Abstract
Background and aimCurrently, non-alcoholic steatohepatitis (NASH) can only be diagnosed histopathologically. Our objective was to establish a new scoring system for the fibrotic stage of NASH.MethodsWe enrolled 139 patients with histologically proven NASH and divided them into two groups to construct (n = 90) and validate (n = 49) a fibrotic score for NASH (FSN). We used 17 variables and their natural logarithmic transformations in the multivariate analysis. To assess the accuracy of the FSN in determining NASH advanced fibrosis (stages 3–4), we compared various fibrotic scores for NASH.ResultsIn the construct group, multivariate regression analysis ultimately obtained the following function: z = 1.022 × ln (type IV collagen 7S) (ng/mL) − 0.00680 × (platelet count) (×109/L) + 1.925 × ln (AST) (IU/L) − 1.239 × ln (ALT) (IU/L) + 0.249. Median values of the FSN for stages 1, 2, 3 and 4 were 1.87, 2.14, 3.26 and 3.89, respectively. The multiple regression coefficient and coefficient of determination were 0.70 and 0.46, respectively. In the validation group, the median value was 2.00, 2.83, 3.08 and 4.37 in each stage. With regard to the utility of the FSN for predicting advanced fibrosis of NASH (stage ≥3), the area under the receiver operating characteristic curves (AUROC), 0.909 (95 % CI 0.847–0.970, p < 0.001), was higher than that for the other fibrotic scores (APRI, NAFLD fibrosis score, FIB-4 index, BARD score, NIKEI) in the construct group.ConclusionsThis simple scoring system accurately predicts fibrotic stage and discriminates patients with advanced fibrosis of NASH.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease in Western countries [1,2,3,4], Hepatol Int (2015) 9:269–277 and more recently, in many Asian nations [5, 6]
Patients with NAFLD and advanced fibrosis have a higher risk of hepatocarcinogenesis, similar to individuals with viral hepatitis [8,9,10]
The non-alcoholic steatohepatitis (NASH) lesions are unevenly distributed throughout the liver parenchyma; liver biopsy has inherent sampling errors, which can lead to substantial inaccuracies in stratification and staging [11]
Summary
Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease in Western countries [1,2,3,4], Hepatol Int (2015) 9:269–277 and more recently, in many Asian nations [5, 6]. Patients with nonalcoholic steatohepatitis (NASH), a subcategory of NAFLD, are at increased risk for developing hepatocellular carcinoma [7]. NASH can only be diagnosed by histopathology. Because of increased cost, possible risks (risk of bleeding, allergic reaction caused by local anesthetics, advanced age), and health-care resource utilization, invasive liver biopsy is poorly suited as a diagnostic method for such a prevalent condition. Non-alcoholic steatohepatitis (NASH) can only be diagnosed histopathologically. Methods We enrolled 139 patients with histologically proven NASH and divided them into two groups to construct (n = 90) and validate (n = 49) a fibrotic score for NASH (FSN). To assess the accuracy of the FSN in determining NASH advanced fibrosis (stages 3–4), we compared various fibrotic scores for NASH
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
