Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological referenceReport as inadecuate

Diagnostic performance of FibroTest, SteatoTest and ActiTest in patients with NAFLD using the SAF score as histological reference - Download this document for free, or read online. Document in PDF available to download.

1 Biopredictive 2 UoA - University of Athens 3 Newcastle University Newcastle 4 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition 5 UNIBO - Università di Bologna Bologna 6 UNITO - Università degli studi di Torino 7 Medizinische Universitât Wien 8 Universidad de Sevilla 9 University of São Paulo School of Medicine 10 Universität Bern Bern 11 UNIMORE - Università degli Studi di Modena e Reggio Emilia Reggio Emilia 12 UPMC - Université Pierre et Marie Curie - Paris 6 13 Hôpital Beaujon

Abstract : BackgroundBlood tests of liver injury are less well validated in non-alcoholic fatty liver disease NAFLD than in patients with chronic viral hepatitis.AimsTo improve the validation of three blood tests used in NAFLD patients, FibroTest for fibrosis staging, SteatoTest for steatosis grading and ActiTest for inflammation activity grading.MethodsWe pre-included new NAFLD patients with biopsy and blood tests from a single-centre cohort FibroFrance and from the multicentre FLIP consortium. Contemporaneous biopsies were blindly assessed using the new steatosis, activity and fibrosis SAF score, which provides a reliable and reproducible diagnosis and grading-staging of the three elementary features of NAFLD steatosis, inflammatory activity and fibrosis with reduced interobserver variability. We used nonbinary-ROC NonBinAUROC as the main endpoint to prevent spectrum effect and multiple testing.ResultsA total of 600 patients with reliable tests and biopsies were included. The mean NonBinAUROCs 95% CI of tests were all significant P < 0.0001: 0.878 0.864–0.892 for FibroTest and fibrosis stages, 0.846 0.830–0.862 for ActiTest and activity grades, and 0.822 0.804–0.840 for SteatoTest and steatosis grades. FibroTest had a higher NonBinAUROC than BARD 0.836; 0.820–0.852; P = 0.0001, FIB4 0.845; 0.829–0.861; P = 0.007 but not significantly different than the NAFLD score 0.866; 0.850–0.882; P = 0.26. FibroTest had a significant difference in median values between adjacent stage F2 and stage F1 contrarily to BARD, FIB4 and NAFLD scores Bonferroni test P < 0.05.ConclusionsIn patients with NAFLD, SteatoTest, ActiTest and FibroTest are non-invasive tests that offer an alternative to biopsy, and they correlate with the simple grading-staging of the SAF scoring system across the three elementary features of NAFLD: steatosis, inflammatory activity and fibrosis.

Author: M Munteanu - D Tiniakos - Q Anstee - F Charlotte - G Marchesini - E Bugianesi - M Trauner - M Romero Gomez - C Oliveira - C Day -

Source: https://hal.archives-ouvertes.fr/


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