Medical Forum / Diseases and Disorders / Hepatitis / July 2005
fibrosure or fibrospect vs a liver Biopsy
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smith21347@msn.com - 11 Jul 2005 00:40 GMT According to Dr Cecil's web site he has done over 100 of these blood tests and is very happy with the results. A while back I was talking to a Doctor about a trigger finger problem I was dealing with and asked him about surgery vs a hydrocortizone shot. He smiled and said they will try and talk you into surgery because that is where the Money is. I am starting to suspect that this is true with most of the medical system. Lets get real, this is America. I have heard a lot argument how only by putting the liver piece under a microscope can you really tell what is happening with your liver. Then I here a sample from one part of your liver may not give the same result as another part of your liver. Has anyone used one of these tests ? As someone who can't bring himself to do the needle I am starting to give this more concideration. Ron
elmoemerson@webtv.net - 11 Jul 2005 01:36 GMT 'Stick' with the biopsy, Ron. Don't be a wimp! All your friends will say, "Oh, my God!!" when you tell them you had one. (you don't have to mention how easy it really was) Elmo
http://community.webtv.net/elmoemerson/DocElmosHepFile
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JV - 11 Jul 2005 01:37 GMT We all belong to the liver biopsy club, and yes they stick a needle in your liver guided by ultra sound, I was sedated and was just fine. Its the only way to see how your liver is really doing. Juanita
Cactus Jammies - 11 Jul 2005 02:13 GMT The needle is inserted properly into the upper right area of the liver, which is I understand, provides the most indicative sample of what is going on throughout your body, RNA wise, and the sample damage to your liver cells in that area. The liver is huge, only smaller than your skin in terms of the relative size of the organ. They don't just jab it in anywhere, like JV says, it is a guided instrument and the procedure is done with precision and care. Wanna know the odds of it going wrong on you? You got more of a chance getting hit by a beer truck. Or so I understand.
seriously, I hope this helps, Ron
cactus jammies ////////////////////////////////////////////////////
> We all belong to the liver biopsy club, and yes they stick a needle in > your liver guided by ultra sound, I was sedated and was just fine. Its > the only way to see how your liver is really doing. > Juanita burningdaylight - 11 Jul 2005 03:04 GMT Did it. Was out cold. Don't remember. Felt nothing. So do it! Sue
Russ - 11 Jul 2005 06:23 GMT yea man, and you get some good sh.t too, fentenal!!! whooo hooooo, after a dose of that stuff I didn't give a rat's a.s what they did, LOL......
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Visit Alaska @ http://www.tannersacre.com
> The needle is inserted properly into the upper right area of the liver, > which is I understand, provides the most indicative sample of what is going [quoted text clipped - 13 lines] > > the only way to see how your liver is really doing. > > Juanita Thomas Wagner - 11 Jul 2005 05:15 GMT > According to Dr Cecil's web site he has done over 100 of these blood >tests and is very happy with the results. Well... he's very happy meaning what - that he has verified the results with a biopsy, and they were accurate? Probably not, so how does he know? Independent studies (most of the published studies on Fibrospect/Fibrotest were anything but - they were done by the same people who license the test) have found very mixed results concerning test accuracy. AFAIK, the problem is false negatives - the test showing that everything is hunky dory when it's not, possibly leading to delayed treatment. If the test is positive, i.e. showing high fibrosis levels, false results are apparently less of a problem.
>A while back I was talking to >a Doctor about a trigger finger problem I was dealing with and asked [quoted text clipped - 6 lines] >of your liver may not give the same result as another part of your >liver. Not really. That is true for some other forms of liver damage (NASH et al), but the damage done by HCV is very uniform, so biopsy results generally reflect liver status very accurately.
>Has anyone used one of these tests ? As someone who can't bring >himself to do the needle I am starting to give this more concideration. Given that the test is not that expensive, and that it could spare you a biopsy if it's positive anyway, why not talk to your doc about it. You might have a problem with your insurance, though, since a number of companies don't pay for it. And if it's negative, you still won't be much wiser than before...
Thomas
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Cindy in Pa - 25 Jul 2005 20:00 GMT I saw this post on the fibrosure test and wanted to know where did you find information that says this test is not accurate for showing no fibrosis? When I google I get mostly labcorp results..
I recently had this test and it showed no fibrosis and min. to mod. inflammation...I have tried to get sedation to have the biopsy and the hospitals here refuse to sedate you. So the biopsy is out for me...my doc indicates he will treat with the fibrosure results...
Cindy in Pa
> > According to Dr Cecil's web site he has done over 100 of these blood > >tests and is very happy with the results. [quoted text clipped - 34 lines] > > Thomas JV - 26 Jul 2005 00:54 GMT Hi Cindy Wow! No sedation? Thats very abusive and, crule they should be put in jail for practicing medicine like Hitler. I was sedated though they didn't want to at first. When I saw the needle I started to climb the wall from my bed and panic set in, then the stupid dr. said "sedate her" like I already told him to do before hand as I didnt need the added stress.. They even did 2 and I never felt a thing. After, they even gave me a shot of morphine cause I refused to move around and sit up. I'm sorry to hear this. Though I would not have let it stop me. I would have taken a few valiums and a codine if they weren't going to sedate me. The only way to know the condition of your liver is to have it done. Good Luck Juanita ¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬ Jul 25, 2005, 3:00pm (PDT+3) From: cnospamleigh1@hotmail.com (Cindy in Pa) I saw this post on the fibrosure test and wanted to know where did you find information that says this test is not accurate for showing no fibrosis? When I google I get mostly labcorp results.. I recently had this test and it showed no fibrosis and min. to mod. inflammation...I have tried to get sedation to have the biopsy and the hospitals here refuse to sedate you. So the biopsy is out for me...my doc indicates he will treat with the fibrosure results... Cindy in Pa "Thomas Wagner" <tomw@capecod.com> wrote in message news:dsr3d19hp30htqdfbc0ckrjqcam04r8o95@4ax.com... On 10 Jul 2005 16:40:51 -0700, "smith21347@msn.com" <smith21347@hotmail.com> wrote: According to Dr Cecil's web site he has done over 100 of these blood tests and is very happy with the results. Well... he's very happy meaning what - that he has verified the results with a biopsy, and they were accurate? Probably not, so how does he know? Independent studies (most of the published studies on Fibrospect/Fibrotest were anything but - they were done by the same people who license the test) have found very mixed results concerning test accuracy. AFAIK, the problem is false negatives - the test showing that everything is hunky dory when it's not, possibly leading to delayed treatment. If the test is positive, i.e. showing high fibrosis levels, false results are apparently less of a problem. A while back I was talking to a Doctor about a trigger finger problem I was dealing with and asked him about surgery vs a hydrocortizone shot. He smiled and said they will try and talk you into surgery because that is where the Money is. I am starting to suspect that this is true with most of the medical system. Lets get real, this is America. I have heard a lot argument how only by putting the liver piece under a microscope can you really tell what is happening with your liver. Then I here a sample from one part of your liver may not give the same result as another part of your liver. Not really. That is true for some other forms of liver damage (NASH et al), but the damage done by HCV is very uniform, so biopsy results generally reflect liver status very accurately. Has anyone used one of these tests ? As someone who can't bring himself to do the needle I am starting to give this more concideration. Given that the test is not that expensive, and that it could spare you a biopsy if it's positive anyway, why not talk to your doc about it. You might have a problem with your insurance, though, since a number of companies don't pay for it. And if it's negative, you still won't be much wiser than before... Thomas
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elmoemerson@webtv.net - 26 Jul 2005 02:39 GMT Where in PA are you, Cindy? Elmo
http://community.webtv.net/elmoemerson/DocElmosHepFile
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Cindy in Pa - 26 Jul 2005 17:13 GMT Near Gettysburg...
Cindy in Pa
> Where in PA are you, Cindy? > Elmo > > http://community.webtv.net/elmoemerson/DocElmosHepFile > > http://community.webtv.net/elmoemerson/TheFamilyAlbum elmoemerson@webtv.net - 26 Jul 2005 22:34 GMT I thought if perhaps you lived close enough to Jersey, that I could hook you up with a facility and docs that would allow you sedation during your biopsy. Elmo ///////////// Re: fibrosure or fibrospect vs a liver Biopsy Group: alt.support.hepatitis-c Date: Tue, Jul 26, 2005, 12:13pm (CDT+1) From: cnospamleigh1@hotmail.com (Cindy in Pa) Near Gettysburg... Cindy in Pa <elmoemerson@webtv.net> wrote in message news:14291-42E59440-1099@storefull-3257.bay.webtv.net... Where in PA are you, Cindy? Elmo http://community.webtv.net/elmoemerson/DocElmosHepFile http://community.webtv.net/elmoemerson/TheFamilyAlbum
http://community.webtv.net/elmoemerson/DocElmosHepFile
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Thomas Wagner - 26 Jul 2005 02:14 GMT >I saw this post on the fibrosure test and wanted to know where did you find >information that says this test is not accurate for showing no fibrosis? [quoted text clipped - 4 lines] >hospitals here refuse to sedate you. So the biopsy is out for me...my doc >indicates he will treat with the fibrosure results... You'll find more results when you search PubMed: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed
The problem there is that most of the studies are co-authored by Poynard and his colleagues in France, who profit from FibroTest. There's one independent study, though:
Validation of the FibroTest biochemical markers score in assessing liver fibrosis in hepatitis C patients.
Rossi E, Adams L, Prins A, Bulsara M, de Boer B, Garas G, MacQuillan G, Speers D, Jeffrey G.
Clinical Biochemistry, PathCentre, Nedlands, Western Australia, Australia. ric.rossi@health.wa.gov.au
BACKGROUND: Determining the stage of fibrosis by liver biopsy is important in managing patients with hepatitis C virus infection. We investigated the predictive value of the proprietary FibroTest score to accurately identify significant fibrosis in Australian hepatitis C patients. METHODS: Serum obtained from 125 confirmed hepatitis C patients before antiviral therapy was analyzed for haptoglobin, alpha(2)-macroglobulin, apolipoprotein A1, bilirubin, and gamma-glutamyltransferase activity, and the FibroTest score was computed. Liver fibrosis pathology was staged according to a defined system on a scale of F0 to F4. We used predictive values and a ROC curve to assess the accuracy of FibroTest scores. RESULTS: The prevalence of significant fibrosis defined by liver biopsy was 0.38. The most useful single test for predicting significant fibrosis was serum alpha(2)-macroglobulin (cutoff value, 2.52 g/L; sensitivity, 75%; specificity, 67%). The negative predictive value of a FibroTest score <0.1 was 85%, and the positive predictive value of a score >0.6 was 78%. Although 33 of the 125 patients had FibroTest scores <0.1 and were therefore deemed unlikely to have fibrosis, 6 (18%) had significant fibrosis. Conversely, of the 24 patients with scores >0.6 who were likely to have significant fibrosis, 5 (21%) had mild fibrosis. Of the 125 patients in the cohort, 57 (46%) could have avoided liver biopsy, but discrepant results were recorded in 11 of those 57 (19%). CONCLUSION: The FibroTest score could not accurately predict the presence or absence of significant liver fibrosis.
The full text of the study is available free at http://www.clinchem.org/cgi/content/full/49/3/450
Thomas
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Cindy in Pa - 26 Jul 2005 17:33 GMT This response letter from Enrico Rossi, Biochemist PathCentre dated 2003 may shed light on the results...my test results list most & more causes for false results...
I have been denied sedation biopsy with 3 different docs and I am satisfied now with this blood test scored 0.5 on fibrosis and the doctor treating me with it.
Thanks...
Cindy in Pa
http://www.clinchem.org/cgi/eletters/49/3/450#91
> >I saw this post on the fibrosure test and wanted to know where did you find > >information that says this test is not accurate for showing no fibrosis? [quoted text clipped - 50 lines] > > Thomas
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