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Utility of a discriminant score for diagnosing advanced fibrosis or cirrhosis in patients with chronic hepatitis C virus infection.

1997; National Institutes of Health; Volume: 92; Issue: 8 Linguagem: Inglês

Maurizio Bonacini, G Hadi, S Govindarajan, Karen L. Lindsay,

Liver Disease and Transplantation

The aim of the study was to assess the utility of a modified three-parameter cirrhosis discriminant score (CDS) for diagnosing advanced fibrosis or cirrhosis in patients with evidence of chronic hepatitis C.We examined liver tissue from 79 patients. Patients with a histological fibrosis score of 0-2 made up group A, and patients with a score of 3 or 4 (advanced fibrosis or cirrhosis) group B.The modified CDS (possible total score 0-11) was derived from three laboratory parameters: platelets, ALT/AST ratio, and PT. The total score was significantly lower in group A (4.3 +/- 2.0) than in group B (7.9 +/- 1.4) (p < 0.0001). There was a positive correlation between the CDS and histological fibrosis score (r = 0.64,p < 0.0001). With 8 or above as the cutoff value, the CDS had a sensitivity of 46% and a specificity of 98% for the diagnosis of histological fibrosis scores of 3 or 4.We conclude that a three-parameter CDS is useful for identifying patients with hepatitis C and a high likelihood of cirrhosis. Patients with a CDS < or =7 still require histological examination to identify advanced fibrosis or cirrhosis.