Traffic light liver testing
September 7, 2012
ONE third of people admitted to
hospital with end-stage liver disease
die within the first few months,
however a new ‘traffic light’ test
could diagnose the disease earlier
and enable those at risk to change
their behaviour and save lives.
Developed by researchers at the
University of Southampton and
Southampton General Hospital,
Southampton Traffic Light (STL) test
combines several different tests
and clinical markers which are
given a score that indicates the
patient’s likelihood of developing
liver fibrosis and liver cirrhosis.
The STL algorithm combines two
serum markers of fibrosis, collagen
p3 n peptide (P3NP) and hyaluronic
acid (HA), together with platelet
count, and can be calculated in two
ways: either with a complex
exponential function derived from
logistic regression analysis, or,
alternatively, with a simple clinical
rule for the individual test results.
The test results are graded into
three colours: red if the patient has
liver scarring and or cirrhosis;
amber if there is at least a 50:50
chance of scarring with a significant
possibility of death within five years
(here patients are advised to stop
drinking to avoid further disease
and death); and green if there is no
cirrhosis and the patient is highly
unlikely to die from liver disease
over the next five years.
The test was given to over 1,000
patients, and their progress was
followed and monitored, in some
cases over several years, to assess
the accuracy of the test in
predicting whether they developed
liver fibrosis or cirrhosis.
The monitoring proved that the
test was accurate in severe liver
disease, and while not a substitute
for clinical judgement or other liver
function tests, can provide
healthcare practitioners with an
objective means to accurately
assess the potential severity of liver
fibrosis in high-risk patients (heavy
drinkers, type 2 diabetics, obese
people).
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