FibroGENE: A gene-based model for staging liver fibrosis

Mohammed Eslam, Ahmed M. Hashem, Manuel Romero-Gomez, Thomas Berg, Gregory J. Dore, Alessandra Mangia, Henry Lik Yuen Chan, William L. Irving, David Sheridan, Maria Lorena Abate, Leon A. Adams, Martin Weltman, Elisabetta Bugianesi, Ulrich Spengler, Olfat Shaker, Janett Fischer, Lindsay Mollison, Wendy Cheng, Jacob Nattermann, Stephen RiordanLuca Miele, Kebitsaone Simon Kelaeng, Javier Ampuero, Golo Ahlenstiel, Duncan McLeod, Elizabeth Powell, Christopher Liddle, Mark W. Douglas, David R. Booth, Jacob George

Research output: Contribution to journalArticle

Abstract

Background & Aims The extent of liver fibrosis predicts long-term outcomes, and hence impacts management and therapy. We developed a non-invasive algorithm to stage fibrosis using non-parametric, machine learning methods designed for predictive modeling, and incorporated an invariant genetic marker of liver fibrosis risk. Methods Of 4277 patients with chronic liver disease, 1992 with chronic hepatitis C (derivation cohort) were analyzed to develop the model, and subsequently validated in an independent cohort of 1242 patients. The model was assessed in cohorts with chronic hepatitis B (CHB) (n = 555) and non-alcoholic fatty liver disease (NAFLD) (n = 488). Model performance was compared to FIB-4 and APRI, and also to the NAFLD fibrosis score (NFS) and Forns' index, in those with NAFLD. Results Significant fibrosis (≥F2) was similar in the derivation (48.4%) and validation (47.4%) cohorts. The FibroGENE-DT yielded the area under the receiver operating characteristic curve (AUROCs) of 0.87, 0.85 and 0.804 for the prediction of fast fibrosis progression, cirrhosis and significant fibrosis risk, respectively, with comparable results in the validation cohort. The model performed well in NAFLD and CHB with AUROCs of 0.791, and 0.726, respectively. The negative predictive value to exclude cirrhosis was >0.96 in all three liver diseases. The AUROC of the FibroGENE-DT performed better than FIB-4, APRI, and NFS and Forns' index in most comparisons. Conclusion A non-invasive decision tree model can predict liver fibrosis risk and aid decision making.

Original languageEnglish
Pages (from-to)390-398
Number of pages9
JournalJournal of Hepatology
Volume64
Issue number2
DOIs
Publication statusPublished - Feb 1 2016

Keywords

  • Chronic hepatitis B
  • Chronic hepatitis C
  • Data mining analysis
  • Fibrosis
  • IFNL
  • NASH
  • Non-alcoholic steatohepatitis

ASJC Scopus subject areas

  • Hepatology

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    Eslam, M., Hashem, A. M., Romero-Gomez, M., Berg, T., Dore, G. J., Mangia, A., Chan, H. L. Y., Irving, W. L., Sheridan, D., Abate, M. L., Adams, L. A., Weltman, M., Bugianesi, E., Spengler, U., Shaker, O., Fischer, J., Mollison, L., Cheng, W., Nattermann, J., ... George, J. (2016). FibroGENE: A gene-based model for staging liver fibrosis. Journal of Hepatology, 64(2), 390-398. https://doi.org/10.1016/j.jhep.2015.11.008