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Diagnostic value of multiple biomarker panel for prediction of significant fibrosis in chronic hepatitis C
Seung Ha Park1, Chang Hoon Kim, Dong Joon Kim
1Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Insights
New biomarkers offer modest improvement for predicting liver fibrosis in chronic hepatitis C patients. The multibiomarker score, while a predictor, minimally enhances the existing AST to platelet ratio index (APRI) test.
Area of Science:
- Hepatology
- Biomarker Discovery
- Diagnostic Accuracy
Background:
- Assessing liver fibrosis in chronic hepatitis C (CHC) is crucial for patient management.
- Existing noninvasive tests, like the AST to platelet ratio index (APRI), are simple but may lack comprehensive predictive power.
Purpose of the Study:
- To evaluate the incremental value of seven novel biomarkers in predicting significant liver fibrosis in CHC patients.
- To determine if these biomarkers improve upon the diagnostic accuracy of the established APRI score.
Main Methods:
- Seven biomarkers (haptoglobin, apolipoprotein A1, α2-macroglobulin, hyaluronic acid, type III procollagenic peptide, matrix metalloproteinase-2, tissue inhibitor of metalloproteinase-1) were measured in 91 CHC patients.
- A multibiomarker score was developed and its predictive performance for significant fibrosis was assessed, both independently and in combination with APRI.
Main Results:
- The multibiomarker score independently predicted significant fibrosis (APRI-adjusted odds ratio, 2.41).
- Incorporating the multibiomarker score into APRI resulted in a minor improvement in diagnostic accuracy (0.83 vs. 0.79), which was not statistically significant (p=0.19).
Conclusions:
- The seven contemporary biomarkers studied provide only a modest additional benefit for assessing significant fibrosis in individual CHC patients.
- The readily available, simple noninvasive index (APRI) remains a primary tool, with limited enhancement from these specific novel biomarkers.
Objectives:
Whether new biomarkers contribute significantly to the existing, simple noninvasive test (comprising of routine laboratory parameters such as the AST to platelet ratio index (APRI)) for predicting liver fibrosis remains unknown.
Methods:
We measured 7 biomarkers in 91 patients with chronic hepatitis C (CHC): haptoglobin, apolipoprotein A1, α2-macroglobulin, hyaluronic acid, type III procollagenic peptide, matrix metalloproteinase-2, and tissue inhibitor of metalloproteinase-1.
Results:
The "multibiomarker" score (based on regression coefficients of significant biomarkers) is an independent predictive factor for significant fibrosis [APRI-adjusted odds ratio, 2.41 (95% CI, 1.28 to 4.55)]. However, the incorporation of the multibiomarker score into the APRI resulted in only a small diagnostic improvement [0.83 (95% CI, 0.74 to 0.92) vs. 0.79 (0.69 to 0.89); p=0.19].
Conclusions:
For assessing significant fibrosis in individual CHC patients, the 7 contemporary biomarkers that we studied add only modestly to the readily available, simple noninvasive index.
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