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2017 ; 8
(10
): e3135
Nephropedia Template TP
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English Wikipedia
The non-invasive serum biomarker soluble Axl accurately detects advanced liver
fibrosis and cirrhosis
#MMPMID29072690
Staufer K
; Dengler M
; Huber H
; Marculescu R
; Stauber R
; Lackner C
; Dienes HP
; Kivaranovic D
; Schachner C
; Zeitlinger M
; Wulkersdorfer B
; Rauch P
; Prager G
; Trauner M
; Mikulits W
Cell Death Dis
2017[Oct]; 8
(10
): e3135
PMID29072690
show ga
Soluble Axl (sAxl) was recently shown to be strongly released into the blood
during liver fibrogenesis and hepatocellular carcinoma suggesting sAxl as a
biomarker of liver diseases. In this study we are the first to evaluate sAxl in
human serum in comparison to Enhanced Liver Fibrosis (ELF) test and transient
elastography (TE; Fibroscan) for its value to detect significant (F?2), advanced
fibrosis (F?3), and cirrhosis (F4) in different liver disease etiologies and
healthy controls. To properly determine the diagnostic accuracy of sAxl, a test
cohort as well as a validation cohort was employed using liver biopsy as a
reference method. Most notably, sAxl was confirmed to be an accurate biomarker of
liver fibrosis and cirrhosis. Its accuracy was increased, if total serum albumin
was added to build a sAxl/albumin ratio. Thereby an AUC of 0.763, 0.776, 0.826,
and 0.832 was achieved corresponding to histological fibrosis stages F?2, F?3, F4
with liver biopsy as a reference method, and cirrhosis according to imaging
techniques, respectively. With a cut-off of 1.29, a sensitivity, specificity,
PPV, and NPV of 78.5%, 80.1%, 44%, 94.9% for the detection of cirrhosis was
achieved. In comparison, ELF test and TE showed an AUC of 0.910, and 0.934,
respectively, for the detection of cirrhosis. However, performance of TE was not
possible in 14.4% of patients and both, ELF? test and TE bear the disadvantage of
high costs. In conclusion, the sAxl/albumin ratio is suggested as an accurate
biomarker of liver fibrosis and cirrhosis. Due to its easy applicability and low
costs it is suitable as screening parameter for significant to advanced liver
fibrosis and cirrhosis, especially if TE is not available or not applicable.
free
free
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