Abstract
BACKGROUND: Collagen proportionate area (CPA) measurement is a technique that quantifies fibrous tissue in liver biopsies by measuring the amount of collagen deposition as a proportion of the total biopsy area. CPA predicts clinical outcomes in patients with HCV and can sub-classify cirrhosis.
AIM: To test the ability of CPA to quantify fibrosis and predict clinical outcomes in patients with NAFLD.
METHODS: We assessed consecutive patients with biopsy-proven NAFLD from three European centres. Clinical and laboratory data were collected at baseline and at the time of the last clinical follow-up or death. CPA was performed at two different objective magnifications, whole biopsy macro and ×4 objective magnification, named standard (SM) and high (HM) magnification respectively. The correlation between CPA and liver stiffness was assessed in a sub-group of patients.
RESULTS: Of 437 patients, 32 (7.3%) decompensated and/or died from liver-related causes during a median follow-up of 103 months. CPA correlated with liver stiffness and liver fibrosis stage across the whole spectrum of fibrosis. HM CPA was significantly higher than SM CPA in stages F0-F3 but similar in cirrhosis, reflecting a higher ability to capture pericellular/perisinusoidal fibrosis at early stages. Age at baseline (HR: 1.04, 95% CI: 1.01-1.08), HM CPA (HR: 1.04 per 1% increase, 95% CI: 1.01-1.08) and presence of advanced fibrosis (HR: 15.4, 95% CI: 5.02-47.84) were independent predictors of liver-related clinical outcomes at standard and competing risk multivariate Cox-regression analysis.
CONCLUSIONS: CPA accurately measures fibrosis and is an independent predictor of clinical outcomes in NAFLD; hence it merits further evaluation as a surrogate endpoint in clinical trials.
| Original language | English |
|---|---|
| Pages (from-to) | 1214-1222 |
| Number of pages | 9 |
| Journal | Alimentary Pharmacology and Therapeutics |
| Volume | 49 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - May 2019 |
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Collagen proportionate area is an independent predictor of long-term outcome in patients with non-alcoholic fatty liver disease. / Buzzetti, Elena; Hall, Andrew; Ekstedt, Mattias; Manuguerra, Roberta; Guerrero Misas, Marta; Covelli, Claudia; Leandro, Gioacchino; Luong, TuVinh; Kechagias, Stergios; Manesis, Emanuel K; Pinzani, Massimo; Dhillon, Amar P; Tsochatzis, Emmanuel A.
In: Alimentary Pharmacology and Therapeutics, Vol. 49, No. 9, 05.2019, p. 1214-1222.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Collagen proportionate area is an independent predictor of long-term outcome in patients with non-alcoholic fatty liver disease
AU - Buzzetti, Elena
AU - Hall, Andrew
AU - Ekstedt, Mattias
AU - Manuguerra, Roberta
AU - Guerrero Misas, Marta
AU - Covelli, Claudia
AU - Leandro, Gioacchino
AU - Luong, TuVinh
AU - Kechagias, Stergios
AU - Manesis, Emanuel K
AU - Pinzani, Massimo
AU - Dhillon, Amar P
AU - Tsochatzis, Emmanuel A
N1 - © 2019 John Wiley & Sons Ltd.
PY - 2019/5
Y1 - 2019/5
N2 - BACKGROUND: Collagen proportionate area (CPA) measurement is a technique that quantifies fibrous tissue in liver biopsies by measuring the amount of collagen deposition as a proportion of the total biopsy area. CPA predicts clinical outcomes in patients with HCV and can sub-classify cirrhosis.AIM: To test the ability of CPA to quantify fibrosis and predict clinical outcomes in patients with NAFLD.METHODS: We assessed consecutive patients with biopsy-proven NAFLD from three European centres. Clinical and laboratory data were collected at baseline and at the time of the last clinical follow-up or death. CPA was performed at two different objective magnifications, whole biopsy macro and ×4 objective magnification, named standard (SM) and high (HM) magnification respectively. The correlation between CPA and liver stiffness was assessed in a sub-group of patients.RESULTS: Of 437 patients, 32 (7.3%) decompensated and/or died from liver-related causes during a median follow-up of 103 months. CPA correlated with liver stiffness and liver fibrosis stage across the whole spectrum of fibrosis. HM CPA was significantly higher than SM CPA in stages F0-F3 but similar in cirrhosis, reflecting a higher ability to capture pericellular/perisinusoidal fibrosis at early stages. Age at baseline (HR: 1.04, 95% CI: 1.01-1.08), HM CPA (HR: 1.04 per 1% increase, 95% CI: 1.01-1.08) and presence of advanced fibrosis (HR: 15.4, 95% CI: 5.02-47.84) were independent predictors of liver-related clinical outcomes at standard and competing risk multivariate Cox-regression analysis.CONCLUSIONS: CPA accurately measures fibrosis and is an independent predictor of clinical outcomes in NAFLD; hence it merits further evaluation as a surrogate endpoint in clinical trials.
AB - BACKGROUND: Collagen proportionate area (CPA) measurement is a technique that quantifies fibrous tissue in liver biopsies by measuring the amount of collagen deposition as a proportion of the total biopsy area. CPA predicts clinical outcomes in patients with HCV and can sub-classify cirrhosis.AIM: To test the ability of CPA to quantify fibrosis and predict clinical outcomes in patients with NAFLD.METHODS: We assessed consecutive patients with biopsy-proven NAFLD from three European centres. Clinical and laboratory data were collected at baseline and at the time of the last clinical follow-up or death. CPA was performed at two different objective magnifications, whole biopsy macro and ×4 objective magnification, named standard (SM) and high (HM) magnification respectively. The correlation between CPA and liver stiffness was assessed in a sub-group of patients.RESULTS: Of 437 patients, 32 (7.3%) decompensated and/or died from liver-related causes during a median follow-up of 103 months. CPA correlated with liver stiffness and liver fibrosis stage across the whole spectrum of fibrosis. HM CPA was significantly higher than SM CPA in stages F0-F3 but similar in cirrhosis, reflecting a higher ability to capture pericellular/perisinusoidal fibrosis at early stages. Age at baseline (HR: 1.04, 95% CI: 1.01-1.08), HM CPA (HR: 1.04 per 1% increase, 95% CI: 1.01-1.08) and presence of advanced fibrosis (HR: 15.4, 95% CI: 5.02-47.84) were independent predictors of liver-related clinical outcomes at standard and competing risk multivariate Cox-regression analysis.CONCLUSIONS: CPA accurately measures fibrosis and is an independent predictor of clinical outcomes in NAFLD; hence it merits further evaluation as a surrogate endpoint in clinical trials.
U2 - 10.1111/apt.15219
DO - 10.1111/apt.15219
M3 - Article
C2 - 30882933
VL - 49
SP - 1214
EP - 1222
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
SN - 0269-2813
IS - 9
ER -