Plasma FSTL-1 as a non-invasive diagnostic biomarker for patients with advanced liver fibrosis
Wenzhu Li, Yongquan Chi, Xuan Xiao, Junda Li, Minming Sun, Shanke Sun, Wei Xu, Long Zhang, Xiaoguo Li, Feng Cheng, Xiaolong Qi, Jianhua RaoObjective:
Reliable novel non-invasive biomarkers for the diagnosis of advanced liver fibrosis are urgently needed in clinical practice. We aimed to investigate the accuracy of plasma Follistatin-like protein 1 (FSTL-1) in the diagnosis of advanced liver fibrosis in chronic liver diseases.
Design:
We collected cross-sectional clinical data for a Derivation Cohort (n=86) and a Validation Cohort (n=431), totaling 517 subjects with the liver biopsy. Advanced liver fibrosis was defined by the METAVIR pathological score (F≥3). Dual cut-off values for diagnosis were explored.
Results:
In the Derivation Cohort, plasma FSTL-1 levels were significantly elevated in patients with advanced liver fibrosis, with an area under the receiver operating characteristic curve (AUROC) of 0.83 (95% confidence interval [CI], 0.74-0.92). In the Validation Cohort, plasma FSTL-1 maintained good diagnostic performance, with an AUROC of 0.88 (95% CI, 0.83-0.92). Plasma FSTL-1 levels were significantly associated with individual histological features of METAVIR scoring system, including interface hepatitis, lobular necrosis, and hepatocellular ballooning (
Conclusion:
Plasma FSTL-1 has high diagnostic accuracy and could potentially reduce the need for liver biopsy in identifying patients with advanced liver fibrosis.