Non-invasive diagnosis of alcoholic liver disease

Table 1 Diagnosis of confirmed advanced fibrosis/cirrhosis (F3-4) (histology, elastography) by conventional clinical parameters (ultrasound, laboratory) from Salem Medical Center (n = 364)

Parameter	Pathologic	F0-2 elevated	F3-4 normal
Bilirubin	> 1.3 mg/dL	7.6%	58.3%
INR	> 1.27	1.2%	74.8%
Platelets	< 150 /nL	18.5%	49.6%
Spleen size	> 11.5 cm	6.4%	70.4%
Signs of liver cirrhosis	> 0	1.6%	59.1%
Bilirubin, INR, signs of liver cirrhosis	> 0	10.0%	43.5%
Bilirubin, INR, platelets, spleen size, signs of liver cirrhosis	> 0	27.7%	22.6%

The table shows typical findings of fibrosis/cirrhosis as indicated in the ultrasound (spleen size, signs of cirrhosis) or laboratory [bilirubin, international normalized ratio (INR) and platelets] in patients with no or low fibrosis stages (F0-2) vs advanced fibrosis stages (F3-4). In the last two rows, cirrhosis was considered if one of 3 or 5 parameters was pathologic. As an example, ca. 43% of F3-4 cirrhosis are not diagnosed by a combination of bilirubin, INR and ultrasound signs of liver cirrhosis.