Multivariate discriminant function based on six biochemical markers in blood can predict the cirrhotic evolution of chronic hepatitis

Background: Serologic markers have been proposed for monitoring hepatic fib rosis in chronic active liver disease. Because none of these markers, when used singly, is totally satisfactory, we developed and evaluated a multivar iate approach. Methods: We studied two cohorts of chronic hepatitis (54 patients) and cirr hosis patients (49 patients) to identify a panel of biochemical markers tha t discriminates between the two diseases. Using multivariate discriminant a nalysis, we selected a function, based on the concentrations of six biochem ical markers (fibronectin, prothrombin, pseudocholinesterase, alanine amino transferase, manganese superoxide dismutase, and N-acetyl-beta -glucosamini dase). We then prospectively validated this function on a second temporal c ohort of patients. Results: Multivariate discriminant analysis correctly classified 93.7% of p atients (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 biochemica l markers provides a high predictive value for differentiation between live r 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. (C) 2001 America n Association for Clinical Chemistry.