Accuracy of non-invasive scoring systems for diagnosing non-alcoholic steatohepatitis-related fibrosis: Multicenter validation study

Yoshito Itoh, Yuya Seko, Toshihide Shima, Tomoaki Nakajima, Kei Mizuno, Yusuke Kawamura, Norio Akuta, Kiyoaki Ito, Miwa Kawanaka, Akira Hiramatsu, Michiie Sakamoto, Kenichi Harada, Yoshihito Goto, Takeo Nakayama, Hiromitsu Kumada, Takeshi Okanoue

Research output: Contribution to journalArticle

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Abstract

Aim: Hepatic fibrosis is the most important factor for estimating the prognosis of patients with non-alcoholic fatty liver disease (NAFLD). A novel non-invasive scoring system, the FM-fibro index, showed high accuracy in a pilot study. The purpose of this study was to validate the efficacy of the FM-fibro index in a multicenter cohort. Methods: Among 18 institutions, we analyzed 400 Japanese patients with biopsy-proven NAFLD. We evaluated the accuracies of the FM-fibro index, CA-fibro index, and European Liver Fibrosis (ELF) panel by area under the receiver operator characteristics curves (AUROC). The FM-fibro index includes three formulas for type IV collagen 7S, hyaluronic acid, and vascular cell adhesion molecule-1. Results: Among 400 patients, 205 were women, and the median age was 56 years. The histological distribution of Matteoni types 1, 2, 3, and 4 was 11, 40, 15, and 334, and the distribution of hepatic fibrosis stages 0 to 4 was 67, 183, 55, 63, and 32, respectively. The AUROCs of the FM-fibro index, CA-fibro index, and ELF panel for non-alcoholic steatohepatitis (NASH)-related fibrosis were 0.7178/0.7095/0.7065, 0.7093, and 0.7245, respectively. The sensitivity and specificity of the FM-fibro index for predicting NASH-related fibrosis was 0.5359/0.5210/0.4641 and 0.8333/0.8182/0.8788, respectively. The accuracy of the FM-fibro index was not significantly different from that of the CA-fibro index or the ELF panel. Conclusions: The FM-fibro index can predict NASH-related fibrosis with sufficient accuracy compared with previous scoring systems. Further analyses that verify the accuracy of the FM-fibro index to distinguish significant or advanced fibrosis in patients with NAFLD are awaited. (UMIN-CTR: UMIN000018158).

Original languageEnglish
JournalHepatology Research
DOIs
Publication statusAccepted/In press - 2018 Jan 1

Fingerprint

Validation Studies
Fatty Liver
Multicenter Studies
Fibrosis
Liver Cirrhosis
Collagen Type IV
Vascular Cell Adhesion Molecule-1
Liver
Hyaluronic Acid
Biopsy
Sensitivity and Specificity
Non-alcoholic Fatty Liver Disease

Keywords

  • FM-fibro index
  • liver fibrosis
  • non-alcoholic fatty liver disease

ASJC Scopus subject areas

  • Hepatology
  • Infectious Diseases

Cite this

Accuracy of non-invasive scoring systems for diagnosing non-alcoholic steatohepatitis-related fibrosis : Multicenter validation study. / Itoh, Yoshito; Seko, Yuya; Shima, Toshihide; Nakajima, Tomoaki; Mizuno, Kei; Kawamura, Yusuke; Akuta, Norio; Ito, Kiyoaki; Kawanaka, Miwa; Hiramatsu, Akira; Sakamoto, Michiie; Harada, Kenichi; Goto, Yoshihito; Nakayama, Takeo; Kumada, Hiromitsu; Okanoue, Takeshi.

In: Hepatology Research, 01.01.2018.

Research output: Contribution to journalArticle

Itoh, Y, Seko, Y, Shima, T, Nakajima, T, Mizuno, K, Kawamura, Y, Akuta, N, Ito, K, Kawanaka, M, Hiramatsu, A, Sakamoto, M, Harada, K, Goto, Y, Nakayama, T, Kumada, H & Okanoue, T 2018, 'Accuracy of non-invasive scoring systems for diagnosing non-alcoholic steatohepatitis-related fibrosis: Multicenter validation study', Hepatology Research. https://doi.org/10.1111/hepr.13226
Itoh, Yoshito ; Seko, Yuya ; Shima, Toshihide ; Nakajima, Tomoaki ; Mizuno, Kei ; Kawamura, Yusuke ; Akuta, Norio ; Ito, Kiyoaki ; Kawanaka, Miwa ; Hiramatsu, Akira ; Sakamoto, Michiie ; Harada, Kenichi ; Goto, Yoshihito ; Nakayama, Takeo ; Kumada, Hiromitsu ; Okanoue, Takeshi. / Accuracy of non-invasive scoring systems for diagnosing non-alcoholic steatohepatitis-related fibrosis : Multicenter validation study. In: Hepatology Research. 2018.
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T2 - Multicenter validation study

AU - Itoh, Yoshito

AU - Seko, Yuya

AU - Shima, Toshihide

AU - Nakajima, Tomoaki

AU - Mizuno, Kei

AU - Kawamura, Yusuke

AU - Akuta, Norio

AU - Ito, Kiyoaki

AU - Kawanaka, Miwa

AU - Hiramatsu, Akira

AU - Sakamoto, Michiie

AU - Harada, Kenichi

AU - Goto, Yoshihito

AU - Nakayama, Takeo

AU - Kumada, Hiromitsu

AU - Okanoue, Takeshi

PY - 2018/1/1

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N2 - Aim: Hepatic fibrosis is the most important factor for estimating the prognosis of patients with non-alcoholic fatty liver disease (NAFLD). A novel non-invasive scoring system, the FM-fibro index, showed high accuracy in a pilot study. The purpose of this study was to validate the efficacy of the FM-fibro index in a multicenter cohort. Methods: Among 18 institutions, we analyzed 400 Japanese patients with biopsy-proven NAFLD. We evaluated the accuracies of the FM-fibro index, CA-fibro index, and European Liver Fibrosis (ELF) panel by area under the receiver operator characteristics curves (AUROC). The FM-fibro index includes three formulas for type IV collagen 7S, hyaluronic acid, and vascular cell adhesion molecule-1. Results: Among 400 patients, 205 were women, and the median age was 56 years. The histological distribution of Matteoni types 1, 2, 3, and 4 was 11, 40, 15, and 334, and the distribution of hepatic fibrosis stages 0 to 4 was 67, 183, 55, 63, and 32, respectively. The AUROCs of the FM-fibro index, CA-fibro index, and ELF panel for non-alcoholic steatohepatitis (NASH)-related fibrosis were 0.7178/0.7095/0.7065, 0.7093, and 0.7245, respectively. The sensitivity and specificity of the FM-fibro index for predicting NASH-related fibrosis was 0.5359/0.5210/0.4641 and 0.8333/0.8182/0.8788, respectively. The accuracy of the FM-fibro index was not significantly different from that of the CA-fibro index or the ELF panel. Conclusions: The FM-fibro index can predict NASH-related fibrosis with sufficient accuracy compared with previous scoring systems. Further analyses that verify the accuracy of the FM-fibro index to distinguish significant or advanced fibrosis in patients with NAFLD are awaited. (UMIN-CTR: UMIN000018158).

AB - Aim: Hepatic fibrosis is the most important factor for estimating the prognosis of patients with non-alcoholic fatty liver disease (NAFLD). A novel non-invasive scoring system, the FM-fibro index, showed high accuracy in a pilot study. The purpose of this study was to validate the efficacy of the FM-fibro index in a multicenter cohort. Methods: Among 18 institutions, we analyzed 400 Japanese patients with biopsy-proven NAFLD. We evaluated the accuracies of the FM-fibro index, CA-fibro index, and European Liver Fibrosis (ELF) panel by area under the receiver operator characteristics curves (AUROC). The FM-fibro index includes three formulas for type IV collagen 7S, hyaluronic acid, and vascular cell adhesion molecule-1. Results: Among 400 patients, 205 were women, and the median age was 56 years. The histological distribution of Matteoni types 1, 2, 3, and 4 was 11, 40, 15, and 334, and the distribution of hepatic fibrosis stages 0 to 4 was 67, 183, 55, 63, and 32, respectively. The AUROCs of the FM-fibro index, CA-fibro index, and ELF panel for non-alcoholic steatohepatitis (NASH)-related fibrosis were 0.7178/0.7095/0.7065, 0.7093, and 0.7245, respectively. The sensitivity and specificity of the FM-fibro index for predicting NASH-related fibrosis was 0.5359/0.5210/0.4641 and 0.8333/0.8182/0.8788, respectively. The accuracy of the FM-fibro index was not significantly different from that of the CA-fibro index or the ELF panel. Conclusions: The FM-fibro index can predict NASH-related fibrosis with sufficient accuracy compared with previous scoring systems. Further analyses that verify the accuracy of the FM-fibro index to distinguish significant or advanced fibrosis in patients with NAFLD are awaited. (UMIN-CTR: UMIN000018158).

KW - FM-fibro index

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