Proton nuclear magnetic resonance-based metabonomic models for non-invasive diagnosis of liver fibrosis in chronic hepatitis C:Optimizing the classification of intermediate fibrosis

• 作者: Andrea Dória Batista Carlos Jonnatan Pimentel Barros Edmundo Pessoa de Almeida Lopes Joelma Carvalho Santos Mariana Montenegro de Melo Lira Michele Maria Goncalves de Godoy Norma ThoméJucá Ricardo Oliveira Silva Ronaldo Dionísio Silva Tássia Brena Barroso Carneiro Costa
• 来源期刊: 世界肝病学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Metabolomics Nuclear magnetic resonance spectroscopy Chronic hepatitis C Liver FIBROSIS Surrogate MARKERS
• 年，卷（期）: 2018,（1）
• 页码范围: 105-115
• 页数: 11页
• 分类号: R

摘要

AIM To develop metabonomic models(MMs),using 1H nuclear magnetic resonance(NMR)spectra of serum,to predict significant liver fibrosis(SF:Metavir≥F2),advanced liver fibrosis(AF:METAVIR≥F3)and cirrhosis(C:METAVIR=F4 or clinical cirrhosis)in chronic hepatitis C(CHC)patients.Additionally,to compare the accuracy of the MMs with the aspartate aminotransferase to platelet ratio index(APRI)and fibrosis index based on four factors(FIB-4).METHODS Sixty-nine patients who had undergone biopsy in the previous 12 mo or had clinical cirrhosis were included.The presence of any other liver disease was a criterion for exclusion.The MMs,constructed using partial least squares discriminant analysis and linear discriminant analysis formalisms,were tested by cross-validation,considering SF,AF and C.RESULTS Results showed that forty-two patients(61%)presented SF,28(40%)AF and 18(26%)C.The MMs showed sensitivity and specificity of 97.6%and 92.6%to predict SF;96.4%and 95.1%to predict AF;and 100%and 98.0%to predict C.Besides that,the MMs correctly classified all 27(39.7%)and 25(38.8%)patients with intermediate values of APRI and FIB-4,respectively.CONCLUSION The metabonomic strategy performed excellently in predicting significant and advanced liver fibrosis in CHC patients,including those in the gray zone of APRI and FIB-4,which may contribute to reducing the need for these patients to undergo liver biopsy.