Prospective evaluation of FIBROSpect II for fibrosis detection in hepatitis C and B patients undergoing laparoscopic biopsy

Lennox J Jeffers, Rafael A. Cortes, Pablo A. Bejarano, Esther Oh, Arie Regev, Katie M. Smith, Maria De Medina, Margaret Smith-Riggs, Marlene Colon, Keith Hettinger, Sandra Jara, Tulia Patricia Mendez, Eugene R Schiff

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Serum markers of liver fibrosis are difficult to validate, due to the sampling error and observer variability associated with percutaneous liver biopsies. Laparoscopic biopsy decreases sampling error and increases the reliability of histopathologic assessment. We prospectively evaluated the FIBROSpectSM II serum marker test for viral liver fibrosis against laparoscopic biopsies by studying 145 patients with chronic hepatitis B or C who underwent laparoscopy in a tertiary care setting. Serum samples obtained at biopsy were tested with FIBROSpect II to assess the degree of fibrosis. Multiple biopsies were obtained from each patient and scored blindly using the Batts-Ludwig system. An average biopsy stage was calculated and the performance of the test panel assessed. FIBROSpect II was able to rule in significant fibrosis (stages 2-4), with a likelihood ratio of 2.6. It correctly indicated absence of disease in 74% of stages 0-1 patients and correctly predicted significant disease in 67% of stages 2-4 patients. Test correlation was highest with Batts-Ludwig stages 3 (77%) and 4 (96%) and lowest with stage 2 (43%). Multiple biopsies from 52% of patients differed by at least 1 stage. In 13 patients (9%), cirrhosis was detected by laparoscopy but not histologically; in 4 (3%), a stage of 4 was obtained, but cirrhosis was not evident by laparoscopy. FIBROSpect II provided valuable additional information for assessing fibrosis. The discordance in fibrosis stage seen in multiple biopsies from the same patient underscores the need to consider all available information when assessing fibrosis. This study confirms and extends results of previous studies evaluating FIBROSpect II using percutaneous liver biopsy.

Original languageEnglish
Pages (from-to)367-376
Number of pages10
JournalGastroenterology and Hepatology
Volume3
Issue number5
StatePublished - May 1 2007

Fingerprint

Hepatitis C
Hepatitis B
Fibrosis
Biopsy
Laparoscopy
Selection Bias
Liver Cirrhosis
Biomarkers
Liver
Chronic Hepatitis B
Chronic Hepatitis C
Tertiary Healthcare
Serum

Keywords

  • Biopsy
  • Fibrosis
  • FIBROSpect II
  • Hepatitis B
  • Hepatitis C
  • Laparoscopy
  • Noninvasive
  • Serum markers

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Prospective evaluation of FIBROSpect II for fibrosis detection in hepatitis C and B patients undergoing laparoscopic biopsy. / Jeffers, Lennox J; Cortes, Rafael A.; Bejarano, Pablo A.; Oh, Esther; Regev, Arie; Smith, Katie M.; De Medina, Maria; Smith-Riggs, Margaret; Colon, Marlene; Hettinger, Keith; Jara, Sandra; Mendez, Tulia Patricia; Schiff, Eugene R.

In: Gastroenterology and Hepatology, Vol. 3, No. 5, 01.05.2007, p. 367-376.

Research output: Contribution to journalArticle

Jeffers, LJ, Cortes, RA, Bejarano, PA, Oh, E, Regev, A, Smith, KM, De Medina, M, Smith-Riggs, M, Colon, M, Hettinger, K, Jara, S, Mendez, TP & Schiff, ER 2007, 'Prospective evaluation of FIBROSpect II for fibrosis detection in hepatitis C and B patients undergoing laparoscopic biopsy', Gastroenterology and Hepatology, vol. 3, no. 5, pp. 367-376.
Jeffers, Lennox J ; Cortes, Rafael A. ; Bejarano, Pablo A. ; Oh, Esther ; Regev, Arie ; Smith, Katie M. ; De Medina, Maria ; Smith-Riggs, Margaret ; Colon, Marlene ; Hettinger, Keith ; Jara, Sandra ; Mendez, Tulia Patricia ; Schiff, Eugene R. / Prospective evaluation of FIBROSpect II for fibrosis detection in hepatitis C and B patients undergoing laparoscopic biopsy. In: Gastroenterology and Hepatology. 2007 ; Vol. 3, No. 5. pp. 367-376.
@article{a2519afc2479455fb3c7c2052ab29b5c,
title = "Prospective evaluation of FIBROSpect II for fibrosis detection in hepatitis C and B patients undergoing laparoscopic biopsy",
abstract = "Serum markers of liver fibrosis are difficult to validate, due to the sampling error and observer variability associated with percutaneous liver biopsies. Laparoscopic biopsy decreases sampling error and increases the reliability of histopathologic assessment. We prospectively evaluated the FIBROSpectSM II serum marker test for viral liver fibrosis against laparoscopic biopsies by studying 145 patients with chronic hepatitis B or C who underwent laparoscopy in a tertiary care setting. Serum samples obtained at biopsy were tested with FIBROSpect II to assess the degree of fibrosis. Multiple biopsies were obtained from each patient and scored blindly using the Batts-Ludwig system. An average biopsy stage was calculated and the performance of the test panel assessed. FIBROSpect II was able to rule in significant fibrosis (stages 2-4), with a likelihood ratio of 2.6. It correctly indicated absence of disease in 74{\%} of stages 0-1 patients and correctly predicted significant disease in 67{\%} of stages 2-4 patients. Test correlation was highest with Batts-Ludwig stages 3 (77{\%}) and 4 (96{\%}) and lowest with stage 2 (43{\%}). Multiple biopsies from 52{\%} of patients differed by at least 1 stage. In 13 patients (9{\%}), cirrhosis was detected by laparoscopy but not histologically; in 4 (3{\%}), a stage of 4 was obtained, but cirrhosis was not evident by laparoscopy. FIBROSpect II provided valuable additional information for assessing fibrosis. The discordance in fibrosis stage seen in multiple biopsies from the same patient underscores the need to consider all available information when assessing fibrosis. This study confirms and extends results of previous studies evaluating FIBROSpect II using percutaneous liver biopsy.",
keywords = "Biopsy, Fibrosis, FIBROSpect II, Hepatitis B, Hepatitis C, Laparoscopy, Noninvasive, Serum markers",
author = "Jeffers, {Lennox J} and Cortes, {Rafael A.} and Bejarano, {Pablo A.} and Esther Oh and Arie Regev and Smith, {Katie M.} and {De Medina}, Maria and Margaret Smith-Riggs and Marlene Colon and Keith Hettinger and Sandra Jara and Mendez, {Tulia Patricia} and Schiff, {Eugene R}",
year = "2007",
month = "5",
day = "1",
language = "English",
volume = "3",
pages = "367--376",
journal = "Gastroenterology and Hepatology",
issn = "1554-7914",
publisher = "Gastro-Hep Communications, Inc.",
number = "5",

}

TY - JOUR

T1 - Prospective evaluation of FIBROSpect II for fibrosis detection in hepatitis C and B patients undergoing laparoscopic biopsy

AU - Jeffers, Lennox J

AU - Cortes, Rafael A.

AU - Bejarano, Pablo A.

AU - Oh, Esther

AU - Regev, Arie

AU - Smith, Katie M.

AU - De Medina, Maria

AU - Smith-Riggs, Margaret

AU - Colon, Marlene

AU - Hettinger, Keith

AU - Jara, Sandra

AU - Mendez, Tulia Patricia

AU - Schiff, Eugene R

PY - 2007/5/1

Y1 - 2007/5/1

N2 - Serum markers of liver fibrosis are difficult to validate, due to the sampling error and observer variability associated with percutaneous liver biopsies. Laparoscopic biopsy decreases sampling error and increases the reliability of histopathologic assessment. We prospectively evaluated the FIBROSpectSM II serum marker test for viral liver fibrosis against laparoscopic biopsies by studying 145 patients with chronic hepatitis B or C who underwent laparoscopy in a tertiary care setting. Serum samples obtained at biopsy were tested with FIBROSpect II to assess the degree of fibrosis. Multiple biopsies were obtained from each patient and scored blindly using the Batts-Ludwig system. An average biopsy stage was calculated and the performance of the test panel assessed. FIBROSpect II was able to rule in significant fibrosis (stages 2-4), with a likelihood ratio of 2.6. It correctly indicated absence of disease in 74% of stages 0-1 patients and correctly predicted significant disease in 67% of stages 2-4 patients. Test correlation was highest with Batts-Ludwig stages 3 (77%) and 4 (96%) and lowest with stage 2 (43%). Multiple biopsies from 52% of patients differed by at least 1 stage. In 13 patients (9%), cirrhosis was detected by laparoscopy but not histologically; in 4 (3%), a stage of 4 was obtained, but cirrhosis was not evident by laparoscopy. FIBROSpect II provided valuable additional information for assessing fibrosis. The discordance in fibrosis stage seen in multiple biopsies from the same patient underscores the need to consider all available information when assessing fibrosis. This study confirms and extends results of previous studies evaluating FIBROSpect II using percutaneous liver biopsy.

AB - Serum markers of liver fibrosis are difficult to validate, due to the sampling error and observer variability associated with percutaneous liver biopsies. Laparoscopic biopsy decreases sampling error and increases the reliability of histopathologic assessment. We prospectively evaluated the FIBROSpectSM II serum marker test for viral liver fibrosis against laparoscopic biopsies by studying 145 patients with chronic hepatitis B or C who underwent laparoscopy in a tertiary care setting. Serum samples obtained at biopsy were tested with FIBROSpect II to assess the degree of fibrosis. Multiple biopsies were obtained from each patient and scored blindly using the Batts-Ludwig system. An average biopsy stage was calculated and the performance of the test panel assessed. FIBROSpect II was able to rule in significant fibrosis (stages 2-4), with a likelihood ratio of 2.6. It correctly indicated absence of disease in 74% of stages 0-1 patients and correctly predicted significant disease in 67% of stages 2-4 patients. Test correlation was highest with Batts-Ludwig stages 3 (77%) and 4 (96%) and lowest with stage 2 (43%). Multiple biopsies from 52% of patients differed by at least 1 stage. In 13 patients (9%), cirrhosis was detected by laparoscopy but not histologically; in 4 (3%), a stage of 4 was obtained, but cirrhosis was not evident by laparoscopy. FIBROSpect II provided valuable additional information for assessing fibrosis. The discordance in fibrosis stage seen in multiple biopsies from the same patient underscores the need to consider all available information when assessing fibrosis. This study confirms and extends results of previous studies evaluating FIBROSpect II using percutaneous liver biopsy.

KW - Biopsy

KW - Fibrosis

KW - FIBROSpect II

KW - Hepatitis B

KW - Hepatitis C

KW - Laparoscopy

KW - Noninvasive

KW - Serum markers

UR - http://www.scopus.com/inward/record.url?scp=34250662941&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34250662941&partnerID=8YFLogxK

M3 - Article

C2 - 21960853

AN - SCOPUS:34250662941

VL - 3

SP - 367

EP - 376

JO - Gastroenterology and Hepatology

JF - Gastroenterology and Hepatology

SN - 1554-7914

IS - 5

ER -