Egy-Score Predicts Severe Hepatic Fibrosis and Cirrhosis in Egyptians With Chronic Liver Diseases: A Pilot Study

Background: non-invasive methods for assessment of hepatic fibrosis are increasingly needed. recent studies showed that combined elevation of tumor markers ca 19-9 and ca 125 is predictive of severe hepatic fibrosis or cirrhosis with high specificity. objectives: we aimed at developing a new panel of surrogate biomarkers for prediction of the stage of hepatic fibrosis by combining tumor markers with other known biomarkers of hepatic fibrosis. patients and methods: a total of 92 patients with different types of chronic liver diseases (chronic hepatitis b, chronic hepatitis c and autoimmune hepatitis), were prospectively enrolled in our cohort. they were subjected to: alt, ast, ggt, alp, total bilirubin, inr, total cholesterol, albumin, platelet count, cancer antigen 19-9 (ca 19-9), cancer antigen 125 (ca 125), cancer antigen 15-3 (ca 15-3), haptoglobin, alpha-2-macroglobulin, apolipoprotein a1, abdominal ultrasound, liver biopsy and histological staging of hepatic fibrosis using the metavir system. results: combined elevation of ca 19-9 and ca 125 with a summated value > 37 u/ml is predictive of severe hepatic fibrosis or cirrhosis (stage f3-f4 metavir) with a probability of 77.6%. multivariate analysis showed that the most relevant collection of biomarkers for prediction of stage of hepatic fibrosis is: ca 19-9, age, alpha-2- macroglobulin, total bilirubin, platelet count & albumin. we developed a new score, named the “egy-score”, using a regression equation composed of this panel of biomarkers. egy-score could differentiate no or early fibrosis (stage f0-f2 metavir) from severe fibrosis or cirrhosis (stage f3-f4 metavir) with 83.7% accuracy. conclusions: non-invasive assessment of hepatic fibrosis could be done using the egy-score. egy-score could differentiate no or early fibrosis (stage f0-f2 metavir) from severe fibrosis or cirrhosis (stage f3 - f4 metavir) with 83.7% accuracy.