Systematic screening for liver fibrosis in heavy-drinking patients is a challenge.
Dr Nguyen-Khac and colleagues from France assessed Fibroscan for non-invasive diagnosis of asymptomatic liver fibrosis in alcohol abuse patients.
The research team determined diagnostic liver stiffness cut-off values, and compared the performance of Fibroscan with 7 non-invasive laboratory tests.
The researchers studied 103 alcoholic patients.
Liver fibrosis was staged by METAVIR system. Fibroscan, Fibrotest, Fibrometer, Hepascore, APRI, PGA, PGAA and hyaluronic acid tests were performed.
|Sensitivity was 80% for F2 using Fibroscan|
|Alimentary Pharmacology & Therapeutics|
Liver stiffness cut-offs were determined using receiver-operating characteristic curves.
Liver stiffness was correlated with fibrosis, with median at 5, 6, 8, 15 and 47 kPa for F0, F1, F2, F3, and F4 stage fibrosis, respectively.
For Fibroscan, areas under receiver-operating characteristic curves were 0.8 for F1, and 0.9 for F2 to F4.
The team noted that the diagnostic stiffness cut-offs were 6 kPa for F1, 8 kPa for F2, 11 kPa for F3, and 20 kPa for F4.
Using Fibroscan for F2, the sensitivity, specificity, positive- and negative predictive values were 80%, 91%, 93%, and 70%, respectively.
The researchers observed that using Fibroscan for F4, the sensitivity, specificity, positive- and negative predictive values were 86%, 84%, 69% and 88%, repectively.
Performance of Fibroscan was higher than 7 laboratory tests, for which areas under receiver-operating characteristic curves ranged from 0.7 to 0.8 for F1.
The area under receiver-operating characteristic curve for the performance of Fibroscan ranged from 0.5 to 0.8 for F2, 0.4 to 0.9 for F3, and 0.6 to 0.9 for F4.
Combining Fibroscan with each test, such as Hepascore, did not improve performance.
Dr Nguyen-Khac’s team concludes, “Fibroscan is effective to assess liver fibrosis in alcoholic patients.”
“Instant screening of liver fibrosis in heavy drinkers is feasible without liver biopsy.”