Transient Elastography And Apri Score: Looking At False Positives And False Negatives. Diagnostic Performance And Association To Fibrosis Staging In Chronic Hepatitis C

dc.creatorMendes
dc.creatorL. C.; Ferreira
dc.creatorP. A.; Miotto
dc.creatorN.; Zanaga
dc.creatorL.; Goncales
dc.creatorE.; Lazarini
dc.creatorM. S.; Goncales Junior
dc.creatorF. L.; Stucchi
dc.creatorR. S. B.; Vigani
dc.creatorA. G.
dc.date2016
dc.date2017-11-13T11:35:25Z
dc.date2017-11-13T11:35:25Z
dc.date.accessioned2018-03-29T05:49:32Z
dc.date.available2018-03-29T05:49:32Z
dc.identifierBrazilian Journal Of Medical And Biological Research. Assoc Bras Divulg Cientifica, v. 49, p. , 2016.
dc.identifier0100-879X
dc.identifier1678-4510
dc.identifierWOS:000381098700009
dc.identifier10.1590/1414-431X20165432
dc.identifierhttp://www.scielo.br/scielo.php?pid=S0100-879X2016000900702&script=sci_arttext
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/326626
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1363632
dc.descriptionAlthough long regarded as the gold standard for liver fibrosis staging in chronic hepatitis C (CHC), liver biopsy (LB) implies both the risk of an invasive procedure and significant variability. The aim of this study was to evaluate the diagnostic performance for transient elastography (TE) and aspartate aminotransferase to platelet index (APRI) used alone and in combination compared to liver biopsy and to analyze false positive/negative results. Patients with CHC, and no previous clinical diagnosis of cirrhosis were enrolled to undergo liver biopsy, TE and APRI. A total of 182 adult patients with a median age of 55 years and median body mass index of 26.71 kg/m(2) were analyzed. On LB, 56% of patients had significant levels of fibrosis (METAVIR F >= 2) and 28% had advanced fibrosis (F3/F4). The strongest performance for both tests was observed for exclusion of advanced fibrosis with good negative predictive values (89 and 86%, respectively). Low necroinflammatory activity on LB was associated with false negative TE. False positives were associated with NASH and smaller LB fragments. Correlation between APRI and Fibroscan for F >= 2 was 100% and 84% for F >= 3 and remained high in both false negative and false positive instances, correctly identifying F < 2 in 71% of cases and F < 3 in 78% (and potentially foregoing up to 84% of LB). We concluded that low individual performance indicators could be attributable to limitations of LB. Poorer differentiation of lower levels of fibrosis is a known issue for LB and remains so for noninvasive tests. Good predictability is possible, however, for advanced fibrosis.
dc.description49
dc.description9
dc.languageEnglish
dc.publisherAssoc Bras Divulg Cientifica
dc.publisherSão Paulo
dc.relationBrazilian Journal of Medical and Biological Research
dc.rightsaberto
dc.sourceWOS
dc.subjectLiver Biopsy
dc.subjectNoninvasive Tests
dc.subjectApri
dc.subjectTransient Elastography
dc.subjectAccuracy
dc.subjectFalse Results
dc.titleTransient Elastography And Apri Score: Looking At False Positives And False Negatives. Diagnostic Performance And Association To Fibrosis Staging In Chronic Hepatitis C
dc.typeArtículos de revistas


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