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Proposed cut-off values for the enhanced liver fibrosis score

A study in the most recent issue of the Journal of Hepatology evaluates normal values, influence factors and proposed cut-off values of the Enhance Liver Fibrosis score.

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Progressive fibrosis is a major cause of morbidity and mortality in chronic liver disease.

To replace liver biopsy for disease staging, multiple serum markers are under evaluation with multiparametric panels yielding the most promising results.

The Enhanced Liver Fibrosis score is an ECM marker set consisting of tissue inhibitor of metalloproteinases, amino-terminalpropeptide of type III procollagen and hyaluronic acid showing good correlations with fibrosis stages in chronic liver disease.

Dr Ralf Lichtinghagen and colleagues from Germany measured the Enhanced Liver Fibrosis score in 400 healthy controls, and 79 chronic Hepatitis C patients using an ADVIA Centaur automated system.

The Enhanced Liver Fibrosis score was calculated using the published algorithm combining TIMP-1, amino-terminalpropeptide of type III procollagen and hyaluronic acid values.

Patients’ fibrosis stage was defined histologically.

Age was a notable influence factor
Journal of Hepatology

ROC analyses were performed to study marker validity.

Reference values and influence factors for the Enhanced Liver Fibrosis score were validated.

Enhanced Liver Fibrosis score reference values ranged from about 7 to 10, and were significantly higher for men vs. women.

The team observed that afternoon values were slightly higher than morning values.

The research team found that age was a notable influence factor.

The doctors identified 3 cut-off values, including 7.7 for a high sensitivity exclusion of fibrosis, 9.8 for a high specificity identification of fibrosis, and 11.3 to discriminate cirrhosis.

The team noted that the Enhanced Liver Fibrosis score validity was superior to the results of the single tests.

Dr Lichtinghagen's team concludes, "The Enhanced Liver Fibrosis score can predict moderate fibrosis and cirrhosis."

"However, influence factors such as gender and age need to be taken into account."

J Hepatology 2013: 59(2): 236-242
06 August 2013

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