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Prospective evaluation of the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample
Hepatic copper determination is an important test for the diagnosis of Wilson's disease (WD). However, the method has not been standardized, the diagnostic accuracy has not been evaluated prospectively, and the optimal cut‐off value remains controversial. Accordingly, we aimed to prospectively...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744736/ https://www.ncbi.nlm.nih.gov/pubmed/26095812 http://dx.doi.org/10.1002/hep.27932 |
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author | Yang, Xu Tang, Xiao‐peng Zhang, Yong‐hong Luo, Kai‐zhong Jiang, Yong‐fang Luo, Hong‐yu Lei, Jian‐hua Wang, Wen‐long Li, Ming‐ming Chen, Han‐chun Deng, Shi‐lin Lai, Li‐ying Liang, Jun Zhang, Min Tian, Yi Xu, Yun |
author_facet | Yang, Xu Tang, Xiao‐peng Zhang, Yong‐hong Luo, Kai‐zhong Jiang, Yong‐fang Luo, Hong‐yu Lei, Jian‐hua Wang, Wen‐long Li, Ming‐ming Chen, Han‐chun Deng, Shi‐lin Lai, Li‐ying Liang, Jun Zhang, Min Tian, Yi Xu, Yun |
author_sort | Yang, Xu |
collection | PubMed |
description | Hepatic copper determination is an important test for the diagnosis of Wilson's disease (WD). However, the method has not been standardized, the diagnostic accuracy has not been evaluated prospectively, and the optimal cut‐off value remains controversial. Accordingly, we aimed to prospectively evaluate the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample. Patients for whom a liver biopsy was indicated were consecutively enrolled. Hepatic copper content was determined with atomic absorption spectroscopy. All assays were performed using careful quality control by a single technician. WD diagnosis was based on WD score or its combination with clinical follow‐up results. A total of 3,350 consecutive patients underwent liver biopsy. Six hundred ninety‐one patients, including 178 with WD, underwent two passes of liver biopsy with hepatic copper determination. Mean hepatic content in WD patients was 770.6 ± 393.2 μg/g dry weight (wt). Sensitivity, specificity, and positive and negative predictive values of hepatic copper content for WD diagnosis in the absence of primary biliary cirrhosis (PBC) or primary sclerosing cholangitis at the cut‐off value of 250 μg/g dry wt. were 94.4%, 96.8%, 91.8%, and 97.8%, respectively. The most useful cut‐off value was 209 μg/g dry wt, with a sensitivity and specificity of 99.4% and 96.1%, respectively. A total of 23.3% of patients without WD and PBC had hepatic copper content >75 μg/g dry wt. Conclusion: A liver biopsy sample of more than 1 mg dry wt may reliably reflect hepatic copper content and should be used for hepatic copper determination. Hepatic copper determination is a very valid procedure for the diagnosis of WD, and the most useful cut‐off value is 209 μg/g dry wt.(Hepatology 2015;62:1731–1741) |
format | Online Article Text |
id | pubmed-4744736 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-47447362016-02-18 Prospective evaluation of the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample Yang, Xu Tang, Xiao‐peng Zhang, Yong‐hong Luo, Kai‐zhong Jiang, Yong‐fang Luo, Hong‐yu Lei, Jian‐hua Wang, Wen‐long Li, Ming‐ming Chen, Han‐chun Deng, Shi‐lin Lai, Li‐ying Liang, Jun Zhang, Min Tian, Yi Xu, Yun Hepatology Steatohepatitis/Metabolic Liver Disease Hepatic copper determination is an important test for the diagnosis of Wilson's disease (WD). However, the method has not been standardized, the diagnostic accuracy has not been evaluated prospectively, and the optimal cut‐off value remains controversial. Accordingly, we aimed to prospectively evaluate the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample. Patients for whom a liver biopsy was indicated were consecutively enrolled. Hepatic copper content was determined with atomic absorption spectroscopy. All assays were performed using careful quality control by a single technician. WD diagnosis was based on WD score or its combination with clinical follow‐up results. A total of 3,350 consecutive patients underwent liver biopsy. Six hundred ninety‐one patients, including 178 with WD, underwent two passes of liver biopsy with hepatic copper determination. Mean hepatic content in WD patients was 770.6 ± 393.2 μg/g dry weight (wt). Sensitivity, specificity, and positive and negative predictive values of hepatic copper content for WD diagnosis in the absence of primary biliary cirrhosis (PBC) or primary sclerosing cholangitis at the cut‐off value of 250 μg/g dry wt. were 94.4%, 96.8%, 91.8%, and 97.8%, respectively. The most useful cut‐off value was 209 μg/g dry wt, with a sensitivity and specificity of 99.4% and 96.1%, respectively. A total of 23.3% of patients without WD and PBC had hepatic copper content >75 μg/g dry wt. Conclusion: A liver biopsy sample of more than 1 mg dry wt may reliably reflect hepatic copper content and should be used for hepatic copper determination. Hepatic copper determination is a very valid procedure for the diagnosis of WD, and the most useful cut‐off value is 209 μg/g dry wt.(Hepatology 2015;62:1731–1741) John Wiley and Sons Inc. 2015-08-27 2015-12 /pmc/articles/PMC4744736/ /pubmed/26095812 http://dx.doi.org/10.1002/hep.27932 Text en © 2015 The Authors. HEPATOLOGY published by Wiley Periodicals, Inc., on behalf of the American Association for the Study of Liver Diseases. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Steatohepatitis/Metabolic Liver Disease Yang, Xu Tang, Xiao‐peng Zhang, Yong‐hong Luo, Kai‐zhong Jiang, Yong‐fang Luo, Hong‐yu Lei, Jian‐hua Wang, Wen‐long Li, Ming‐ming Chen, Han‐chun Deng, Shi‐lin Lai, Li‐ying Liang, Jun Zhang, Min Tian, Yi Xu, Yun Prospective evaluation of the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample |
title | Prospective evaluation of the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample |
title_full | Prospective evaluation of the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample |
title_fullStr | Prospective evaluation of the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample |
title_full_unstemmed | Prospective evaluation of the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample |
title_short | Prospective evaluation of the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample |
title_sort | prospective evaluation of the diagnostic accuracy of hepatic copper content, as determined using the entire core of a liver biopsy sample |
topic | Steatohepatitis/Metabolic Liver Disease |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744736/ https://www.ncbi.nlm.nih.gov/pubmed/26095812 http://dx.doi.org/10.1002/hep.27932 |
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