Diagnostic and prognostic values of noninvasive biomarkers of fibrosis in patients with alcoholic liver disease†

Targeting Liver Fibrosis

“…Thus, several studies suggest that certain marker combinations, such as Fibrotest, the enhanced liver fibrosis panel of ECM markers (ELF), or other selected ECM markers may have more value in predicting progression rather than fibrosis stage. [85][86][87][88][89][90] However, their validation as dynamic markers is difficult and will require more long-term studies. Such studies should also be complemented by determination of hepatic fibrogenesis by quantitative PCR for transcripts that are related to fibrogenesis or fibrolysis in matched liver biopsies.…”

Noninvasive assessment of patients with alcoholic liver disease

“…3 Some rely on biochemical parameters together with other clinical features. The socalled FibroTest has been evaluated in ALD and has been shown to reach a diagnostic accuracy of 0.8.…”

“…The socalled FibroTest has been evaluated in ALD and has been shown to reach a diagnostic accuracy of 0.8. 3 Other proposed markers include the enhanced liver fibrosis test and caspase cleaved fragments of cytokeratin 18. However, these serum markers have not been well studied with respect to interfering steatohepatitis, nor have they found frequent usage in clinical practice.…”

Back to the future with noninvasive biomarkers of liver fibrosis†‡

“…The study by Naveau et al 5 in this issue of HEPATOL-OGY heralds the possibility of a changing direction in how we judge the performance of biomarkers in liver disease. The authors retrospectively tested a number of panel biomarker tests on a cohort of 218 patients with alcoholic liver disease.…”

“…A test that is derived and validated on a population with severe disease will have a different diagnostic performance in a population with mild disease. The study by Naveau et al 5 addresses the issue of prevalence by applying a statistical correction called difference of mean stages observed between advanced fibrosis and nonadvanced fibrosis (known as DANA analysis); the prevalence of advanced fibrosis in this cohort was 63%. The purpose of trying to account for prevalence is justified, but it may not eliminate spectrum bias.…”