Noninvasive Diagnosis of Liver Fibrosis and Cirrhosis in Chronic Hepatitis C Patients

Background: We aimed to derive a simple noninvasivetestforliver-fibrosisstagingand then estimate its performance against four simple noninvasive tests in chronic hepatitis C (CHC) patients. Methods: CHC patients were divided into two cohorts: an estimation set (n = 324) and a validation set (n = 524). Liver fibrosis was staged according to the METAVIR scoring system. Statistical analysis was done using stepwise linear discriminant analysis and area under receiver-operating characteristic curves (AUCs). Results: Biotechnology Research Center (BRC) score was constructed combining several blood markers that proved useful to stage liver fibrosis. Aspartate aminotransferase /alanine aminotransferaseratio(AAR),aspartatetoplatelet ratio index (APRI), Fibro-α, King, and BRC scores correlated with the histological fibrosis stages with correlation coefficient 0.26, 0.36, 0.58, 0.45, and 0.73, respectively. BRC score produced AUCs 0.87, 0.83, and 0.89 for significant (F2‐F4), advanced fibrosis (F3‐F4), and cirrhosis (F4), respectively. These results were reproduced in the validation study with no significant difference yielding AUCs 0.85 for F2‐F4, 0.82 for F3‐F4, and 0.88 for F4. Conclusion: BRC score, a novel noninvasive test, is a useful and easy tool to evaluate liver fibrosis in CHC patients and seems more efficient than AAR, APRI, Fibro-α score, and King’s score in this group of Egyptian patients. J. Clin. Lab. Anal. 27:121‐129, 2013. C � 2013 Wiley Periodicals, Inc.