Mid-infrared spectroscopy of serum, a promising non-invasive method to assess prognosis in patients with ascites and cirrhosis Article - Octobre 2017

Maëna Le Corvec, Caroline Jezequel, Valérie Monbet, Nadia Fatih, Frédéric Charpentier, Hugues Tariel, Catherine Boussard-Plédel, Bruno Bureau, Olivier Loréal, Olivier Sire, Edouard Bardou-Jacquet

Maëna Le Corvec, Caroline Jezequel, Valérie Monbet, Nadia Fatih, Frédéric Charpentier, Hugues Tariel, Catherine Boussard-Plédel, Bruno Bureau, Olivier Loréal, Olivier Sire, Edouard Bardou-Jacquet, « Mid-infrared spectroscopy of serum, a promising non-invasive method to assess prognosis in patients with ascites and cirrhosis  », PLoS ONE, octobre 2017, e0185997. ISSN 1932-6203

Abstract

Background & aims:Prognostic tests are critical in the management of patients with cirrhosis and ascites. Biological tests or scores perform poorly in that situation. Mid-infrared fibre evanescent wave spectroscopy (MIR-FEWS) which allows for global serum metabolic profiling may provide more relevant information by measuring a wider range of metabolic parameters in serum. Here we present the accuracy of a MIR-FEWS based predictive model for the prognosis of 6 months survival in patients with ascites and cirrhosis.Methods : Patients with ascites were prospectively included and followed up for 6 months. MIR-FEWS spectra were measured in serum samples. The most informative spectral variables obtained by MIR-FEWS were selected by FADA algorithm and then used to build the MIR model. Accuracy of this model was assessed by ROC curves and 90%/10% Monte Carlo cross-validation. MIR model accuracy for 6 months survival was compared to that of the Child-Pugh and MELD scores.Results : 119 patients were included. The mean age was 57.36±13.70, the MELD score was 16.32±6.26, and the Child-Pugh score was 9.5±1.83. During follow-up, 23 patients died (20%). The MIR model had an AUROC for 6 months mortality of 0.90 (CI95 : 0.88–0.91), the MELD 0.77 (CI95 : 0.66–0.89) and Child-Pugh 0.76 (CI95 : 0.66–0.88). MELD and Child-Pugh AUROCs were significantly lower than that of the MIR model (p = 0.02 and p = 0.02 respectively). Multivariate logistic regression analysis showed that MELD (p<0.05, OR:0.86 ;CI95:0.76–0.97), Beta blockers (p = 0.036 ;OR:0.20 ;CI95:0.04–0.90), and the MIR model (p<0.001 ; OR:0.50 ; CI95:0.37–0.66), were significantly associated with 6 months mortality.Conclusions : In this pilot study MIR-FEWS more accurately assess the 6-month prognosis of patients with ascites and cirrhosis than the MELD or Child-Pugh scores. These promising results, if confirmed by a larger study, suggest that mid infrared spectroscopy could be helpful in the management of these patients.

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