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.

Collagen proportionate area is an independent predictor of long-term outcome in patients with non-alcoholic fatty liver disease / Buzzetti, E.; Hall, A.; Ekstedt, M.; Manuguerra, R.; Guerrero Misas, M.; Covelli, C.; Leandro, G.; Luong, T.; Kechagias, S.; Manesis, E. K.; Pinzani, M.; Dhillon, A. P.; Tsochatzis, E. A.. - In: ALIMENTARY PHARMACOLOGY & THERAPEUTICS. - ISSN 0269-2813. - 49:9(2019), pp. 1214-1222. [10.1111/apt.15219]

Collagen proportionate area is an independent predictor of long-term outcome in patients with non-alcoholic fatty liver disease

Buzzetti E.;
2019

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.
2019
49
9
1214
1222
Collagen proportionate area is an independent predictor of long-term outcome in patients with non-alcoholic fatty liver disease / Buzzetti, E.; Hall, A.; Ekstedt, M.; Manuguerra, R.; Guerrero Misas, M.; Covelli, C.; Leandro, G.; Luong, T.; Kechagias, S.; Manesis, E. K.; Pinzani, M.; Dhillon, A. P.; Tsochatzis, E. A.. - In: ALIMENTARY PHARMACOLOGY & THERAPEUTICS. - ISSN 0269-2813. - 49:9(2019), pp. 1214-1222. [10.1111/apt.15219]
Buzzetti, E.; Hall, A.; Ekstedt, M.; Manuguerra, R.; Guerrero Misas, M.; Covelli, C.; Leandro, G.; Luong, T.; Kechagias, S.; Manesis, E. K.; Pinzani, M.; Dhillon, A. P.; Tsochatzis, E. A.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1222785
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