The non-invasive accessible informative laboratory panel for detection of liver fibrosis - TEA index.

Abstract

The article presents the results of continued studies of informative accessible tests as a screening non-invasive technique of diagnostic of fibrosis under chronic hepatitis C. The sampling included 70 patients with chronic hepatitis C. The comparable control group included 30 healthy individuals. The ultrasonic elastography of liver was implemented using FibroScan («EchoSens», France). The concentration of tumor necrosis factor-alpha (TNF-α) in blood serum was detected by the enzyme-linked immunosorbent assay technique («StatFax», USA) using reagents of "Vektor-Best" (Russia); thrombocytes - by hematologic analyzer Medonic-620M (Sweden); albumin - by analyzer Archtekt-4000. The ROC-analysis and detection of odds ratio (QR) was implemented to calculate threshold values and diagnostic efficiency of indices with predictor value. The correlation relationship is established between density of hepatic tissue according ultrasonic elastography data and three applied tests: number of thrombocytes (r = -0,9), content of TNF-α (r = 0,89) and albumin (r = -0,9). These are the three tests included into mathematical model of diagnostic of fibrosis stage. The equation of multiple regression is reproduced in the utility patent № 2592371. The diagnostic value of the proposed index of fibrosis TTA (thrombocytes, TNF and albumin) according the scale METAVIR for F0 made up to 0-0.5; for F1-2 - 0.6-2.5; in case of expressed fibrosis/cirrhosis index made up to more than 2.5. The index TTA by its efficiency is comparable with more complicated analogues. The individual application of fibrosis predictors is possible: the test permit to exclude fibrosis under chronic hepatitis C at number of thrombocytes in blood more or equal to 282×109l,, value of TNF-α les or equal 1.9 pg/ml, level of albumin more or equal 47.3 g/l and also to differentiate stages of moderate (F1-2) and expressed fibrosis (F3-4). The index TTA of liver fibrosis can be applied to exclude fibrosis under chronic hepatitis C and also to establish stages of fibrosis with diagnostic sensitivity 93.3% and specificity 83%. At that, low approximate cost of examination has an important value.