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P1526 - Performance of Lab-Based Scoring Tests for the Assessment of Hepatic Fibrosis Compared to the Liver Biopsy Among Patients With Non-Alcoholic Fatty Liver Disease

Monday, October 28

10:30 AM - 4:15 PM

Location: Exhibit Halls 3 and 4 (Street Level)

Presenting Author(s)

AM

Alexander Miller, MD

Columbus, Ohio

Alexander Miller, MD¹, Na Li, MD, PhD¹, Alice Hinton, PhD², Khalid Mumtaz, MD¹

¹The Ohio State University Wexner Medical Center, Columbus, OH; ²The Ohio State University, Columbus, OH

Introduction: The prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing worldwide. Hepatic fibrosis is the most important predictor for its prognosis. Various lab-based scoring tests have been developed as non-invasive measures to assess for hepatic fibrosis. The aim of this study was to examine the performance of these tests compared to the liver biopsy.

Methods: This is a retrospective study that included 354 biopsy-proven NAFLD patients. The sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver operating characteristic (AUROC) curve of aspartate aminotransferase to platelet ratio (APRI), Fibrosis-4 (FIB-4), and NAFLD fibrosis score (NFS) were compared to histological fibrosis between groups without (F0-2) and with advanced hepatic fibrosis (F3-4).

Results: The mean age of our study population was 50±13 years. The mean BMI was 33.92 ±8.51 kg/m2. The majority were whites (87.29%) and females (57.63%). The overall mean prevalence of F0-2 fibrosis and F3-4 were 73.7% and 26.3%, respectively. Patients with NFS ≤0.675 were less likely to have advanced hepatic fibrosis (P=0.011) compared to those who had NFS >0.675. With NFS ≤0.675 and >0.675, the sensitivity and specificity for advanced hepatic fibrosis were 37.6% and 76.2%, and the AUROC was 0.56. The sensitivities and specificities of NFS, APRI and FIB-4 for detecting advanced histological fibrosis are shown in the table.

Discussion: This is the largest study comparing various lab-based scoring tests with the liver biopsy. The performance of lab-based scoring tests is overall not satisfactory. Therefore, new tests or a combination of these tests with other modality such as elastography is warranted to reliably assess the stages of hepatic fibrosis.

Sensitivity, specificity, and positive and negative predictive values for identifying patients with F3-4.

Disclosures:

Alexander Miller indicated no relevant financial relationships.

Na Li indicated no relevant financial relationships.

Alice Hinton indicated no relevant financial relationships.

Khalid Mumtaz indicated no relevant financial relationships.

Citation: Alexander Miller, MD; Na Li, MD, PhD; Alice Hinton, PhD; Khalid Mumtaz, MD. P1526 - PERFORMANCE OF LAB-BASED SCORING TESTS FOR THE ASSESSMENT OF HEPATIC FIBROSIS COMPARED TO THE LIVER BIOPSY AMONG PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE. Program No. P1526. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.