Transient elastography and apri score: looking at false positives and false negatives. Diagnostic performance and association to fibrosis staging in chronic hepatitis c

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dc.contributor.authorMendes, L. C.
dc.contributor.authorFerreira, P. A. [UNIFESP]
dc.contributor.authorMiotto, N.
dc.contributor.authorZanaga, L.
dc.contributor.authorGoncales, E.
dc.contributor.authorLazarini, M. S.
dc.contributor.authorGoncales Junior, F. L.
dc.contributor.authorStucchi, R. S. B.
dc.contributor.authorVigani, A. G.
dc.date.accessioned2019-01-21T10:29:53Z
dc.date.available2019-01-21T10:29:53Z
dc.date.issued2016
dc.description.abstractAlthough long regarded as the gold standard for liver fibrosis staging in chronic hepatitis C (CHC), liver biopsy (LB) implies both the risk of an invasive procedure and significant variability. The aim of this study was to evaluate the diagnostic performance for transient elastography (TE) and aspartate aminotransferase to platelet index (APRI) used alone and in combination compared to liver biopsy and to analyze false positive/negative results. Patients with CHC, and no previous clinical diagnosis of cirrhosis were enrolled to undergo liver biopsy, TE and APRI. A total of 182 adult patients with a median age of 55 years and median body mass index of 26.71 kg/m(2) were analyzed. On LB, 56% of patients had significant levels of fibrosis (METAVIR F >= 2) and 28% had advanced fibrosis (F3/F4). The strongest performance for both tests was observed for exclusion of advanced fibrosis with good negative predictive values (89 and 86%, respectively). Low necroinflammatory activity on LB was associated with false negative TE. False positives were associated with NASH and smaller LB fragments. Correlation between APRI and Fibroscan for F >= 2 was 100% and 84% for F >= 3 and remained high in both false negative and false positive instances, correctly identifying F < 2 in 71% of cases and F < 3 in 78% (and potentially foregoing up to 84% of LB). We concluded that low individual performance indicators could be attributable to limitations of LB. Poorer differentiation of lower levels of fibrosis is a known issue for LB and remains so for noninvasive tests. Good predictability is possible, however, for advanced fibrosis.en
dc.description.affiliationDepartamento de Doenças Infecciosas, Universidade Estadual de Campinas, Campinas, SP, Brasil
dc.description.affiliationDepartamento de Doenças Infecciosas, Universidade Federal de São Paulo, São Paulo, SP, Brasil
dc.description.affiliationUnifespDepartamento de Doenças Infecciosas, Universidade Federal de São Paulo, São Paulo, SP, Brasil
dc.description.sourceWeb of Science
dc.format.extente5432
dc.identifierhttp://dx.doi.org/10.1590/1414-431X20165432
dc.identifier.citationBrazilian Journal Of Medical And Biological Research. Sao paulo, v. 49, n. 9, p. e5432, 2016.
dc.identifier.doi10.1590/1414-431X20165432
dc.identifier.fileS0100-879X2016000900702.pdf
dc.identifier.issn0100-879X
dc.identifier.scieloS0100-879X2016000900702
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/49453
dc.identifier.wosWOS:000381098700009
dc.language.isoeng
dc.publisherHindawi Ltd
dc.relation.ispartofBrazilian Journal Of Medical And Biological Research
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectLiver Biopsyen
dc.subjectNoninvasive Testsen
dc.subjectAprien
dc.subjectTransient Elastographyen
dc.subjectAccuracyen
dc.subjectFalse ResultsChronic Viral-Hepatitisen
dc.subjectLiver Fibrosisen
dc.subjectNoninvasive Assessmenten
dc.subjectStiffness Measurementen
dc.subjectBiopsyen
dc.subjectCirrhosisen
dc.subjectAccuracyen
dc.subjectInfectionen
dc.subjectMulticenteren
dc.subjectPredictionen
dc.titleTransient elastography and apri score: looking at false positives and false negatives. Diagnostic performance and association to fibrosis staging in chronic hepatitis cen
dc.typeinfo:eu-repo/semantics/article
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