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Medical Forum / Diseases and Disorders / Hepatitis / July 2005

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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

http://community.webtv.net/elmoemerson/TheFamilyAlbum
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......

Signature

Russ

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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To reach me, complete my last name in the address.

elmoemerson@webtv.net - 26 Jul 2005 02:39 GMT
Where in PA are you, Cindy?
Elmo

http://community.webtv.net/elmoemerson/DocElmosHepFile

http://community.webtv.net/elmoemerson/TheFamilyAlbum
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

http://community.webtv.net/elmoemerson/TheFamilyAlbum
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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