fibrotest

Latar belakang

• Biopsi hati bukanlah suatu peperiksaan yang sempurna, terkait dengan sampling error&/ukuran sampel biopsi, serta variasi inta&inter observer

• Selain itu biopsi hati juga menimbulkan ketidaknyamanan pasien, adanya komplikasi.

• Diperlukan pemeriksaan fibrosis hati yang non invasif dan dapat diulang kembali bila diperlukan.

Fibrotest• Fibrotest telah divalidasi sebagai initial diagnosis untuk fibrosis, juga

untuk monitoring .• Pada tahun2006 , the French National Authority for Health

merekomendasikan penggunaan fibrotest sebagai first line assesment tool untuk fibrosis

• Adalah suatu biomerker yang telah dipatenkan , dimana menggunakan 6 parameter pemeriksaan yang akan dikalkulasikan dan dikombinasikan dengan usia dan jenis kelamin untuk menilai derajat keparahan fibrosis hati

• 6 parameter :– ALT– α2Macroglobulin– Total bilirubin– δGT– Apolipoprotein A1– Haptoglobin

Langkah-langkah fibrotest

Pre-analytical phase: essential conditions requireda. Blood sample• Blood is obtained by venipuncture (the classical requested 12 hour patient fast is

necessary for FibroMax® but is not required for Fibro Test-ActitTest®)• Blood samples are collected in 5-ml or 7-ml tubes, without anticoagulant• Blood sample is centrifugated within 2 hours of the blood collection, The

centrifugation conditions (speed and time) must be in conformity with recommendations of tube manufacturer

b. Storage and transport conditions, pretreatment before analysis• Biochemical assays are usually performed on fresh serum• Serum can be decanted and stored for no more than 72 hours at + 2°C/ + 4°C,

while protected from light to avoid bilirubin degradation• The assays of the specific proteins can be carried out on serum stored at +2°C /

+4°C for no more than 5 days• If you intend to defer analysis beyond the recommended time, serum must be

frozen at – 80°C from the start• Freezing and thawing can be done only once

Pre-analytical phase: essential conditions required

Interference

•Lipids and hemolysis interfere with measurements. It is always possible to dilute alightly lipemic serum according to the recommendations of the standardized methods.•Hemolysed and/or hyperlipemic serum must be rejected.

B. BioPredictive Test parameter assays•The performances of the assay methods of the FibroTest and ActiTest have been verified on analyzers and under the conditions specified in the Tecnical Recommendations document which can be sourced from www.biopredictive.com.•They are a guarantee of the quality of the results of the BioPredictive tests.•The materials of assessment (including the reagents and analyzers), as wellas the various assay methods (ie immunonephelemetric and nephlometry for proteinassays) are also covered in detail in the Technical Recommendations document.

Rumus fibrotest

Fibrotest : 4,467 x log10 [alpha2macroglobulin(g/L)] - 1,357 x log 10 [haptoglobin(g/L)] + 1,017 x log10[GMT(IU/L)] + 0,0281 x [age(years)] + 1,737 x log10[bilirubin(mol/L)] -1,184 x [apolipoprotein A1(g/L)] + 0,301 x sex(female=0,male=1) - 5,54

Interpretasi

Rangkuman penelitian

Rangkuman penelitian

kesimpulan

• Keuntungan fibrotest : – Risiko lebih kecil– Dapat digunakan untuk skrining dan monitoring