Noninvasive estimation of liver fibrosis in biopsy-proven hepatitis C virus-infected patients: angiogenic fibrogenic link.

Abstract

BACKGROUND/AIM:

The assessment of liver fibrosis provides useful information not only for diagnosis but also for therapeutic decisions. This study aimed to develop and evaluate a predictive score named the angiogenic index (Angio-Index) for liver fibrosis staging and to compare Angio-Index by King, Gotebörg University Cirrhosis Index, Lok, FIB-4, and aspartate aminotranferase/alanine aminotranferase scores in hepatitis C virus-infected patients.

PATIENTS AND METHODS:

Serum levels of angiopoietin-2, basic fibroblast growth factor, hepatocyte growth factor, and endostatin were assayed using an enzyme-linked immunosorbent assay in 122 HCV patients represented in two sets (estimation group and validation group). Stepwise linear discriminant analysis and area under receiver-operating characteristic curves (AUCs) were utilized to produce a predictive score comprising significant angiogenic biomarkers.

RESULTS:

A novel score named the Angio-Index score was created on the basis of a combination of angiopoietin-2, basic fibroblast growth factor, hepatocyte growth factor, and endostatin. Angio-Index produces an AUC of 0.90 for significant fibrosis, 0.865 for advanced fibrosis, and 0.857 for cirrhosis. The Angio-Index score correctly classified 71% of the significant fibrosis (F2-F4) with a sensitivity of 93% and a specificity of 91%. The Angio-Index had a similar AUC in the validation study. The above six scores showed lower AUCs than Angio-Index.

CONCLUSION:

Whereas liver biopsy is invasive, costly, and associated with complications, Angio-Index is simple, noninvasive, and more accurate; it may decrease the need for liver biopsy in Egyptian patients.

• Authors: El-Shahat A Toson, Gamal E Shiha, Hatem A El-Mezayen, Waleed Samir, Mohamed M El-Khininy
• Journal: European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 29 Issue 2 Pg. 199-207 (Feb 2017) ISSN: 1473-5687 [Electronic] England
• PMID: 27930387 (Publication Type: Journal Article)

Chemical References

• ANGPT2 protein, human
• Angiopoietin-2
• Endostatins
• HGF protein, human
• Fibroblast Growth Factor 2
• Hepatocyte Growth Factor

Topics

• Adult
• Angiopoietin-2 (blood)
• Area Under Curve
• Discriminant Analysis
• Egypt
• Endostatins (blood)
• Enzyme-Linked Immunosorbent Assay
• Female
• Fibroblast Growth Factor 2 (blood)
• Hepatitis C, Chronic (blood, complications)
• Hepatocyte Growth Factor (blood)
• Humans
• Linear Models
• Liver Cirrhosis (blood, etiology)
• Male
• Middle Aged
• ROC Curve
• Sensitivity and Specificity