2‐Step PLT16‐AST44 method: Simplified liver fibrosis detection system in patients with non‐alcoholic fatty liver disease

Abstract

Aim: Accurate detection of the hepatic fibrosis stage is essential to estimate the outcome of patients with non-alcoholic fatty liver disease (NAFLD). Many formulas, biomarkers, and imaging tests are being developed to predict advanced liver fibrosis without performing a liver biopsy. However, these tests do not have high efficiency in detecting early-stage hepatic fibrosis. Therefore, we aimed to detect the presence of hepatic fibrosis (≥F1) merely by using only standard clinical markers.Methods: A total of 436 patients with NAFLD who underwent liver biopsy were retrospectively enrolled as the discovery cohort (316 patients) and the validation cohort (120 patients). Liver biopsy and laboratory data were matched to extract simple parameters for identifying ≥F1. Results:We developed a novel simplified ≥F1 detecting system, designated as 2-Step PLT16-AST44 method, where (1) PLT of 16 � 10 4 /μl or less, or (2) PLT greater than 16 � 10 4 /μl and AST greater than 44 U/L is determined as having ≥F1 fibrosis. The 2-Step PLT16-AST44 method had a sensitivity of 68%, a specificity of 90%, a positive predictive value (PPV) of 97%, a negative predictive value (NPV) of 40%, and an accuracy of 72% to detect ≥F1 fibrosis in the discovery cohort. Validation studies further supported these results. Despite its simplicity, the 2-Step PLT16-AST44 method's power to detect ≥F1 fibrosis in total NAFLD patients was comparable to hyaluronic acid, type 4 collagen 7S, FIB-4, and APRI. Conclusions:We propose the 2-Step PLT16-AST44 method as a simple and beneficial early-stage hepatic fibrosis detection system.

Accuracy of Noninvasive Diagnostic Tests for the Detection of Significant and Advanced Fibrosis Stages in Nonalcoholic Fatty Liver Disease: A Systematic Literature Review of the US Studies

“…Our study concentrated on the diagnostic ability of noninvasive tools to identify and differentiate significant and advanced fibrosis (F2+ and F3+), stipulating that the diagnosis made at this stage may impact clinical decision-making and change the course of the disease. Still, the efficiency of the tools in detecting earlier stages of fibrosis (F1+) has not been reviewed, while it may be increasingly important in the disease course, as treatment measures at earlier stages may positively impact the disease outcomes [ 59 ]. Additionally, some of the multicenter studies cited here did not have a centralized pathological reading, which then introduces substantial bias in relation to inter-pathologist variability.…”

Circulating thrombospondin 2 levels reflect fibrosis severity and disease activity in HCV-infected patients

“…The method for measuring serum ATX was the same as previously reported 19 . FIB-4 index, Forn’s index, and APRI were calculated according to the following formulae: FIB-4 index = (age [years] × AST [IU/L])/(platelet count [10 9 /L] ×ALT [IU/L] 1/2 ) 25 , Forn’s index = 7.811 − (3.131 × ln platelet count [× 10 4 /uL]) + (0.781 × ln GGTP [U/L]) + (3.647 × ln age [years]) – (0.0114 × cholesterol [mg/dL]) 26 , and APRI = (AST/upper limit of normal; 28 [U/L]) × (100/platelet count [10 9 /L]) 27 . Serum TSP2 concentrations were determined using enzyme-linked immunosorbent assays (Quantikine® ELISA, #DTSP20, R&D Systems, Minneapolis, MN).…”

“…Liver specimens of at least 1.5 cm in length were obtained from segments 5 or 8 using a 14-gauge needle as described previously and immediately fixed in 10% neutral formalin 25 . Sections of 4 μm in thickness were cut and stained using the hematoxylin and eosin and Azan-Mallory methods.…”

Higher Responsiveness for Women, High Transaminase Levels, and Fat Percentage to Pemafibrate Treatment for NAFLD

“…All laboratory data and body composition measurements were obtained in a fasting state. Fibrosis-4 index (FIB-4) and aspartate aminotransferase (AST) to platelet ratio index (APRI) were calculated according to the following formulas: FIB-4 = (age [years] × AST [U/L])/(platelet count (PLT) [×10 9 /L] × alanine aminotransferase (ALT) [U/L] 1/2 ) [ 17 ], and APRI = AST [U/L]/upper limit of the normal range [U/L]/PLT [10 9 /L] × 100 [ 18 , 19 ]. The interval between patient visits and blood sampling was 4 weeks, at which time the patient was also interviewed about side effects.…”