International Session（Symposium）1(JSH・JSGE・JSGCS)
Thu. November 5th   9:00 - 11:20   Room 5: Portopia Hotel South Wing Ohwada A
IS-S1-4_H
 The utility of combination uses two different approach fibrotic stages and disease phenotype for predicting high-risk NAFLD
Yusuke Kawamura1, Norio Akuta1, Hiromitsu Kumada1
1Department of Hepatology, Toranomon Hospital
Background: Previously, we reported, the importance of ethanol consumption (over 40g/day) and liver fibrosis for prediction hepatocarcinogenesis using almost 10,000 patients with fatty liver disease (FLD).
Aim: In this study, to detect the high-risk patients of non-alcoholic FLD (NAFLD) using two different approach fibrotic stages and disease phenotype based on initial laboratory data and clinical characteristics.
Methods: We enrolled consecutive 243 patients with histologically proven NAFLD. In this study, we combination uses two different pathological approaches, the fibrotic-score for NASH (FSN) and discriminant formula for the prediction of the aggressive-phenotype (AP) of NAFLD (D-APN). Advanced fibrosis was defined as FSN ≥2.8 and AP indicates the patient has disease progression potential progressed to a fibrotic stage beyond -2 in current and future.
In this study, advanced fibrosis defined at histologically ≥stage 3.
Results: In this study group include stage-0;n=14, stage-1;n=91, stage-2;n=31, stage-3;n=85, stage-4;n=22. At first, we estimate advanced fibrosis patients using FSN. FSN predict 84(78.5%) advanced fibrosis patients (sensitivity 78.5%, specificity 86.8%, positive and negative predictive value were 82.4%, 83.7%, respectively).
And, second, the distribution of the AP in misjudged non-advanced fibrosis using FSN, 17 of 23(74%) presented AP. Finally, almost 101 of 107(94%) of histologically advanced fibrosis patients could select for truly high-risk patients.
Conclusions: Combination uses FSN and D-APN were useful for predicting patients with advanced fibrosis.
Index Term 1: advanced fibrosis
Index Term 2: fatty liver disease
Page Top