scholarly journals Comparative study between liver biopsy and non-invasive biomarkers in assessment of hepatic fibrosis in children with chronic liver diseases

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Ola Galal Behairy ◽  
Ola Samir El-Shimi ◽  
Naglaa Hamed Shalan
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Liver Diseases ◽  
Area Under The Curve ◽  
Chronic Liver ◽  
Fibrosis Score ◽  
Chronic Liver Diseases ◽  
Non Invasive ◽  
Advanced Liver Fibrosis ◽  
Early Fibrosis

Abstract Background Liver biopsy is the gold standard for detecting the degree of liver fibrosis; however, invasiveness constitutes its main limiting factor in clinical application, so we aimed to evaluate the non-invasive biomarker formulas (APRI and FIB-4) and their modified forms by BMI z-score (M-APRI, M-FIB-4, and B-AST) compared to liver biopsy in the assessment of liver fibrosis in children with chronic liver diseases. Two hundred children aged 6.3 ± 3.8 years (98 males, 102 females) with chronic liver diseases underwent liver biopsy. The stage of fibrosis was assessed according to the METAVIR system for all children, and the following non-invasive biomarker formulas were calculated: APRI, modified APRI (M-APRI: BMI z-score × APRI), Fibrosis-4 index (FIB-4), modified FIB-4 (M-FIB-4: BMI z-score × FIB-4), and B-AST (BMI z-score × AST). The best cutoff value was calculated to detect early fibrosis (F1–F2) from advanced liver fibrosis (F3–F4). Results There were positive correlations between all studied non-invasive biomarker models (APRI, FIB-4, M-APRI, M-FIB-4, B-AST) and fibrosis score as an increase in fibrosis score was associated with an increase in mean ± SD of all studied biomarker formulas. The best cutoff values of non-invasive biomarker models in the diagnosis of early fibrosis (F1–F2) were APRI > 0.96, M-APRI > 0.16, FIB-4 > 0.019, M-FIB-4 > 0.005, and B-AST > −8 with an area under the curve above 0.7 each, while the best cutoff values of non-invasive biomarker models (APRI, M-APRI, FIB-4, M-FIB-4, and B-AST) in the diagnosis of advanced liver fibrosis (F3–F4) were >1.96, >2.2, >0.045, and >0.015, >92.1, respectively, with an area under the curve above 0.8 each. Conclusion APRI, M-APRI, FIB-4, M-FIB-4, and B-AST are good non-invasive alternatives to liver biopsy in the detection of liver fibrosis in children with chronic liver diseases of different etiologies especially those that include BMI z-scores in their formulas.

scholarly journals Matrix metalloproteinase-1 as a non-invasive biomarker to assess liver fibrosis in children with chronic liver disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ola Galal Behairy ◽  
Mohamed Mostafa El-Bakry ◽  
Amira Ibrahim Mansour ◽  
Amira M. N. Abdelrahman ◽  
Ghada Mansour Emam
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Liver Diseases ◽  
Serum Biomarkers ◽  
Chronic Liver ◽  
Control Group ◽  
Chronic Liver Diseases ◽  
Non Invasive ◽  
Matrix Metalloproteinase 1 ◽  
The Mean

Abstract Background Abnormal extracellular matrix (ECM) turnover is linked to liver fibrosis as it reflects an imbalance between repair and progressive substitution of the liver parenchyma by scar tissue. Matrix metalloproteinases (MMPs) are the primary enzymes involved in ECM breakdown. So, this study aims to measure the value of serum matrix metalloproteinase-1 (MMP-1) in children with chronic liver diseases (CLD) in comparison with liver biopsy and serum biomarkers. A hundred twenty children with chronic liver diseases and sixty healthy children as a control group were included in this study. Both groups were evaluated via medical history, clinical, radiological, laboratory investigations, and serum MMP-1 level was measured by ELISA. Liver biopsy was performed for studied patients only. Results The mean MMP-1 was 15.2 ± 5.1 ng/ml in children with CLD, and 64.7 ± 27.4 ng/ml in the control group. MMP-1 was statistically lower in the children with CLD than controls (p < 0.001). The mean ± SD of aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 (FIB-4) scores in all studied cases showed a significant trend of increase with progressive fibrosis stage evident with histological METAVIR scoring system, while serum MMP-1 concentration was decreased significantly with increasing the degree of fibrosis in CLD group (P 0.001). Serum MMP-1 was indirectly correlated with serum biomarkers and the degree of fibrosis in patients. Conclusions MMP-1 is a useful non-invasive marker for detection of the stage of liver fibrosis in children with chronic liver diseases.

CHANGES IN CONCENTRATION OF SERUM FIBROSIS DIRECT BIOMARKERS IN CHRONIC LIVER DISEASES IN CHILDREN

2021 ◽  
Vol 100 (2) ◽  
pp. 112-118
Author(s):  
E.A. Kulebina ◽  
◽  
A.N. Surkov ◽  
N.M. Alyabeva ◽  
I.V. Zubkova ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Blood Serum ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Type I ◽  
Chronic Liver Diseases ◽  
Non Invasive ◽  
Study Characteristics ◽  
A Prospective Study

It is assumed that serum concentrations of type I, III, IV collagen (Col I, Col III, Col IV) and hyaluronic acid (HA) can provide informative evidence for the diagnosis of liver fibrosis (LF) using non-invasive procedures, however, there is insufficient data on the subject in paediatrics. Objectives: to study characteristics of changes in concentrations of Col I, Col III, Col IV and HA in blood serum in accordance with the stages of liver fibrosis in children. Materials and methods of research: a prospective study was carried out, which included 80 patients aged 5 to 17 years with chronic liver diseases of various etiologies, who underwent marginal resection of liver tissue under laparoscopic control, then a morphological study of the obtained biopsy was performed with determination of the stage of fibrosis on the METAVIR scale and the content of Col I, Col III, Col IV and HA in blood serum by the method of enzyme immunoassay. Results: the assessment of the content of K-I in the blood serum allows differentiating the stage F1 and F3 from F4 (p=0,025, p=0,006), Col IV – F1 from F2 (p=0,011), F3 (p=0,002) and F4 (p<0,001), HA – F1 from F3 (p=0,041), and also F4 from F1 (p<0,001), F2 (p<0,001) and F3 (p<0,001). There were no statistically significant differences in the content of Col III at different stages of LF (p=0,061). Statistically significant correlations of the histological stage of LF with changes in serological levels of Col I (ρ=–0,267, p=0,023), Col IV (ρ=0,409, p<0,001), and HA (ρ=0,575, p<0,001), and also the relationship between the concentrations of Col IV and HA (ρ=0,265, p=0,023). Conclusions: the correlations found in the histological phase of LF with changes in serological levels of Col I, Col IV and HA lead to the conclusion that fibrosis direct biomarkers are of diagnostic importance in determining the stage of LF, which is of great importance for practical medicine, especially in pediatrics.

Serum N-glycan fingerprint nomogram predicts liver fibrosis: a multicenter study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Chenjun Huang ◽  
Lijuan Liu ◽  
Hao Wang ◽  
Meng Fang ◽  
Huijuan Feng ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Hepatitis Virus ◽  
Area Under The Curve ◽  
Chronic Liver Diseases ◽  
Non Invasive ◽  
Type Iv ◽  
End Stage ◽  
Procollagen Iii ◽  
Severe Fibrosis

Abstract Objectives Liver cirrhosis (LC) is the end-stage of fibrosis in chronic liver diseases, non-invasive early detection of liver fibrosis (LF) is particularly essential for therapeutic decision. Aberrant glycosylation of glycoproteins has been demonstrated to be closely related to liver abnormalities. Methods This study was designed to enroll a total of 1,565 participants with LC/LF, chronic hepatitis virus (CHB) and healthy controls. Fibrosis was confirmed by liver biopsy. Using capillary electrophoresis N-glycan fingerprint (NGFP) analysis, we developed a nomogram algorithm (FIB-G) to discriminate LC from non-cirrhotic subjects. Results The FIB-G demonstrated good diagnostic performances in identifying LC with the area under the curve (AUC) 0.895 (95%CI: 0.857–0.915). Furthermore, the diagnostic efficiencies of FIB-G were superior to that of log (P2/P8), procollagen III N-terminal (PIIINP), type IV collage (IV-C), laminin (LN), hyaluronic acid (HA), aspartate transaminase to platelets ratio index (APRI), and FIB-4 when detecting significant fibrosis (S0–1 vs. S2–4, AUC: 0.787, 95%CI: 0.701–0.873), severe fibrosis (S0–2 vs. S3–4, AUC: 0.844, 95%CI: 0.763–0.924), and LC (S0–3 vs. S4, AUC: 0.773, 95%CI: 0.667–0.880). Besides, changes of FIB-G were associated well with the regression of fibrosis and liver function Child–Pugh classification. Conclusions FIB-G is an accurate multivariant N-glycomic algorithm for LC prediction and fibrosis progression/regression monitoring. The high throughput feasible NGFP using only 2 μL of serum could help physicians make the more precise non-invasive staging of LF or cirrhosis and reduce the need for invasive liver biopsy.

scholarly journals Elast PQ Ultrasound - a Noninvasive, Reproducible, Easily Performed Method and a New Era in Liver Fibrosis Assessment

2018 ◽  
Vol 13 (1) ◽  
pp. 44-46
Author(s):  
Hafizur Rahman
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Viral Hepatitis ◽  
Ultrasound Imaging ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Invasive Technique ◽  
Liver Imaging ◽  
Chronic Liver Diseases

Liver fibrosis represents the repair mechanism in liver injury and is a feature of most chronic liver diseases. The degree of liver fibrosis in chronic viral hepatitis infection has major clinical implications and presence of advanced fibrosis or cirrhosis determines prognosis. Treatment initiation for viral hepatitis is indicated in most cases of advanced liver fibrosis and diagnosis of cirrhosis entails hepatology evaluation for specialized clinical care. Liver biopsy is an invasive technique and has been the standard of care of fibrosis assessment for years; however, it has several limitations and procedure related complications. Recently, several methods of noninvasive assessment of liver fibrosis have been developed which require either serologic testing or imaging of liver. Imaging based noninvasive techniques are reviewed here and their clinical use is described. Some of the imaging based tests are becoming widely available, and collectively they are shown to be superior to liver biopsy in important aspects. Clinical utilization of these methods requires understanding of performance and quality related parameters which can affect the results and provide wrong assessment of the extent of liver fibrosis. Familiarity with the strengths and weakness of each modality is needed to correctly interpret the results in appropriate clinical content. A new technique called Elast PQ uses ultrasound shear wave elastography to provide a noninvasive, reproducible, easily performed method of assessing liver fibrosis. It can easily combine a routine ultrasound imaging exam of the liver anatomy with targeted tissue stiffness values, assess liver fibrosis in patient with clinically suspected disease even before abnormalities are detected with ultrasound imaging, evaluate and obtain a baseline stiffness value in patients with chronic liver disease, follow up patients under treatment to monitor progression, stabilization or regression of liver disease and help avoid the need for liver biopsies when elastography results are consistent with other clinical findings. Both the prognosis and potential treatment of chronic liver diseases greatly depend on the progression of liver fibrosis, which is the ultimate outcome of chronic liver damage. Historically, liver biopsy has been instrumental in adequately assessing patients allows clinicians both to obtain diagnosis information and initiate adequate therapy. However, the technique is not exempt of deleterious effects. Multiple diagnostic tests have been developed for the staging of fibrosis using noninvasive methods, most of them in the setting of chronic hepatitis C. The goal of this paper is to review available data on the staging and assessment of liver fibrosis with two methods: serum markers & transient elastography (FibroScan).Faridpur Med. Coll. J. Jan 2018;13(1): 44-46

scholarly journals Options of non-invasive assessment of liver fibrosis based on the clinical data

2015 ◽  
Vol 156 (2) ◽  
pp. 43-52 ◽  
Author(s):  
Anna Egresi ◽  
Gabriella Lengyel ◽  
Krisztina Hagymási
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Gold Standard ◽  
Liver Diseases ◽  
Causes Of Death ◽  
Therapeutic Response ◽  
Transient Elastography ◽  
Chronic Liver Diseases ◽  
Indirect Methods ◽  
Non Invasive

Liver cirrhosis is one of the leading causes of death worldwide. Liver biopsy is considered as the gold standard for the diagnosis of chronic liver diseases. Studies have focused on non-invasive markers for liver fibrosis because of the dangers and complications of liver biopsy. The authors review the non-invasive direct as well as indirect methods for liver fibrosis assessment and present the positive and negative predictive value, sensitivity and specificity of those. Clinical utilities of transient elastography (Fibrsocan) is also reviewed. Non-invasive methods are useful in the assessment of liver fibrosis, monitoring disease progression and therapeutic response. Their accuracy can be increased by the combined or sequential use of non-invasive markers. Orv. Hetil., 2015, 156(2), 43–52.

scholarly journals Modern Possibilities of Endosurgical Biopsy in Children with Chronic Liver Diseases

2018 ◽  
Vol 15 (3) ◽  
pp. 238-248
Author(s):  
Polina V. Khrolenko ◽  
Elena Y. Dyakonova ◽  
Andrej N. Surkov ◽  
Aleksej A. Gusev ◽  
Tat’yana A. Prudnikova ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Liver Biopsy ◽  
Liver Diseases ◽  
Chronic Liver ◽  
Efficacy And Safety ◽  
Histopathological Changes ◽  
Chronic Liver Diseases ◽  
Orthotopic Transplantation ◽  
Non Invasive ◽  
Pathological Conditions

Chronic liver diseases in children are a group of pathological conditions which varies greatly in etiopathogenetic features heterogeneity and clinical picture, tends to progress if associated with cirrhosis and decompensate hepatic functions consequently following by orthotopic transplantation. Despite the introduction of many non-invasive methods of examination, biopsy continues to be a standard in the diagnosis of histopathological changes in liver tissue. The article reflects modern ideas about the efficacy and safety of various methods of liver biopsy in children. Comparative analysis results on the informative value of hepatobioptates obtained by various puncture techniques are provided.

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