Razul Md Nazrl, Md Kassim
(2007)
The relation between non invasive markers and using the
Fibrotic index in liver biopsy specimen, from hepatitis c
Patients, at Hospital Alor Star.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background
Liver biopsy is a mandatory procedure in the management of patients with hepatitis C
virus infection, especially for staging fibrosis. We aimed, in our cross sectional study, to
assess the relation of the serum biochemical markers for the diagnosis of clinically
significant fibrosis(inc1uding early stages).
Method
We assessed liver biopsy patients with detectable hepatitis C by PCR, for eligibility and
took their blood sample for the biochemical test. The analysis was done on 60 patients.
We devised a fibrosis index that included the most informative markers (combined
With age and sex). Eleven serum markers were assessed as well as fibrosis stages: 80=
no fibrosis, 81 =fibrous expansion of some portal tracts ± short fibrous septa, S2=fibrous
expansion of most portal tracts ± short fibrous septa, 83= fibrous expansion of most
portal areas with occasional portal to portal (PP) bridging, 84=fibrous expansion of
portal areas with marked bridging ( PP as well as portal-central (PC), SS= marked
bridging (pP and or PC) with occasional nodules (incomplete cirrhosis), 86= cirrhosis,
probable or definite. Statistical analysis was done using mann whitney U test and receiver
operating characteristics ( ROC) curves.
xi RESULTS
Mean value of ALT, GMT, aldosterone, HOL, and albumin with mild fibrosis and severe
fibrosis, was 82±4and 125±31,47.5±31 and 81±25, 116.6±56and 184± 43,1.4±
0.3 and 0.9 ± 0.2 and, 42 ± 4 and 35 ± 3.2, respectively with a significant difference
between them was (p <0.05). The area under the operating receiver characteristics
showed significant accuracy for each biochemical parameters.
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