Diagnostic performance of a new noninvasive test for nonalcoholic steatohepatitis using a simplified histological reference

dc.creatorPoynard, Thierry
dc.creatorMunteanu, Mona
dc.creatorCharlotte, Frederic
dc.creatorPerazzo, Hugo
dc.creatorNgo, Yen
dc.creatorDeckmyn, Olivier
dc.creatorPais, Raluca
dc.creatorMerrouche, Wassil
dc.creatorLedinghen, Victor de
dc.creatorMathurin, Philippe
dc.creatorRatziu, Vlad
dc.date2018-12-03T16:02:25Z
dc.date2018-12-03T16:02:25Z
dc.date2018
dc.date.accessioned2023-09-26T23:42:21Z
dc.date.available2023-09-26T23:42:21Z
dc.identifierPOYNARD, Thierry et al. Diagnostic performance of a new noninvasive test for nonalcoholic steatohepatitis using a simplified histological reference. European Journal of Gastroenterology and Hepatology, v. 30, n. 5, p. 569-577, 2018.
dc.identifier0954-691X
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/30364
dc.identifier10.1097/MEG.0000000000001064
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8893359
dc.descriptionThe members of the FLIP Partners’ Consortium, the FLIP Pathology Consortium, the FibroFrance-CPAM Group, and the FibroFrance-Obese Group (see Supplementary File, Supplemental digital content 1, http://links.lww.com/EJGH/A259).
dc.descriptionThe members of the FLIP Partners’ Consortium, the FLIP Pathology Consortium, the FibroFrance-CPAM Group, and the FibroFrance-Obese Group (see Supplementary File, Supplemental digital content 1, http://links.lww.com/EJGH/A259). Financial support was provided by European Community’s Seventh Framework Program (FP7/2007-2013) grant agreement HEALTH-F2-2009-241762 for the project FLIP.
dc.descriptionBackground One of the unmet needs in patients with metabolic risks is the prediction of metabolic liver disease (MLD) by noninvasive tests (NITs). Objective The primary aim of this study was to construct a new quantitative test for the diagnosis of nonalcoholic steatohepatitis (NASH) using a simplified histological definition. Patients and methods As a reference, we used a simplified histological definition of NASH derived from the FLIP-CRNdefinition that does not require the presence of steatosis and the presence of both lobular inflammation and ballooning. We analyzed 1081 patients from two prospective cohorts at risk of MLD who had biopsies and contemporaneous blood samples. These patients were divided randomly into a training group (n= 541) and a control group (n= 540) for internal validation. The new test was compared with standard tests, and applied in two large populations at risk of MLD. Results Out of 1081 patients with biopsy, 39 (3.6%) cases with significant inflammatory activity or fibrosis (A2orF2) were missed by the current histological definitions. The combination of 11 parameters permitted to construct a test (NIT-NASHs) predicting NASH with an area under the receiver operating characteristic curve (AUROC) of 0.773 (95% confidence interval: 0.730–0.810), confirmed in the control group 0.814 (0.774–0.847). The AUROCs of NIT-NASHs were higher (all P<0.001) than those of ActiTest, FIB4, BARD, and nonalcoholic fatty liver disease scores. A combination of NIT-NASHs with FibroTest (AUROC=0.800; 0.759–0.835) enabled a better prediction (P< 0.0001) of significant MLD, A2orF2, than the ActiTest–FibroTest combination. Conclusion These results suggested that this new test enables a quantitative assessment of NASH, and when associated with the FibroTest, identifies cases with clinically significant MLD. An external validation is needed.
dc.description2038-08-30
dc.formatapplication/pdf
dc.languageeng
dc.publisherLippincott, Williams & Wilkins
dc.rightsrestricted access
dc.subjectNonalcoholic steatohepatitis
dc.subjectMetabolic liver disease
dc.subjectFibroTest
dc.subjectNoninvasive tests
dc.titleDiagnostic performance of a new noninvasive test for nonalcoholic steatohepatitis using a simplified histological reference
dc.typeArticle


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