibroTest, Hepascore, FibroMeter(V2G)). Prognostic accuracy was evaluated in a longitudinal study including 360 NAFLD patients.Results LSM and FibroMeter(V2G) were the two best-performing tests in the cross-sectional study: AUROCs for advanced fibrosis (F3/4) were, respectively, 0.831±0.019 and 0.817±0.020 (p⩽0.041 vs. other tests); rates of patients with ⩾90% negative/positive predictive values for F3/4 were 56.4% and 46.7% (p<0.001 vs. other tests); Obuchowski indexes were 0.834±0.014 and 0.798±0.016 (p⩽0.036 vs. other tests). Two fibrosis classifications were developed to precisely estimate the histological fibrosis stage from LSM or FibroMeter(V2G) results without liver biopsy (diagnostic accuracy, respectively: 80.8% vs. 77.4%, p=0.190). Kaplan-Meier curves in the longitudinal study showed that both classifications categorised NAFLD patients into subgroups with significantly different prognoses (p<0.001): the higher was the class of the fibrosis classification, the worse was the prognosis.Conclusions LSM and FibroMeter(V2G) were the most accurate of nine evaluated tests for the non-invasive diagnosis of liver fibrosis in NAFLD. LSM and FibroMeter(V2G) fibrosis classifications help physicians estimate both fibrosis stage and patient prognosis in clinical practice.Lay summary The amount of liver fibrosis is the main determinant of the liver-related prognosis in patients with non-alcoholic fatty liver disease (NAFLD). We evaluated eight blood tests and FibroScan in a cross-sectional diagnostic study and found that FibroScan and the blood test FibroMeter(V2G) were the two most accurate tests for the non-invasive evaluation of liver fibrosis in NAFLD. A longitudinal prognostic study showed these two tests initially developed for the diagnosis are also prognostic markers as they allow for the stratification of NAFLD patients in several subgroups with significantly different prognosis.

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Metadata

Authors
Boursier, J., Vergniol, J., Guillet, A., Hiriart, J.-B., Lannes, A., Le Bail, B., Michalak, S., Chermak, F., Bertrais, S., Foucher, J., Oberti, F., Charbonnier, M., Fouchard-Hubert, I., Rousselet, M.-C., Calès, P., & de Lédinghen, V.
Affiliations
  • Centre Hospitalier Universitaire d'Angers (FR)
  • Centre Hospitalier Universitaire de Bordeaux (FR)
  • Université d'Angers (FR)
  • Université Nantes Angers Le Mans (FR)
Corresponding author
Boursier, Jérôme
ORCID
Venue
Journal of Hepatology
Publisher
Elsevier BV
Published
2016-09
Volume
65
Issue
3
Pages
570-578
ISSN
0168-8278 (ISSN-L)
DOI
10.1016/j.jhep.2016.04.023
OpenAlex
W2346887577
Cited by
400
References
45
Citations by year
2026: 15 · 2025: 27 · 2024: 40 · 2023: 38 · 2022: 47 · 2021: 60 · 2020: 51 · 2019: 47 · 2018: 35 · 2017: 31 · 2016: 6
FWCI
37.13
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
  • Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
Keywords
non-alcoholic fatty liver disease, liver fibrosis, liver stiffness measurement, FibroScan, noninvasive fibrosis assessment, prognostic accuracy, NAFLD fibrosis score, APRI, FIB-4, fibrosis staging, liver biopsy alternative, liver-related mortality
MeSH terms
Biopsy, Cross-Sectional Studies, Humans, Liver Cirrhosis, Longitudinal Studies, Prognosis, Biomarkers, Non-alcoholic Fatty Liver Disease

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