ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> <html> <head> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <title>EASL 2010 - Poster Presentations</title> <link rel="stylesheet" type="text/css" href="style.css"> </head> <body> <table width="750" align="center" border="0" cellspacing="0" cellpadding="0" class="MainTable"> <tr> <td><img src="http://www2.kenes.com/liver-congress/PublishingImages/top_ei.jpg" width="760" height="129" /></td> </tr> <tr> <td class="content"><h1>Poster Presentations</h1> <P><b>Session Title:</b> Category 9. ELASTOGRAPHY / LIVER STIFFNESS<br><b>Presentation Date:</b> Apr 15, 2010</P><h2 align='left'><B>PROSPECTIVE INDEPENDENT VALIDATION AND COMPARISON OF 10 BIOMAKERS AND TRANSIENT ELASTROGRAPHY (FIBROSCAN"!) FOR LIVER FIBROSIS ASSESSMENT IN PATIENTS WITH CHRONIC HEPATITIS C</B></h2> <p align='left'><b>J.P. Zarski</b><sup>1,2</sup>*, N. Sturm<sup>3</sup>, J. Guéchot<sup>4</sup>, A. Paris<sup>5</sup>, ANRS HCEPT 23 Fibrostar Group<br> <em><sup>1</sup>Hepato-Gastroenterology, CHU de Grenoble, <sup>2</sup>Unité INSERM UJF U823 IAPC, Institut Albert Bonniot, <sup>3</sup>Anatomie et Cytologie Pathologiques, CHU de Grenoble, Grenoble, <sup>4</sup>Laboratoire de Biochimie A, Hopital St Antoine, Paris, <sup>5</sup>Centre d'Investigation Clinique, CHU de Grenoble, Grenoble, France. *jpzarski@chu-grenoble.fr</em></p><br> <p align='justify'>No independent study has compared all the non invasive markers for the diagnosis of liver fibrosis in CHC. The aim of the multicenter prospective and independent study was to compare the diagnosis performance of 10 non invasive blood tests and Fibroscan"! to assess liver fibrosis as compared to liver biopsy in untreated patients with CHC. <br>512 patients with simultaneous liver biopsy, blood tests (Fibrotest®, Fibrometer®, Forns, Apri, MP3, ELFG, Hepascore, FIB-4, hyaluronate) centralized and performed in the same lab and Fibroscan"! were included. Liver biopsy (mean length = 25 +/- 8.4 mm) was independently reviewed by 2 senior pathologist with consensual reanalysis in cases of disagreements. Performance was evaluated using receiver operating characteristics (ROC) curves corrected by DANA method and Obuchowski measure in order to prevent spectrum bias and to assess diagnostic accuracy. <br>Metavir stages were F0 : 6.5 %, F1 45.3 %; F2 18.2 %, F3 15.5 %, and F4 14.5 %. The AUROC's range from 0.83 Fibrometer<sup>®</sup> to 0.5 Hyaluronate, F e" 2, from 0.87 (Fibroscan"!) to 0.78 for F e" 3, and from 0.92 (Fibroscan"!) to 0.80 (MP3) for cirrhosis. The 2 best tests were Fibrometer<sup>®</sup> (0.90) and Fibrotest® (0.80) by Obuchowski measure. Liver biopsy could be avoided with 90 % NPV in 26.9 % of cases by Fibroscan"!, 23.8 % by Hepascore, 21.5 % by Fibrometer<sup>®</sup> and 21.3 % by Fibrotest®. The synchronous combination of Fibrometer<sup>®</sup> or Fibrotest®, or Hepascore and Fibroscan"! improve the diagnostic accuracy from 73 - 74 % to 87 - 88 % for F e" 2 (p < 0.05). The diagnosis of significant fibrosis could be identified by a sequential algorithm using Fibrometer® > 0.70 then Fibroscan"! > 7.5 KPa with a high accuracy (92.5 %). <br>This independent multicenter prospective study definitely confirms the best diagnostic performance of Fibrometer® and Fibrotest®, which should be used in first intention for the assessement of liver fibrosis in untreated patients with chronic hepatitis C. The synchronous combination of a blood test and Fibroscan"! increases significantly the number of saved biopsies. Fibrometer® then Fibroscan"! have a high accuracy for the diagnosis of F e" 2.</p> <br><a href='Session-P01-9.htm'>Back</a><br> <p>&nbsp;</p> <p>&nbsp;</p></td> </tr> </table> </body> </html>