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Multivariate Discriminant Function Based on Six Biochemical Markers in Blood Can Predict the Cirrhotic Evolution of Chronic Hepatitis

¹ Dipartimento di Biochimica e Biotecnologie Mediche and CEINGE scarl, and
² Dipartimento di Medicina Pubblica e della Sicurezza Sociale-Sezione di Malattie Infettive, Università di Napoli "Federico II", I-80131 Naples, Italy

³ Facoltà di Scienze Matematiche, Fisiche e Naturali, and
⁴ Dipartimento "SAVA", Università del Molise, 86170 Isernia, Italy

^aAddress correspondence to this author at: Dipartimento di Biochimica e Biotecnologie Mediche, via S. Pansini 5, I-80131 Naples, Italy. Fax 39-081-746-3650; e-mail salvator{at}unina.it.

Background: Serologic markers have been proposed for monitoring hepatic fibrosis in chronic active liver disease. Because none of these markers, when used singly, is totally satisfactory, we developed and evaluated a multivariate approach.

Methods: We studied two cohorts of chronic hepatitis (54 patients) and cirrhosis patients (49 patients) to identify a panel of biochemical markers that discriminates between the two diseases. Using multivariate discriminant analysis, we selected a function, based on the concentrations of six biochemical markers (fibronectin, prothrombin, pseudocholinesterase, alanine aminotransferase, manganese superoxide dismutase, and N-acetyl-ß-glucosaminidase). We then prospectively validated this function on a second temporal cohort of patients.

Results: Multivariate discriminant analysis correctly classified 93.7% of patients (94.3% of chronic hepatitis and 92.9% of cirrhosis patients) in the first cohort and 85% of patients (89.5% of chronic hepatitis patients and 81% of cirrhosis patients) in the second cohort.

Conclusions: Discriminant analysis of results of six inexpensive biochemical markers provides a high predictive value for differentiation between liver cirrhosis and chronic hepatitis. Consequently, these biochemical markers condensed into a multivariate discriminant analysis value for each patient provide information that can be contributory for subsequent options during the evolution of the natural history of chronic hepatitis.

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